Citing the need for 50,000 new health care information technology jobs during the next five years-just to achieve meaningful use of electronic health records-the federal government in 2010 awarded $84 million in stimulus-funded grants to create intensive health I.T. curricula lasting six months or less in community colleges and 12 months or less at four-year universities.
The I.T. training programs were spurred by the HITECH Act's intent to accelerate adoption and meaningful use of electronic health records and related technologies by spending billions of dollars on the EHR incentive program.
As providers adopt EHRs and other information systems, they-and vendors-have found it difficult to find I.T. professionals proficient in next-generation computer systems and networks. "If you're looking for people with skills in 20- to 25-year-old technology you'll find them quickly," says Ray Desrochers, COO at payer software vendor HealthEdge Software Inc., Burlington, Mass. "But skills in modern I.T. technology are lacking."
Charles Friedman, chief scientific officer at the Office of the National Coordinator for Health Information Technology, agrees that there is no shortage of health I.T. applicants. "It always comes down to the level of people who are qualified to do the job." (To learn about how some organizations are turning to third-party talent to bridge the skills gap, see story, page 48).
A September 2010 survey of 182 CIO members of the College of Healthcare Information Management Executives found that more than 70 percent say their organizations lack the information technology staff to implement clinical applications. Fifty-one percent report that I.T. staffing deficiencies possibly will affect their chances to implement an electronic health records system and qualify for meaningful use incentive payments; 10 percent say the shortage definitely will have an adverse affect.
Further, 76 percent of respondents have concerns about retaining existing I.T. staff. One-half of respondents report their organization will have little or no additional funds to spend on increasing the I.T. staff in 2011.
Many surveyed CIOs expect to implement various programs to retain staff, such as flexible work hours, telecommuting, recognition programs, and education and professional development initiatives.
The federally funded training programs are expected to reduce the shortfall of skilled health I.T. professionals by 85 percent according to David Blumenthal, M.D., director of the federal Office of the National Coordinator for Health Information Technology, in an Oct. 12, 2010, blog. "The highly trained and specialized personnel developed through these programs will play a critical role in supporting physicians nationwide as they transition to EHRs."
But some question whether courses of six to 12 months can adequately train personnel to manage advanced I.T. systems in an industry as complicated as health care. Because of the massive differences between mainframe technology and new applications, "six months isn't going to make you competent," vendor COO Desrochers says. "I could see an intensive two-year program getting it done."
Just meeting the anticipated need of 50,000 more I.T. workers to achieve meaningful use translates to a nearly 50 percent increase in the size of the current workforce of 108,000, according to Computer Sciences Corp., a Falls Church, Va.-based consultancy and I.T. services firm. Other demands on providers, payers and vendors-such as implementation of HIPAA 5010 transaction sets, adoption of ICD-10 code sets, and health care reform provisions of the Accountable Care Act-will exacerbate the problem.
Attrition caused by the pending retirement of Baby Boomers isn't going to make the situation any better. In a report issued in 2010, CSC recommends a number of steps to get some of them to stay around:
* Discuss options with employees nearing retirement age so they understand there are options and management wants to keep them;
* Offer sabbaticals so those nearing retirement can see what it is like to leave for a while then return to full or part-time roles;
* Offer consulting or contracting options that let employees stay in the game but have more independence and control of their retirement lifestyles; and
* Consider other financial incentives.
Various factors
While the health I.T. shortage is nationwide, there are areas where it is more pronounced, particularly in smaller towns and rural regions. There also are areas where a shortage isn't really being felt.
Tight budgets are a bigger problem for many community hospitals than a shortage of I.T. talent, says Russell Branzell, CIO at Poudre Valley Health System in Fort Collins, Colo. "We don't have a recruitment or training issue and most of the people I'm talking to say that's not the issue," he notes. "The issue is how to get the FTEs needed through the budget process."
Most of the other CIOs whom Branzell talks to have been told to keep their budgets relatively flat in 2011. "We're going to have to figure out how to do more with less anyway with health care reform bringing pressure on us."
In the CHIME survey, about half of respondents were requesting budget increases to address workforce shortages. But 26 percent of respondents said they expect no increase in the overall I.T. budget for 2011, and 24 percent expected increases of less than 5 percent.
At 159-bed St. Claire Regional Medical Center in Morehead, Ky., CIO Randy McCleese is seeing non-qualified applicants for systems analyst and help desk positions. In particular, he's seeing "kids applying right out of school and thinking they can do these jobs without experience. We need three to five years of experience." But McCleese can't always get seasoned workers; he recently hired someone with one year of experience.
Most applicants are from northeast Kentucky, and half of St. Claire's I.T. staff comes from nearby Morehead State University. Absent the college, the hospital would be in trouble because it isn't seeing interest from applicants elsewhere, McCleese says. And when the hospital finds a candidate with the right skill sets and experience, it can be tough to seal the deal. A couple times recently the hospital has made an offer and the applicant's current employer countered and won.
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