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IT labor crunch slows hospital data initiatives
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 industrys 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 people 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 healthcares demand for technology-savvy 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.

Hospitals can try to compete with Silicon Valley by offering candidates greater freedom in finding solutions and appealing to their desire to help people. 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, Geisingers 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. Healthcares 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 Geisingers 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 Microsofts headquarters than any other college campus, and the demand for the colleges 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 hasnt 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 systems evolving projects. To compete, Geisinger executives and 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, Geisingers 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 dont care if theyre from healthcare or not, said Matthew Chambers, the systems chief information officer. Sometimes theyll bring new techniques that were overlooked internally. Weve 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 healthcares 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.