IT LA­BOR CRUNCH

slows hos­pi­tal data ini­tia­tives

Modern Healthcare - - NEWS - By Me­lanie Evans

Health­care has lagged other in­dus­tries in in­vest­ment and in­no­va­tion in in­for­ma­tion tech­nol­ogy. Now, scram­bling to catch up, hos­pi­tals and health sys­tems are fac­ing a tight sup­ply of skilled IT man­agers and ex­ec­u­tives that is hold­ing them back.

The health­care in­dus­try’s race to in­crease its use of elec­tronic health records and data an­a­lyt­ics has pit­ted its re­cruiters against Sil­i­con Val­ley, Wall Street and For­tune 500 com­pa­nies in the hunt for tal­ented, ex­pe­ri­enced IT man­agers and ex­ec­u­tives. The com­pe­ti­tion for in­for­ma­tion-se­cu­rity an­a­lyst man­agers, re­search sci­en­tists and data­base ad­min­is­tra­tors is in­tense, and hos­pi­tals of­ten can­not match more lu­cra­tive of­fers else­where, hos­pi­tal re­cruiters say.

But they can try to com­pete by of­fer­ing can­di­dates greater free­dom in find­ing so­lu­tions and ap­peal­ing to their ide­al­is­tic de­sire to help peo- ple through bet­ter health­care. “They see an op­por­tu­nity to have an im­pact, where in other in­dus­tries there may not be that per­sonal im­pact,” said Grace McCluskey, an IT re­cruiter at Geisinger Health Sys­tem in Danville, Pa.

Be­hind the boom in health­care’s de­mand for tech­nol­o­gysavvy work­ers are bil­lions of dol­lars in fed­eral in­cen­tives to pro­mote EHRs pro­vided in the past five years. The in­cen­tives soon will dis­ap­pear, but pres­sure to adopt dig­i­tal records con­tin­ues since fi­nan­cial penal­ties will start next year. Hos­pi­tals also have in­vested in big-data an­a­lyt­ics and data ware­houses.

Those health IT in­vest­ments have ac­cel­er­ated as providers seek to mine data to meet qual­ity and cost tar­gets un­der new value-based pay­ment mod­els such as accountable care con­tracts. This has height­ened de­mand for pro­fes­sion­als ca­pa­ble of lead­ing so­phis­ti­cated data-anal­y­sis pro­grams that iden­tify waste and find op­por­tu­ni­ties to im­prove the health of en­rolled pop­u­la­tions.

Skilled, ex­pe­ri­enced IT man­agers hold the up­per hand in the job hunt, said Dr. Ni­cholas Marko, Geisinger’s chief data of­fi­cer. “Mi­crosoft wants peo­ple who are gen­er­ally

bright and good at math. Google wants those peo­ple. Ama­zon wants those peo­ple,” he said.

An­other fac­tor driv­ing staffing needs is con­sumers’ ex­pec­ta­tion for easy-to-use in­ter­faces based on their ex­pe­ri­ences with on­line re­tail, bank­ing, travel and other goods and ser­vices. They want that from health­care providers as well. “We think our elec­tronic health record is, and should be, as ac­ces­si­ble as our fi­nan­cial data,” said Pa­tri­cia Dom­browski, ex­ec­u­tive direc­tor of the Health Ework­force Con­sor­tium at the Belle­vue (Wash.) Col­lege Life Science In­for­mat­ics Cen­ter near Seat­tle. “That is so far from the case in health­care,” she said.

In ad­di­tion, data-se­cu­rity breaches have in­ten­si­fied com­pe­ti­tion for ex­perts in health IT se­cu­rity. Health in­sur­ers An­them, Carefirst Blue Cross and Blue Shield and Pre­mera Blue Cross, and health sys­tems in­clud­ing Part­ners Health­care, Com­mu­nity Health Sys­tems and Ad­vo­cate Health Care all have re­ported stolen data and cy­ber­at­tacks.

Al­lina Hos­pi­tals and Clin­ics in Min­neapo­lis is con­sid­er­ing cre­at­ing a new chief in­for­ma­tion-se­cu­rity of­fi­cer po­si­tion, said Su­san He­ichert, chief in­for­ma­tion of­fi­cer for the sys­tem. But the com­pe­ti­tion for qual­i­fied can­di­dates is in­tense. “With all the breaches in the news, start­ing with Tar­get, that makes the job mar­ket heat up,” she said.

Health IT jobs are pro­jected to in­crease 15% to 37% by 2020—far faster than em­ploy­ment growth for other types of jobs. Com­puter in­for­ma­tion-se­cu­rity an­a­lyst jobs are pro­jected to in­crease “much faster than av­er­age” through 2020, grow­ing by more than one-third, ac­cord­ing to the U.S. Bureau of La­bor Statis­tics. In 2013, ex­ec­u­tive-level IT pro­fes­sion­als av­er­aged $189,435 in salary, up 6.1% from the prior year, ac­cord­ing to the Health­care In­for­ma­tion and Man­age­ment Sys­tems So­ci­ety.

Not-for-profit hos­pi­tals, which ac­count for most U.S. hos­pi­tal op­er­a­tors, typ­i­cally can­not com­pete on salary. An anal­y­sis by CIO.com of an an­nual salary sur­vey con­ducted by Com­put­er­world and IDG En­ter­prise found the health­care sec­tor paid less to IT di­rec­tors and IT man­agers than the man­u­fac­tur­ing, legal, in­sur­ance, com­puter and con­sult­ing sec­tors. For IT di­rec­tors, the gap be­tween those in­dus­tries and health­care was $12,000 to $31,000. For IT man­agers, the gap ranged from $3,000 to $22,000.

Smaller health­care or­ga­ni­za­tions par­tic­u­larly strug­gle to com­pete, of­fer­ing lower av­er­age salaries than larger or­ga­ni­za­tions, HIMSS data show. The av­er­age IT salary in 2013 at health­care or­ga­ni­za­tions with less than $5 mil­lion in rev­enue was $106,216, com­pared with $143,715 at or­ga­ni­za­tions with $1 bil­lion or more in rev­enue.

“Health­care’s not go­ing to win a bid­ding war with any­body,” said Marko, who has re­cruited a half-dozen math­e­ma­ti­cians and pro­gram­mers and two com­pu­ta­tional bi­ol­o­gists for not-for-profit Geisinger’s am­bi­tious big-data di­vi­sion.

The in­abil­ity to fill IT po­si­tions has forced some hos­pi­tals to leave projects on hold. Roughly one-third of 200 health­care IT ex­ec­u­tives sur­veyed last year by HIMSS re­ported a project on hold be­cause of IT va­can­cies.

Dom­browski has a front-row seat to the health IT la­bor crunch. Belle­vue Col­lege is closer to Mi­crosoft’s head­quar­ters than any other col­lege cam­pus, and the de­mand for the col­lege’s grad­u­ates is fierce. She has over­seen $20 mil­lion in fed­eral grants to train more health IT work­ers.

Up to now, health­care or­ga­ni­za­tions have re­cruited heav­ily from their own work­force for IT po­si­tions. But more could be done to cap­i­tal­ize on the in­ter­ests of health­care work­ers, ex­pand op­por­tu­ni­ties for ca­reer devel­op­ment and ad­vance­ment, and train IT work­ers from out­side of health­care for jobs in the health­care in­dus­try, Dom­browski said. She urged hos­pi­tals to con­sider new ap­proaches to IT work­force devel­op­ment, such as com­pet­ing for ap­pren­tice­ship grants avail­able through the U.S. La­bor Depart­ment to tar­get high-growth oc­cu­pa­tions.

Health­care work­ers, she said, are ea­ger to learn how to best use IT. Reg­is­tra­tion for a re­cent na­tional on­line train­ing course for health­care work­ers filled up within an hour, with peo­ple on the East Coast us­ing their time zone ad­van­tage to grab all the spots. “One thou­sand peo­ple reg­is­tered be­fore the Mid­west woke up,” she said.

Health sys­tems have been so ab­sorbed in meet­ing fed­eral EHR re­quire­ments that they have done lit­tle to ad­dress their work­force needs. “Health­care hasn’t had the time and re­sources to grow their own,” Dom­browski said. That has forced some hos­pi­tals to out­source health IT ser­vices, which can quickly drain their bud­gets.

In­dus­try re­cruiters say they do look out­side health­care for tal­ent. But they add that health­care ex­pe­ri­ence can be valu­able in un­der­stand­ing the com­plex rules and re­quire­ments for health data, such as med­i­cal pri­vacy laws.

Geisinger em­ploys about 1,000 IT work­ers. Its re­cruit­ing must keep pace with chang­ing tech­nol­ogy and the sys­tem’s evolv­ing projects. To com­pete, Geisinger ex­ec­u­tives and

Up to now, health­care or­ga­ni­za­tions have re­cruited heav­ily from their own work­force for IT po­si­tion.

re­cruiters say their strat­egy is to re­cruit work­ers who are mo­ti­vated by the po­ten­tial health­care ad­vances made pos­si­ble through the use of big data from fi­nan­cial, clin­i­cal and ge­nomic data­bases. That can be ap­peal­ing for the “true data nerds” in the mar­ket, Geisinger’s McCluskey said. Health sys­tems have an ad­van­tage in re­cruit­ing peo­ple who seek so­cially mean­ing­ful work and are drawn to the busi­ness of car­ing for pa­tients.

Marko said he thinks a lot about what would mo­ti­vate po­ten­tial IT re­cruits. He eval­u­ates can­di­dates on their will­ing­ness and de­sire to lever­age data to im­prove clin­i­cal care. He prefers to re­cruit peo­ple who will “fol­low the prob­lem” rather than use one spe­cific tech­nol­ogy to solve a piece of the prob­lem. “I want some­one who is think­ing, ‘How do I solve this thing that needs to be solved?’ ” That al­lows Geisinger to com­pete for IT pro­fes­sion­als who might feel con­strained by more limited, tech­ni­cal work at large soft­ware or tech­nol­ogy com­pa­nies, he added.

Health­care ex­pe­ri­ence is not re­quired for IT man­age­ment jobs at Baylor Scott & White, the Texas health sys­tem formed by the merger of Baylor Health Care Sys­tem and Scott & White Health­care, which em­ploys about 1,000 IT staffers. “We don’t care if they’re from health­care or not,” said Matthew Cham­bers, the sys­tem’s chief in­for­ma­tion of­fi­cer. “Some­times they’ll bring new tech­niques” that were over­looked in­ter­nally. “We’ve had some of the best ideas from out­side of health­care.”

Cham­bers said de­mand has been in­tense lately for mo­bile-ap­pli­ca­tion de­vel­op­ers, se­cu­rity spe­cial­ists and an­a­lysts with EHR ex­pe­ri­ence. But Baylor Scott & White suspended all IT hir­ing to as­sess its needs af­ter the merger, ex­cept for jobs in in­for­ma­tion se­cu­rity. The need for data se­cu­rity takes pri­or­ity for now, he said.

Baylor Scott & White finds it some­times loses promis­ing can­di­dates be­cause they re­ceive lu­cra­tive con­sult­ing job of­fers fea­tur­ing high salaries and lots of travel. “In some in­stances, we find our­selves priced out of spe­cific can­di­dates,” Cham­bers said.

To re­cruit and re­tain IT work­ers, the health sys­tem seeks to foster a work­place cul­ture where work­ers are happy, en­gaged and en­cour­aged to con­trib­ute, he said. Cham­bers in­vites mi­dlevel IT man­agers to dis­cuss the work­place and their projects, with­out their bosses present. He so­lic­its anony­mous ques­tions ahead of the meet­ings.

Among those he per­son­ally re­cruits, Cham­bers stresses the pro­fes­sional op­por­tu­nity that health­care’s rapidly chang­ing busi­ness model presents. The in­dus­try is con­fronted with many chal­lenges, he said, and his pitch to can­di­dates is a string of in­spi­ra­tional ques­tions along the lines of “What are we go­ing to do to fix that?” and “Who bet­ter to do that than us?”

But that is not al­ways enough. Baylor Scott & White re­cently lost an IT se­cu­rity re­cruit to a com­pany three blocks away that of­fered a 20% higher salary.

“We’ve had some of the best ideas from out­side of health­care.” Matthew Cham­bers CIO Baylor Scott & White

As the health­care in­dus­try in­vests in big-data an­a­lyt­ics and data ware­houses, the need for skilled, ex­pe­ri­enced em­ploy­ees in­creases. Also, data se­cu­rity breaches have in­ten­si­fied com­pe­ti­tion for ex­perts in health IT se­cu­rity.

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