Short on support: Too few in health care IT work force

As physicians further embrace technology, they encounter a practical problem -- how to make sure they have someone ready to solve the technical problems new technology brings.

By John McCormack, amednews correspondent — Posted July 16, 2007

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There are many reasons why families bring puppies home. The companionship, the fun, the unconditional love. Studies even show that owning a dog can result in health benefits such as lower blood pressure.

Similarly, there are many reasons why medical groups adopt information technology systems. Improved communication, enhanced operational efficiency, reduced costs. There are studies showing that computers can help improve patient health.

Eventually, though, in both scenarios, a big question rears its ugly head: Who's going to take care of these beasts?

Health care organizations, including physician practices, are finding that nurturing a computer system can be a big job -- and one that requires not only time and effort but specific expertise as well.

The problem is, as more physicians move toward automation, it will become increasingly difficult to hire and retain the information technology talent -- whether full-time staff members, consultants or temporary workers -- required to manage computer systems, says Stanley Hochberg, MD, director of the graduate program in health informatics at Northeastern University, Boston.

"We are at a phase now where we are seeing a significant increase in the implementation of electronic systems across all health care settings, including acute care organizations and outpatient practices," Dr. Hochberg says. "So, as more organizations are using electronic medical records, computerized physician ordering and e-prescribing systems, the need for information technology leaders and staff members is growing considerably -- and we are starting to see a shortage."

As the cadence toward computerized medicine quickens, doctors need to understand the supply-and-demand challenges associated with bringing information technology talent into the fold. They also need to recognize that successful health care information technology professionals will possess both clinical and technical acumen, and they'll have to develop and implement strategies to bring in the personnel needed to support information technology initiatives.

Symptoms of a shortage

Although there is some debate over the severity of the health care IT shortage -- with some arguing that calling it a full-fledged "shortage" is a bit strong -- one thing is certain: Physicians, health care entities and health software companies definitely are running into some obstacles finding IT staff.

The fact that health care organizations compete with companies from multiple industries for the same IT staff and resources is challenge No. 1, according to Mark A. McManus, vice president of IT Research at Computer Economics, an information technology and research consulting firm based in Irvine, Calif.

Unfortunately, the competition for talent is getting even more intense, as IT staff needs are growing in all business sectors. According to a survey of 160 organizations across multiple industries, conducted by Computer Economics, 25% of companies will increase IT head count by 25% or more, while more than 50% of companies will increase IT staff head count by 5% or more in 2007.

A closer look at recruiting dynamics makes it easy to see why health care is having a rough time attracting IT talent. Of the 16 industries, health care ranked fifth in "desirability" as perceived by the IT hiring manager respondents, trailing other more desirable industries such as finance and education.

"Health care is middle of the road. So, it is not among the top-tier industries that aspiring information technology professionals are gravitating toward," McManus says.

Competing with companies from other industries, indeed, has been quite a problem for North Medical PC, a 60-physician multispecialty practice based in Liverpool, N.Y.

"We have a lot of large defense contractors in the area, and they tend to snap up the high-end talent," says Jim Brulé, chief information officer at North Medical.

What's more, physician practices have an even tougher road to travel than larger organizations such as hospitals and software vendors themselves, according to Bruce Cerullo, chair of Lucida Staffing Group, a Reading, Mass.-based health care recruiting company that places candidates in temporary and full-time positions. Because the larger organizations have more resources, they typically can offer more financial and lifestyle incentives to prospective candidates. That's true for many of the small software companies that are prevalent in the health industry.

In addition, it's easier for larger organizations to nurture talent from within. For example, large organizations can hire junior-level technology professionals and invest in training and career development to help them acquire health care industry expertise, Cerullo says.

"It's much more difficult for a physician practice to do that. Many of them just don't have the depth and breadth of resources," Cerullo says.

What makes health harder

No matter how much money is thrown at recruiting -- and no matter how many IT candidates are available -- health care organizations have always struggled to find the right candidates for the job, says Betsy Hersher, president of Hersher Associates Ltd., a Northbrook, Ill.-based executive search firm that specializes in health care technology.

"We're not really dealing with severe shortages. The challenge, however, is finding people who are truly qualified to do the work. Health care IT professionals need to possess the right mix of clinical and technical skills. And, finding people with this ideal mix is a huge challenge for health care organizations," Hersher says.

For example, when health care organizations hire candidates with an IT background, leaders should ensure that the new staff member either has or quickly develops an understanding of the intricacies of the health care environment and clinical processes. Perhaps, even more important, these IT pros need to have the ability to interact with clinical staff.

"They truly need to know how to share their ideas with doctors. They might be qualified to do the technical work, but if they don't know how to deal with the doctors, it won't do much good in the health care environment," Hersher says.

Indeed, North Medical's Brulé will not even consider hiring anyone who might have trouble communicating with physicians and other staff members. "No matter what the IT position is, the successful candidate has to have the positive attitude and be willing to work with the physicians and other end users. Even if they know the operating system inside and out, if they don't have the right attitude, we won't consider them," he says.

Similarly, doctors jumping into the IT fray need to learn a thing or two about technology and management.

"Certainly, there are a growing number of physicians who are taking an interest in information technology. But to head up these efforts, they need to have business management experience. They need to have operational experience. And, most important, they need to communicate with a wide range of people to be successful. It's a new skill set. And for some physicians, it comes naturally while others have to work at it," Hersher says.

Indeed, the graduate program at Northeastern, which will enroll its first students this fall, exists in large part to develop well-rounded health care IT professionals, according to Dr. Hochberg.

"The program is specifically designed to give technical people a solid grounding in clinical processes and workflow and to give clinical people an understanding of technology," Dr. Hochberg says. "The goal of the program is to educate students so they can go back to health care organizations and make a difference on a day-to-day basis."

While it is difficult enough to recruit professionals who sing from both the health care and technical hymnals, some medical groups are finding it necessary to recruit IT staff or consultants who possess in-depth knowledge of specific systems, says Lucida's Cerullo.

"There are pockets of shortages because health care organizations are all looking for individuals to help install and maintain certain systems. For example, there are probably hundreds of organizations that would hire a person who is highly familiar with and skilled in the use of some of the popular EMR systems," Cerullo says.

Signs of hope

Although difficult, some medical groups are digging in and finding creative ways to meet their IT staffing needs.

For example, after purchasing and implementing an electronic medical records system, leaders at Heart Consultants PC, a 15-physician cardiology practice based in Omaha, Neb., realized that they would have to find a way to keep the EMR and other computer systems up and running optimally on a day-to-day basis.

Jared Boldt, the practice's information technology specialist, did most of the heavy lifting -- but couldn't carry the weight of the entire program on his shoulders. To get the extra support that the medical group needed, Boldt started working with a local information technology services support company. But because the company did not specialize in health care, the assistance offered often fell short. The consultants often spent a great deal of time trying to understand clinical systems and the specialized processes of a medical group practice.

Boldt finally discovered CareIT, a comprehensive health care information technology IT management program administered by IntelliSuite, a Schaumburg, Ill.-based information technology consulting firm. It is one of the growing number of consultancies pitching its specialized health care knowledge.

In addition, because the CareIT consultants specialize in health care, Boldt can use them to develop the practice's strategic IT plans.

"If I need to bounce an idea off of someone, I can," Boldt says. "They really understand information technology and perhaps even more importantly, they know health care."

While Heart Consultants is finding that the Web-based IT management service is helping the group move its technology program forward, North Point's Brulé is looking to support his firm's information systems initiatives by taking a creative approach to IT recruitment and training, such as training all staff on technical matters for temporary help, refusing to hire the first qualified candidate and holding out for the IT help it wants, and offering implementation services to other practices as a means of leveraging its knowledge.

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How a small practice can find the right candidate for the job

North Medical, a 60-physician multispecialty practice on New York's Long Island, has a four-point plan to ride out the health IT worker shortage. North Point is different from smaller practices in that it has its own IT staff, but its lessons can be applied to smaller practices who need to hire an outside consultant to maintain their systems as well.

Practice patience. Although it is tempting to fill positions or retain the first qualified tech person -- especially in a tight labor market -- North Point is waiting for the right candidates. "We would rather operate with a lean staff instead of just hiring any candidate," chief information officer Jim Brulé says.

Turn all staff members into techno-geeks, of sorts. By taking the time to thoroughly train all staff members -- from clinicians to coders to administrative staff -- Brulé is hoping to turn all staff members into technology "support" staff. "We are developing what I call ancillary support within our system with the staff members that we already have in place," he says.

Leave no stone unturned. To find the right job candidates, the medical group has taken out ads in local newspapers and on In addition, the group is recruiting through area colleges and professional associations such as the Healthcare Information Management Systems Society. Similarly, smaller practices can check with such associations and other means to mine contacts for tech help.

Put a glamorous spin on health care IT. North Point is trying to attract in-house tech help by not only rolling out an electronic medical record system to its own physicians, but also planning to offer EMR implementation services to other physicians in the region. Similarly, a smaller practice can convince a highly qualified tech person to see it as not just one job, but a potential referral for many others.

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