NEW ORLEANS -- Under pressure from federal regulators to implement electronic health systems, health care providers are struggling to find and keep a technology staff in what is the fastest growing IT sector in the U.S.
A Healthcare Information and Management Systems (HIMSS) survey of 298 senior IT executives at health care firms found that 21% fear they won't be able to find the tech staff needed to complete an e-health system, including a massive, new medical coding system to be deployed on new mobile technologies.
The results were announced at the HIMSS 2013 conference held here this week.
It was the second year in a row that respondents to an HIMSS survey listed staffing as the biggest barrier to implementing systems that meet new U.S. health care technology requirements.
Thirty-seven percent of respondents indicated that healthcare reform is the number one business issue for them.
Other major barriers to implementing e-health systems were a lack of adequate financial support (15%), the inability of vendors to deliver needed products (13%), and difficulty in end-user acceptance (7%).
The survey found that 51% of respondents plan to increase IT staff in the next year, mostly personnel that can build clinical applications, such as computer physician order entry systems and electronic health records (EHR) systems. Staffers are also needed to build clinical applications (34%) and network and architecture support (21%).
Eighteen percent of respondents said clinical informatics expertise is their biggest need, and another 18% cited IT security knowledge.
Rounding out the top 10 were the need for staff for system integration tasks (14%), process/workflow, PC/server support and clinical transformation (each cited by 12% of respondents), and database administration, help desk and user training (each with 10%).
"We lost a fair amount of our IT staff because of the expertise they have," said Milisa Rizer, chief medical officer for Ohio State University. "Our leadership has been really great at looking at incentive packages because they've become such a valuable commodity to us."
Along with money, one of the most popular incentives for IT staff to stay on is workplace flexibility, or letting people work from home whenever possible. Rizer said an survey of Ohio State IT employees found that they're happier than IT staff prohibited from working at home.
Employees are more likely to stay on the job when there are opportunities to move into managerial and project-focused positions, Rizer said.
Mike Rozmus, CIO of Rockingham Memorial Hospital in Harrisonburg, Va., said his organization has been reaching out to local universities to recruit young talent.
Rozmus has also shifted his processes for training physicians, nurses and other staff from classroom and computer training to more hands on assistance.
"We've learned a lot over the last five years about how to deploy technology initiatives. We've found that you can't just give them technology and expect them to be successful," Rozmus said. "We know we have to provide at-the-elbow support so that the frustration level of the clinicians is taken out at the early stages. We're really investing more in that than ever before."
Many HIMSS survey respondents don't expect a return on investments made to deploy EHRs that will allow them to aggregate patient data and streamline workflow.
For example, EHRs in the largest hospital systems can cost more than $10 million dollars to implement and 30% of respondents expect the ROI to be less than $2 million. Twenty-three percent expect a $2 million to $3 million return, 16% see a return of between $4 and $5 million, 3% expect an ROI of $6 million to $7 million. Only 7% of respondents expect a return of $10 million or more.
By contrast, the level of investment made for stage one of meaningful use ranged from under $250,000 for 14% of those surveyed to $10 million to $19 million for 6% of respondents. The greatest number of IT executives - 17% -- said their companies have to spend $1 million to $2 million to achieve stage one of meaningful use while 11% expect to spend $3 million to $4 million.
The U.S. Centers for Medicare & Medicaid Services (CMS) has to date dispensed more than $7.7B in reimbursement payments to more than 307,000 healthcare professionals and 4,000 hospitals deploying EHRs under government guidelines.
The federal government requires that healthcare facilities eventually achieve three stages of meaningful use of EHRs over the next five years.
To date, Stages 1 and 2 of the meaningful use criteria have been defined by the U.S. Office of the National Coordinator of Health IT (ONC), meaning health care providers can be certified for compliance.
The total cost for the EMR incentive program is expected to hit $22.5 billion over the next decade, according to the latest estimate of the U.S. Office of Management and Budget.
Physicians and other qualified healthcare workers can receive up to $44,000 apiece in incentive payments while hospitals are eligible for base payments of $2 million a year.
Over the past few years, the focus for spending on health care IT has also shifted from deploying EHRs to implementing the World Health organization's ICD-10 classification system.
The move from ICD-9 to ICD-10 calls for replacing about 15,000 codes with approximately 68,000 new ones. It comes at a time when care providers are already under the gun with regulatory and mobile initiatives.
Stephen Fanning, vice president of healthcare industry strategy for CRM and ERP vendor Infor, said an aging IT workforce at the same time the health care industry is under the gun to implement ICD-10 code standards by Oct. 2014.
"We're concerned with ... a 30% loss in productivity as you make the transition [to ICD-10] in addition to an aging workforce where some of those skilled laborers in coding are deciding to retire," Fanning said.
Lucas Mearian covers storage, disaster recovery and business continuity, financial services infrastructure and health care IT for Computerworld. Follow Lucas on Twitter at @lucasmearian, or subscribe to Lucas's RSS feed . His e-mail address is firstname.lastname@example.org.
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