Massachusetts has been one of the pioneers in the use of EMRs and e-prescribing, but until last fall it did not have a master's degree program in health informatics.
After hearing from Boston-area health IT leaders concerned about a growing workforce shortage, however, Northeastern University launched a graduate program in September 2007 with 42 mostly part-time students, including a few CIOs who wanted to enhance certain skills.
Many of the Northeastern program's graduates will become project managers for e-prescribing, data warehouse, and EMR implementations. “It's pretty obvious that unless we invest in the workforce, the pace of change toward full electronic health records has a potential to be slowed,” says Stanley Hochberg, M.D., director of the Northeastern University program.
That sentiment has been echoed in Washington, where the United States House of Representatives last year passed Rep. David Wu's (D-Ore.) “10,000 Trained by 2010 Act” (H.R. 1467), which would provide federal funding for institutions of higher education to establish multidisciplinary centers for informatics research.
The bill, which was referred to the Senate Committee on Health, Education, Labor, and Pensions, would provide about $50 million over five years to the National Science Foundation to help establish programs to train people in both healthcare and IT, says Wu, who began working on the legislation in the last session of Congress. It also provides another $50 million for research in health technology issues, such as standards development.
“As ambitious as this legislation is, the need is significantly greater,” Wu says. “It passed by a huge margin in the House, and it has no opposition that I know of. I believe it's a bill the president will sign, so we're hopeful it will be reported out of committee and the full Senate will vote on it this year.”
According to Dan Rode, vice president of policy and government relations for the American Health Information Management Association (AHIMA), “The administration has not pushed for this, nor objected to it.” The Bush administration, he adds, “is staying away from anything that has dollars attached to it. But we consider it a win that they haven't objected to it.”
AHIMA, along with the American Medical Informatics Association, has been an advocate of more focused spending on higher education programs in health informatics.
So just how serious might the shortage of skilled workers become? Rode notes that both the Wu bill and the American Health Information Community recommend more research into how big a workforce training gap exists.
A recent analysis of the HIMSS Analytics Database by William Hersh, M.D., professor and chair of the Department of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University, estimated the country will need 40,000 more trained workers to fulfill its stated health IT agenda.
The U.S. Bureau of Labor Statistics found there's a need for 6,000 graduates a year in health information management, in a wide range of positions from clerical to top management. Currently there are 252 accredited programs at associate's, bachelor's and master's levels turning out 2,606 graduates a year, says Claire Dixon-Lee, AHIMA's vice president for education and accreditation.
“The real need is for more programs turning out people at the master's degree level who can be at the decision table when systems are designed,” Dixon-Lee adds.
New education programs are designed to help people like Methodist Hospital CIO Kara Marx, who says her biggest day-to-day challenge is recruitment and retention of qualified staff.
Methodist, a 460-bed, not-for-profit hospital serving the central San Gabriel Valley in California, has an IT staff of 35. Marx says workers with both IT skills and experience in a healthcare setting are hard to find. For systems analysts positions, Marx says she often hires Methodist employees such as nurses who have subject matter expertise but no technical skills or, conversely, people from technical schools with no background in healthcare. In either case, there is a steep learning curve. “It takes a minimum of a year to get them fully trained.”
Individuals with master's degrees from programs in health informatics are highly valued, but Marx says she can only afford to hire a few people at that skill level.
The difficulty of finding qualified staff could be a problem if the trend toward widespread health information exchange accelerates, Marx says. “Right now, adoption is more sporadic, but if things speed up, workforce issues could be a problem.”
What can CIOs facing local health information management workforce shortages do to help? Northeastern's Hochberg suggests that if no local program exists, they should call meetings with universities in the area to discuss the potential of starting a new program. “Many universities would respond favorably to a clear opportunity for a new education program,” he says. If a program does exist locally, CIOs can offer to teach a course, give a lecture, provide internships and mentor students.