The ongoing demand for health IT in healthcare delivery organizations, stemming from objectives such as meaningful use attestation as well as population health and data analytics initiatives, has resulted in a corresponding demand for a skilled health IT workforce. Many studies have indicated that as healthcare continues to digitize, there is a talent gap due to growing and emerging IT demands. According to the 2014 HIMSS Workforce Study released in 2015, nearly 70 percent of providers said the lack of qualified talent was the biggest challenge to achieving a fully staffed department and 30 percent said they scaled back or put an IT project on hold due to a shortage in staffing. Healthcare delivery organizations are increasingly finding that health IT professionals with the right skills and expertise are critical to the success of health IT implementations as well as moving forward on key improvement initiatives. Healthcare Informatics Assistant Editor Heather Landi recently spoke with Rebecca Quammen, founder and CEO of Quammen Health Care Consultants, to discuss the challenges and opportunities facing healthcare CIOs and IT leaders with regard to staffing and addressing the talent gap.
What are some of the biggest IT staffing challenges facing healthcare delivery organizations right now?
One significant challenge is just the frequent change cycles required to maintain currency in deployed applications, so just the demand for people. We’re in a time when electronic health record (EHR) vendors and other vendors of smaller applications that are being developed for niche requirements, these are all coming out so fast into the industry, and it’s so fast that there’s constant change. It seems we can’t get our breath, to stop and think and plan.
I still see every day that there is a huge deficit in local knowledge of what products can and can’t do to be able to architect a solution to meet needs. If a healthcare organization is a metropolitan area, there typically is a stronger base of candidates. However, so many thousands of hospitals across the nation are in communities in rural settings, so being able to attract, retain and train experts in these products, the people that can be on the ground working fast for IT initiatives, that’s a huge challenge.
There also is a huge deficit in the actual ability to recruit specific talent with experience in various IT products and EHR products. In my firm, we watch what’s going on with our clients and prospective websites where there are postings for open positions, and we see positions open for three months, six months and even longer periods of time. And the obvious impact of that on an organization is that they’ve lost opportunities during that time to continue to move their initiatives forward.
There are significant trends shaping healthcare delivery right now, such as the transition from volume-based to value-based care, which impacts clinical, business and financial operations. How is this impacting staffing demands?
The buzz around data analytics promotes the need for data scientists and data analysts as among the most sought-after roles, and that is problematic in and of itself. It’s creating a huge demand, but it’s also a demand that many healthcare organizations don’t know how to deal with right now. I see the buzz around data analytics increasing the pressure to “do something” with data, but many organizations across the nation, both large and small and in every setting of care, simply don’t have the foundational knowledge to manage the data to their benefit, and to know the database structure and how to get it the data out and what the data tells them when they get it. We are not an industry historically good at mining good, rich data out of products and doing something meaningful with it. We do traditional reporting and we may do a little bit of historical reporting, but we’re not good at looking at data to predict and promote and to work toward the future, or to see trends and do analysis across the organization. I’m excluding the largest 13 health systems across the nation that have a large staff of data analysts and data scientists. That’s not for the model for everybody in healthcare, that’s only the model for those large organizations, and they are good at it. All the other hospitals are trying to deal with changes in value-based and accountable care, and I think they have challenges there, so data analytics is a big one.
At the same time, traditional EHR vendors are not currently offering much support in this space with the exception of the emerging cloud-based solutions that are data-oriented in their design. The basic needs for report writers, so SQL, Crystal report developers, has been challenging to fulfill since the EHR deployments occurred with regard to resources who are intimate with the data structure of their clinical and financial systems.
Are there other health IT skills or expertise that are in demand now?
Cybersecurity threats have pushed security resources to the forefront, and cybersecurity is a challenge in the healthcare setting because security threats are internal and external as well as rule-based security, network-based security, and firewall-based security. Traditionally, there would be silos of knowledge in an organization for the network, for the firewalls, for the individual applications themselves.
Unlike the data analytics requirements which draw on more common skill sets, such as programming or analysis, the knowledge that is required to combat security threats with attacks occurring internally and externally is multi-faceted. A person leading security efforts in any healthcare venue must have a strong understanding of policy regarding onboarding and existing resources to include employees, contractors, other members of the accountable care organization (ACO), operational process regarding the need to access or lock down data, commercial tools and appliances available to monitor for and prevent intrusion, and role-based security.
You mentioned earlier that small, rural hospitals and healthcare providers face significant health IT staffing challenges. What can these organizations do to fill workforce gaps?
Attracting skilled talent when it is needed to the physical locations where it is needed continues to be a problem and it seems to be one that is best solved by not hiring, training and retaining knowledge workers but by renting them as needed. Gig economy, sharing economy, on demand economy has the potential to bridge the workforce gaps that exist, but it will require non-traditional thinking on the part of human resource directors and managers in the healthcare industry. I think healthcare organizations should start to participate in the “gig economy” where on-demand marketplaces connect independent human resources with healthcare organizations. Through such a model, healthcare organizations contract with independent workers for short- and long-term engagements. As such, these independent contractors could advance their careers by securing meaningful professionals assignments, while the healthcare employer organizations could hire the most qualified resources for crucial roles and assignments.
I think job boards have confused the issue a lot because they become a jumble of every kind of resume and every kind of algorithm to search those resumes. Talking to CIOs across the country, they say they get four different resumes from the same company because all are mining the same thing and they are not really vetting the resources. As the need for qualified healthcare human resources grows, we need better a way to get these needed resources in place more quickly. With on-demand economy, healthcare organizations would no longer need to spend inordinate amounts of time and money recruiting and hiring talent. At the same time, healthcare workers could concentrate solely on advancing their careers through the meaningful work that will enable them to build the skills and amass the experience that will help them rise to the highest levels of the industry. And, they can do this without being encumbered by some of the trappings of traditional employment and without dealing with the time and energy-sap associated with seeking the next opportunity. The gig economy has transformed and improved other industries for employers and independent consultants, and we can apply the same innovation to healthcare.
Studies indicate that within health IT, as with many industries, there is significant pay gap between men and women as well as disparities with advancement. What part could the gig economy play in helping to address these gender-based disparities?
With the on-demand economy, if a professional, either a man or a woman, steps out of the workforce to raise a child or take care of a parent, they can continue to advance their careers or maintain their skills and credibility and have opportunities. The gig economy organizes marketplaces that allow people to perform services in a way that they choose, and I think that will certainly help women because healthcare organizations are looking at people based on skills and experience, so that can help to level that playing field.