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April 22, 2013 Readers Write 9 Comments

Misconceptions About the Health IT Workforce
By Helen Figge, R.Ph, Pharm.D.

4-22-2013 7-02-48 PM

There are many misconceptions out there about workforce development in healthcare IT today. As technologies become introduced into the various healthcare settings to support quality healthcare, it is always assumed that one needs an advanced certification, advanced degree, and advanced resources to implement and support these technologies.

Well, yes and no. For viability if nothing else, these added career efforts are valuable, but truly viable workforce development plans in healthcare IT need to evolve and grow from the bottom up. You don’t make a cake by starting to put the sprinkles together before baking a solid foundation – the cake. The same holds true in the workforce of healthcare IT today.

Many now understand that the backbone to the evolution of the demand for “skilled “workforce today is due in most part to the electronic health record (EHR). Thanks to visionaries like Glen Tullman who positioned the EHR front and center in healthcare discussions, the healthcare market now realizes that the real need in the workforce today involves an understanding of the implementing, programming, interconnecting, and relationship of the EHR to clinician workflow.

One of the backbones to any workforce development plan is continuing education in helping to shape and evolve the IT workforce. Continuing education programs commonly exist for physicians, nurses, and pharmacists. However, there is very little formal infrastructure in place to provide continuing education to the IT workforce. A true educational program for any workforce entity that is sustainable and viable long-term needs to understand the “how” and “why” of the tasks at hand and then educate from that vantage point. 

How would you measure true workforce healthcare IT success? That is yet to be determined, but for all practical purposes, if you don’t understand clinician and healthcare workflow from its various angles and nuances, then you won’t be able to create a viable and competent overall workforce to support the needs out there today. The future of the health IT workforce rests in the hands of those clinicians that adopt the technologies, and in turn, the measurement of success will depend on having critical knowledge about the exact needs of these end users. There is no substitute for knowledge past to bring in the future direction.

The most realistic approach for a viable workforce development program is for organizations to recruit to their organizations and then create loyalty factors for the employees. This in turn provides a base of employees that an organization can draw from for an expanded workforce need. No one really knows the future skills needed in the healthcare workforce, but if an employee can use an iPad or their Android, then they have the potential to learn healthcare IT.

The wave of the healthcare future is mobile applications. You would be surprised how many individuals out there use technologies for various purposes that are non health-related. To get a trained workforce in healthcare IT, maybe we train these individuals through “gaming” learning from such gaming wizards like John Gomez, former CTO for Eclipsys.

Organizations should consider grooming from within and cultivate the talents of motivated employees to fill the voids being felt in today’s healthcare IT marketplace to fill the immediate voids, but also helping to create loyalty programs and career transition pathways for employees. Also, you would be surprised how many prior work experiences are much underestimated in the workplace today. Consider engaging individuals who might have soft and transferable skill sets from other previous positions, encourage them to create new ideas for the healthcare workforce and develop opportunities for long term employment.

There is no nirvana in the formula for developing a healthcare workforce, because if there were one, we would not be hearing endless complaints about not finding “qualified staff” for vacant positions. Groom from within, because healthcare is a forever changing process. It has to be because medicine is an evolving entity, so the skills we are seeking out now may be obsolete in a few years, but if you invest in the person from the ground up, the cake is well baked, so when it’s time for the sprinkles, the final product will look just right.

Helen Figge, BS, PharmD, MBA, CPHIMS, FHIMSS is a principal with Figge Workforce Development.

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Currently there are "9 comments" on this Article:

  1. So we are left with marketing mumbo jumbo and promoting from within as a way to find talented resources for an industry that spent the past 10 years moving sideways? If HIT is to move forward, it needs to reduce or remove the barriers that this poster is specifically supporting. If everyone that works in banking needs to know how to underwrite a loan, or if everyone that works for an airline need to be a pilot, then I could buy her argument. But since that would be silly, why do we need to continue to look inside hospitals and existing organizations to solve the issues these very institutions created? Until this industry recognizes that excellent talent to move technology in hospitals, practices and long term facilities exists in spades, but is being ignored because they aren’t also RNs, MDs, or pharmDs, then we will continue to support old programs that perform poorly and don’t communicate because we can’t imagine a better way forward. Before mobile commerce, video games, and/or social media were advanced, do you think the creators and developers and dreamers had experience? We’re looking for a magic bullet to our problems that involve no risk taking. Until we embrace the risk of change, we won’t change much at all.

    I support the need for clinical experience in most regards, but the need for fresh blood, a second set of eyes, and new thinking has never been as important as it is today. Now, we have put upon the workforce more useless degrees from community colleges that will bankrupt the students, slow advancement, limit participation and perpetuate the insiders only philosophy that result in opinions similar to this poster. A CTO from a company that was acquired years ago does not symbolize a move in a good or new direction. Just more retreads.

    Technology will always advance to the extent of the need and creativity of the audience it serves. If you ignore the audience or are out of new ideas, you will be out of business shortly.

  2. Not really sure if I would hold up Glen & John Gomez as shining beacons of how to hold onto & train IT professionals. That is, unless you are looking for a staff that constantly hears how bad they are and how lucky they are to have a job.

  3. Well to add to the story line, attributes of Glen: Glen for his advertising the EHR and fueling the movement to even have an EHR movement – he is a great advertiser allowing those other EHR organizations who might not have had the platform to get their message out about a need for an EHR; Gomez is very smart, knowledgeable and had the vision and we all know a vision starts the creation of a movement. Taking the emotion out of both of these personalities – each one demonstrated a skill that then created a need. It was never their jobs to train IT professionals – it was their job in the industry to create, direct and provide the “Why” and “how” of an EHR – then comes the possible opportunities for an IT workforce to exist and expand. We find ourselves here today because of the vision. The rest is up to all of us to help figure it all out. And since everyone keeping reiterating “a shortage of a skilled workforce in healthcare IT” – those that think outside the normal channels most likely will figure it out first. Besides, if we start to create true loyalty factors in industry, organizations and the like, we keep Americans working and sustaining our economy. Full circle benefits for all.

  4. Yes, understanding workflow is important for many HIT roles and yes, mobile is important, but meaningless tripe like “…if an employee can use an iPad or their Android, then they have the potential to learn healthcare IT” does nothing to address the many challenges we have. Would we say that an employee who can use an iPad could also figure out desktop virtualization, server load balancing or interface development? Well those things are just as important to “fixing” HIT as understanding clinical workflow. Perhaps the author only meant to address the Business Analyst role within HIT and, if that was the intent, I guess this article isn’t as meaningless. Still not overly useful though.

  5. “.. if an employee can use an iPad or their Android, then they have the potential to learn healthcare IT.”

    I was basically tracking with you till that. That couldn’t possibly be further from the truth. iPads and Droid phones are made specifically for use by non-techies. Techies get them because they can expand on them and they typically like playing with new gadgitry. The potential to learn healthcare-IT has to based on the individual’s expressed desire and demonstrated ability to learn any new industry and to become fully engaged and take ownership – be it healthcare or insurance or manufacturing, or whatever. I will take an ITer who has successfully moved across industries outside of healthcare over one who has remained ineffectually in healthcare. It’s much more a matter of personal work habits and mindset, and considerably less a matter of education and experience.

  6. I think the issue of scarce clinical implementation resources relates more to the lack of available training in basic clinical process and workflow. This isn’t rocket science and it can be taught.

    I participated in training as part of the ONC program. There was a module on clinical process redesign but nothing on basic workflow – in my mind, putting the cart well before the horse. The huge gap in the curriculum was lack of focus on basic workflow; e.g., what physicians and nurses actually do in an inpatient setting, their workflow in a practice management setting, the departmental interdependencies in a full CPOE process and so forth. There just aren’t courses or materials available to train resources. So we are left with this notion that the only option is to grow resources from “within.”

    As an instructor, I remember finding and giving students materials that would help them understand the nursing role and sending them to the IHI Process Map to help them understand what key processes are, the departments involved, measurable outcomes of a process, and so forth. Admittedly, that small amount of supplemental material was clearly not enough training for them to be effective in these new implementation roles.

    Perhaps a certification in basic clinical process and the associated development of materials and a curriculum would help here. Having this would also help the vendor community as many developers, particularly those who are new to healthcare, have almost no idea of complex clinical process and the result is often error and significant rework.

    I agree that we can not be dependent on “growing” resources from within. HIMSS needs to take a leadership role here in the development of educational materials and perhaps the sponsorship of a credential for a technical workforce that would significantly benefit from training in basic clinical process and workflow.

  7. “If you don’t understand clinician and healthcare workflow from its various angles and nuances, then you won’t be able to create a viable and competent overall workforce to support the needs out there today.” I must say, being an IT Healthcare professional for over 20 years, Helen, you hit a home run! Everyone can present their own arguments on what is best to promote and retain a “skill workforce” with “quality staff”. My position is the key will be to have those resouces is to have someone who understands the language between a clinician and the technical folks. I have been lucky that my career has taken me from an Electronics Engineer in the Aerospace world to a Physician Assistant and now an IT Healthcare Professional. Bridging that gap has been very challenging because they are two different worlds with their own thougth processes and one bad decision could cost someones life.

  8. So what everyone is now saying boils down to ‘only those with clinical experience can help improve the process’? I am no Luddite to clinical operations, Health IT, or EMR, as I have been using one for longer than most physicians. BUT WE NEED TO STOP BELIEVING WE ARE THE ONLY ONES ORDAINED TO HELP. This is crazy-talk. I know more people outside of HIT that can help then people within it that can. We have tried to let the ‘old-guard’ fix the problems they made, and they have failed as miserably as they did when they first engineered the crappy programs they are selling.

    The crux of the issue is that everyone is afraid that they are TOO DAMNED IMPORTANT to have anyone tell them a better way to do their job, whether they have “relevant” experience or not — this premise would have kept the Pony Express in business.

    Until we open the doors of our hospitals and practices to truly innovative people, companies, and ideas, we will continue to fail — no offense, but this industry is rotten, it is filled with nepotism, we keep relying on the same tactics again and again, and for the life of me, I don’t think we are doing much actually better. We sure as heck aren’t doing much differently.

    I look at industries that have re-invented themselves over the years and they have done so not by relying on the experienced members, but on the young, the innovative, the disruptive, and in many cases, the annoyingly confident world-beaters. We are left being consulted by people who ‘used to work at Epic’ or companies founded to “optimize ___ technology” — which is a bunch of silly mularkey.

    I propose that if you spent more than 15 years in this industry you should wear a scarlet letter on your lapel (or LinkedIn profile, to stay relevant) because you have the equivalent of technological leprosy — what you touch turns to filth.

    As for people who believe we need specialized skills to ‘communicate tech-speak to clinicians’ are also high. Can you imagine if we needed special people to tell bus drivers how to use the bus’s electronic door? If we needed special handling of our police officers so they understood how a taser works? You see, the tools of the trade MAKE the trade — if you are a physician that rejects the need to know the difference between a mouse-over and a drop-down, you don’t know the tools needed to be successful or relevant (simplistic example, I know) — if we keep coddling the hospital, coddling the doctor and royally screwing the patient over with hidden costs and awful documentation, coordination and communication — well, we won’t need skilled workers because people will find a better way.

    I hate to think that in the future I’ll be going to Walmart or a drug store for a well-woman checkup, but if my local hospital (employer) keeps bringing in late-career consultants who brag about their 1st Gen iPad and how it is going to transcend medicine — I may go to Walmart and then look on Craigslist for a shaman.

    I am scared for our future, folks — scared because every is scared of losing their job, losing out on ‘easy money’ and think they are entitled to stifle true innovation in an industry that ought to be leading the way in imaging technology that actually helps.

    Also, if you need more than 2 abbreviations after your name to declare your brilliance, you probably ought to keep your mouth shut with regards to how to train and retain talent — sounds like the author spent more time getting degrees than gleaning experience.

  9. This is a problem created or made worse by the size and complexity of modern systems deployment. Hundreds of people, millions of dollars, tighter schedules. It takes time to develop internal talent. Should you spend millions and years on trying to hire, develop and retain people for a project, just to lay most of them off once you go into maintenance mode? Or do you bring in the consultants by the dozens?

    I don’t think workforce development, particularly in hospitals, has historically been a problem. Consider the late-career former RN who decided to apply for an IT job ten or twenty years ago and got it because they wanted someone with clinical experience. Or the former keypunch operator who, several decades later, is now a senior systems analyst despite never attending a single college IT course. Or the one who worked as a RN for four or five years but decided maybe IT was a better career path. These are people I work with. They are the majority on the applications side of IT in my experience.

    Healthcare organizations are not afraid to put non-IT people into an IT role. But they are not going to send you (back) to college for an IT degree. Vendor-specific training or maybe a programming/database class if you’re lucky. You are on to something in that regard but the training budget does not usually survive the first round of cuts.

    Of course, we are only talking about the applications side of IT. The network/server/desktop IT people rarely get clinical people transitioned into their roles. But you will still see their job postings and hiring practices still prefer people with that almighty “healthcare experience”!

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