DEC 1, 2011 5:22pm ET

Get a Job


HIMSS, along with the American Society for Healthcare Human Resources Administration, is working on a program to help fill tens of thousands of critical open HIT jobs. Yet we constantly hear very experienced I.T. people complain that they weren't hired for open positions because they weren't nurses, or lack experience with a specific health care application package. This is really unfortunate. Here is the problem and a solution.

First, the medical profession just loves degrees and credentials. It's not uncommon to see a health care professional with a half-dozen degrees, certifications, and affiliations listed behind their names - M.D., PhD., R.N., MBA, FACP, BPOE, OLB.

I.T. professionals rarely have this level of formal education in technology. Most of the best do not have any technical degrees at all.  While many do have certifications in a specific technology or I.T. subject area, they don't "publish" them--unless they work in health I.T.

The best I.T. people tend to not be credentialed. If they have degrees, they're typically in music or the visual arts -lines of study that require being aware of the rhythm of things and non-verbal communications. Computer science degrees are particularly bad fits for I.T. careers--CS degrees should remain in academia. Software engineers work for the I.T. vendors.

Great listeners with terrific problem solving skills are perfect for I.T. For example I would rather have one Data Warehousing Institute Certified Business Intelligence Professional candidate(yes, CBIP) working on ANY health care analytic project than hundreds of Stanford M.D.s, Berkeley PhD.s, Yale JDs, Columbia BSNs or MIT MSEEs.

You do not need a person highly experience in a specific application to implement, enhance or support it. The best implementers have exposure to many different applications in many different businesses. I would much rather hire a person that has done integration and support in warehouse management, a Wall Street trading system, and implemented Oracle Financials or SAP, than one who is the leading expert on Epic --even if the application in my facility was Epic.  (That's why you need people who have great answers for question #7 below.)

Great I.T. people are chameleons (can blend in), problem solvers, well-rounded people who are passionate about helping others.

To help you fill these empty slots here are the interview questions you should be asking:

1) What was the most important thing you did in your last job as an I.T. professional to improve the operating efficiency of the business?

2) What was second most important thing you did in your last job as an I.T. professional to  improve the operating efficiency of the business?

3) What was the third most important thing you did in your last job as an I.T. professional to  improve the operating efficiency of the business?

4) What is the most important thing you did as an I.T. pro to reduce I.T. costs?

5) What is the most important thing you did to increase company revenue?

6) What were the top three things you did to improve user satisfaction with the applications you were involved with?

7) What strategies do you use to get the most out of vendors?

8) If you had it to do all over, what one thing would you have done differently?

9) What is the last book you read?

10) Prussian Field Marshall Helmuth Graf von Moltke once said, "No battle plan survives first contact with the enemy." Do you know what he was talking about?

Rob Tholemeier is a research analyst for Crosstree Capital Management in Tampa, Fla., covering the heath I.T. industry. He has over 25 years experience as an information technology investor, research analyst, investment banker and consultant, after beginning his career as a hardware engineer and designer.



Comments (14)
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Posted by Lavonna K | Wednesday, December 25 2013 at 2:20AM ET
I agree with Professor Hersh. I had eight years of IT experience before I became a nurse. I did so because of extensive research that told me most facilities wouldn't hire me without clinical experience and a license.

Only now, after 4 years on the floor, have I been able to find a job that values both skill sets. I am also getting a degree in informatics because the market is good for clinical people with such background. I am amazed at the nurses who really do not understand what they are getting into, by transitioning to IT.

So there is a learning curve both ways. I also agree that with subject matter experts (RNs, etc.) + skilled progect management staff, you can get a lot done. The trick is getting them together.
Posted by cberding | Tuesday, December 27 2011 at 7:19PM ET
Healthcare informatics is a fluid field with PM, EMR companies racing to meet government standards and sell the most precise and robust product. What is interesting, is that these very same cutting edge companies are not hitting the mark on some of the most basic building blocks of healthcare information as shown by all the comments. Peggy D hit the nail on the head when she said the best results come with collaboration. Instead of trying to make each position an equal skill based position, wouldn't there be at least in the initial phases a better outcome if it was a team teaching situation? What is the point in having an strong IT person with minimal if no clinical experience come out to evaluate office work flow, physician style of practicing medicine and computer competency of staff only to end up with out of control IT support tickets,constant phone calls from CEOs,COOs etc.frustrated because you promised x,y&z but those statistics have not changed with the implementation and use of their product. The companies have something of an obligation in the prework to evaluate and report to the purchasers findings that they may not be receptive to at least initially and may not change their work flow but at least you have put it out there and cannot be held responsible for certain types of failure. I know with our implementation is was never made clear that the for all the talk of customizing the PM is a solid frame that office more or less will have to change their way of doing things to get the most out of it and in the EMR while it certainly is customizable to specialties, type of setting,it too has limitations as far as physician style. To be effective in all aspects of the business, a little better evaluation and customised training would have gone a long way towards an overall consensus of hating the product and wishing we had never done this.
Posted by Deena G | Saturday, December 24 2011 at 8:50AM ET
As I read the negatives from some readers on certification (i.e. they look down their nose at it and see it as some form of diluting what is pure), I see a truth from the organizational psychology perspective that needs to be pointed out; as there is also HOPEFUL discussion here that healthcare might actually be open to hiring from outside of the industry FOR A CHANGE. Before I continue, I'm a senior I.T. guy with management experience who also knows a thing or two about HR.

That truth that needs sharing is this: in the world of human organization there are people who are naturally wired to be "specialists", and then there are "generalists". The former are usually best as individual contributors. The latter work well in management slots.

It is the tendency with departments managed by specialists to fall into sweat-shop mode without the generalist's balancing temperament. It is also a waste of time for a job candidate, who has "related" but otherwise weak to no direct experience (and a *certification* to make up the difference) in their new area of endeavor -- to interview with a company where the specialist has final say on the hire. This is because specialist culture thrives on meritocracy where the person who knows the most, works the most hours and hits the most balls over the fence gets to be the alpha. And so success with the Gallup Organization's landmark statistical findings on hire by talent first instead of by skill will never happen.

HR departments and the dept managers they serve need to understand that "driving diversity" into an organization is far more than just gender and EEO factors: it must also assert career and learning style diversity as well; which will usually mean keeping staffing decisions in the hands of the generalists, and being proficient at the strategic capability of talent management.

Companies should STOP hiring their competitor's retreads who know everything and did it 500 times just yesterday: the specialists might like to hire that way - and doing so certainly adds to the salary bubble while this game of human ping-pong across companies in a given vertical goes on. But as you displace responsibility for the management of your culture to the wrong people in your organization, your competition who has higher standards is quietly usurping your present position in the marketplace.

WATCH for those on your staff who poo-poo certification: their attitude is part of the problem and is a reflection of the weakness of your learning-challenged culture where the inmates rather than the leadership are running the asylum. My thanks to HDM for a great publication !
Posted by Frank ISO | Thursday, December 08 2011 at 7:45PM ET
Great perspectives. As HIMSS member organization in the informatics space, we never hire "one-trick ponies", so to speak. We always look for well rounded individuals who are problem solvers and not someone who is just proficient in one technology.
Posted by KISHORE NAIR | Thursday, December 08 2011 at 2:23PM ET
I am a 20+ year IT vet. My wife is an RN and our daughter an OT. I took thr HITECH Workflow Certification sequence and did fine. EVERY job open I saw said I had to have 3 - 5 years of clinical experience to be considered. The content of the course I took made it fairly plain that, if left in the clutches of the clinically trained, health care IT is doomed, The provider comments throughout the entire course were more oriented to, essentially, maintaining the status quo than to using IT to make health care better. Yes, physicians, you may be correct that the EHR's user interface sucks; BUT it you don't care enough to help redesign it, stop complaining.
Posted by mike h | Thursday, December 08 2011 at 2:16PM ET
Given that the title of your publication is "Health Data Management" it is apropos that you have written about the HIT employment problem from the perspective of an experienced IT professional seeking work in the medical field. But the reverse situation is equally applicable.

A journal entitled "Electronic Health management" could contain a mirror-image editorial regarding experienced health professionals seeking work in the HIT field, and be completely appropriate.

The central conundrum in the "cats and dogs" relationship that medicine and IT seem unable to escape is that there are very few IT professionals who have the ability to adapt IT processes to the chaotic origin and flow of information which characterizes medicine, and there are equally few medical professionals who can accommodate the logical and structural demands of IT within that same storm of data.

In most industries there is some sort of repetitive and replicable foundational transaction or event which drives the industry. It might be a banking transaction, or a step in a manufacturing process, or the need to solve an equation, but the foundational step both sets the direction of workflow and defines parameters for that work. In clinical medicine, that foundational transaction is the patient encounter, which is as non-standardized and as non-replicable as a massively injured patient arriving in a trauma bay, or a healthy 30 year old arriving for an annual physical exam. By necessity, that encounter has no pre-set parameters - all possible options from aspirin to emergency surgery are initially open until closed by the clinician - and the resultant work flow cannot be predicted. Clarity begins to occur only well into the process; analogous to a banking transaction where the amount is unknown until after it is completed, or a manufacturing step wherein the raw material is unknown until after the blank is placed in the mold.

At present, there are about 500 IT vendors who are demonstrating that the "ultimate solution" to the problem of the patient encounter remains undiscovered, and it seems unwise to assume that only the IT half of the HIT partnership has the potential to resolve the issue.
Posted by A D | Tuesday, December 06 2011 at 7:01PM ET
While I agree that there is much value to be had in including those who have experience in areas outside of the health care sector, how these folks get up to speed on the specialized needs of this industry is essential. As someone who had a ton of health care experience and NO technology experience when I started with a health care technology company 10 years ago - I quickly realized that collaboration and information sharing across the team was essential to successful implementations.
It is the intimate understanding of the workflows in which technology is used, the needs of users, the other technologies that is needed in concert with strong technical knowledge, project management skills, etc. Finding ways for folks with this subject matter expertise to work and support the work of those with strong technical experience will make us all successful.
Posted by peggyd | Tuesday, December 06 2011 at 1:34PM ET
I agree with your comments and the healthcare information technology industry will have to identify candidates from other industries such as Financial Services who have domain expertise in technologies that are not prime time in healthcare as of yet. This includes, master data management, metadata management, data quality, enterprise information integration and complex events processing.

Interesting as of 2Q11 only 1% of the US hospitals has achieved the HIMSS EMR Adoption Model stage 7 (aka data warehousing). Simply analytical systems are complex to develop and with a global shortage of qualified business intelligence professional, the healthcare industry will face some interesting challenges to address meaningful use, ICD-9/ICD-10. HIPPA5010, ACO and more data driven requirements.
Posted by Jim S | Sunday, December 04 2011 at 4:12PM ET
I don't disagree that certifications can obscure a professional's true value in the health IT setting. However, this article is implying there are only two roads: formal clinical training or some type of IT experience. But you are missing a third road that many working in the industry increasingly take: formal education in biomedical/health informatics. Individuals trained in informatics usually understand the intersection between the clinical and IT worlds, and are very effective at implementing and advancing the use of systems. That is certainly what we aim for in our program at Oregon Health & Science University.

William Hersh
Posted by hersh | Saturday, December 03 2011 at 6:55PM ET
Thank you for this badly needed article. I have been working for months to find another job as an HIT Project Manager after having been let go by an EHR re-seller as they downsized. I have 15 years experience in the financial industry as an IT project manager and workflow re-engineering specialist but I have experience with only one EHR product and I hold no certifications. No one wants to hire me because I have no health care experience, I am not a PMP, not six-sigma certified, not a scrum master, etc. But I am an experienced PM and expert problem solver, an intuitive business thinker and a meticulous planner.

I have shared this article with recruiters from 4 agency I have been working with. These agencies need to understand as well that their client's bias toward degrees can work toward their own detriment.
Posted by CLIFF W | Friday, December 02 2011 at 11:31PM ET
Certifications are (often) a crutch, used by screeners or interviewers, when they lack the technical/business/application knowledge to personally decide whether a candidate has the skills and knowledge to fit an advertised need.

As a hiring manager, I NEVER let H.R. screen out ANY application that comes in for a position I'm filling; I personally read them all, and decide who's most interesting.

NOTHING affects your likelihood of success more than the people you hire, so that's way too important to delegate.
Posted by Douglas D | Friday, December 02 2011 at 5:36PM ET
Over-focus on experience with a particular application is certainly a part of the complaint about not enough qualified people. Another aspect is just the time: organizations everywhere are so reluctant to hire based on fear of the economic situation. Most large organizations have effective "freezes" on hiring. They aren't official, they just hold decisions on hiring at such a high level that it is effectively a freeze.
Posted by Guy W | Friday, December 02 2011 at 4:14PM ET
Well done. Someone really needed to publish that point.
Posted by Richard P | Friday, December 02 2011 at 1:36PM ET
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