From bad to worse?
In Myeroff's view, however, health IT shortages are substantial and growing. "Technology is moving forward, and we don't have the staff for it," he says. "Tens of thousands of jobs are going to be needed and we don't have the people for it."
One major reason for these shortages, he says, is the government's incentive program for electronic health records (EHRs). That initiative has resulted in the majority of hospitals and physicians acquiring EHRs in the past several years. Known as the "meaningful use" program for the criteria that providers must meet to obtain the financial incentives, this program is now in the penalty phase: For the next few years, Medicare will cut its payments to organizations that do not show meaningful use of EHRs.
Another IT-intensive government program requires all healthcare providers to move to a new diagnostic coding system in October. This shift entails internal and external software testing, not only with health plans and claims clearinghouses, but also with other trading partners.
In addition, doctors and hospitals are grappling with the transition to an entirely new method of payment, known as "value-based reimbursement," that rewards healthcare providers for quality and efficiency. The data aggregation and analysis needed for success in this game require specialized IT staff such as data analysts, who are in short supply.
Because of government-mandated time frames, Myeroff interprets the HIMSS survey results differently than Hood does. Whether or not a healthcare organization has the budget to hire more IT people, he notes, it must achieve certain objectives by a specific date. For example, stage 2 of the meaningful use program requires hospitals and physicians to meet its criteria this year. "To meet those stringent deadlines, you need IT staff," he says.
Is in-house training the key?
To close the workforce gap, many healthcare systems are developing additional IT workers internally. These staffers typically nurses take IT courses offered by vendors or professional associations. But most of their training occurs on the job.
Hood says this is not a very sophisticated approach. No healthcare organization that he knows of has a formal in-house training program. Most of the lower-level clinicians who take on roles in IT are super-users who often function in a help-desk capacity to help other users, he says.
Myeroff says that many healthcare systems have done a good job of developing in-house IT talent. The problem he sees is that clinicians who take on IT roles don't have all of the competencies required. Health IT professionals who know healthcare but are not clinicians may supply these missing skills. "But neither one of them can do the whole job."
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