Brains, Need More Brains! Any time I get dialed into a discussion about the health I.T. worker shortage, that classic line from the “Return of the Living Dead” cycles through my mind. That, and “Send more police!” (To understand the context of those quotes, you really have to see the movie, and you really have to make sure your pre-teen kids aren’t around when you do.)

This industry needs more brains. A report from Computer Sciences Corp. compiles data from sources including the Bureau of Labor and ONC and projects a shortage of 50,000 HIT workers in the next few years. That’s a big number, and it’s even bigger when you factor in that there are about 108,000 HIT workers in the industry right now. Which means the workforce needs to grow by roughly 50 percent to meet demand in the era of EHRs.

I.T.  leaders are aware of the problem … when asked  in the annual HIMSS CIO Survey about the biggest barriers to achieving meaningful use, the No. 1 response was lack of skilled I.T. workers. They’re aware of the problem, but everyone is going to have to come up with their own solutions. Unlike many issues besetting this industry, the workforce shortage has to be dealt with on a local level, one brain at a time. This will pit vendors against customers, large facilities against small, rural vs. urban. It’s going to be fascinating to watch who “wins” and who “loses” here, and why.

This isn’t really a “build or buy” debate like some past I.T. worker shortages. For example, during the early stages of the dot-com era I worked for the IEEE, the world’s largest technological society. One solution to the expected worker shortage then was an expansion of the H1-B visa program, which offered three-year work visas for non-U.S. technology workers.  

The program, was, ands is, very controversial because while it was designed to extend visas to workers with unique skills, opponents cited convincing evidence that the visas were being handed out to young, overseas university graduates whose skill sets were not particularly unique, but whose willingness to work long hours for below-average wages really was extraordinary. Love it or hate it, the program did deliver brains to the U.S. high-tech industry, which it turns out didn’t need as many as it expected after the Internet house of cards collapsed.

But health care is really, really going to need those brains—there’s real money and real work here. And it’s extremely unlikely that HIT can benefit from any short-term efforts to bulk up I.T. staffs by bringing in non-U.S. personnel. The powers in government are leery of increasing any form of immigration in the post-9/11 era, and with unemployment so high domestically there’s little chance of anyone signing off on bringing in help when there’s so many domestic workers looking for jobs.  

So health I.T. likely is going to rely on a “build” strategy, mainly through increasing community college and university-level training. The government is also taking part in this by pushing money into programs aimed at training HIT workers and providing technological support to organizations that lack the resources to staff up. It’s awarded $144 million in grants to train more HIT workers through a community college consortium, curriculum development centers and competency examinations, among other programs.

But government-funded programs aren’t going to start kicking out grads until March 2011 at the very earliest, and the jury is still out it if they can really make a dent in that workforce shortfall. Their cumulative goal is to add 10,500 total HIT workers annually by 2012, but that’s awfully ambitious, especially since they’ll be competing for brains with financial services and other industries that to date have offered better wages and “lifestyle” packages than health care has.

So as with so much else in health I.T., this is going to get interesting. I’m wondering if providers are going to bite the bullet and start offering real enticing competition packages; if they’ll start looking inward and find nurses, compliance managers and HIM staff who could move over to the I.T. department; or if remote hosting and/or consultant-run I.T. shops will be the model going forward.

The truth is someone, or a lot of C-level someone’s, has to get innovative real fast to ensure they have the workforce they need to execute their I.T. strategies. If not, the I.T. department is going to become a financial sinkhole instead of the innovation center it needs to be to deal with not only meaningful use but ICD-10, data security, the I.T. unknowns of health reform and whatever other surprises are in store.

In “Return of the Living Dead” the call went out for more brains because the zombie hoard wanted to eat them. Health I.T. needs to nurture them, a lot of them, if it’s going to come out the other side of this era intact.

 

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