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Tuesday, March 17, 2009

Another Elephant Blocking Health IT in Australia

The following appeared a few days ago in iHealthBeat.

Where Will the 'Mini-Army' of Health IT Workers Come From?

Friday, March 13, 2009

The American Recovery and Reinvestment Act contains a set of provisions known as the Health Information Technology for Economic and Clinical Health Act, or HITECH Act, that advances the use of technology in health care.

Among other things, the HITECH Act provides funding for the integration of health IT education in the training of health care professionals.

Industry experts predict that not only must current health care providers be trained in health IT, but a whole new tier of health IT specialists will be needed to convert the country's health system to digital records.

Many predict it will take a small army to achieve the goal of computerizing the nation's medical records within five years. Don Detmer, president of the American Medical Informatics Association, estimates it will take as many as 130,000 information technicians and 70,000 informatics specialists.

Where will this "mini-army" of new workers come from? Does the stimulus package include enough money to train enough people? How long will this new learning curve take?

Training Programs Already Under Way

Bill Hersh, chair of the Department of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University's School of Medicine, predicts many members of the new mini-army will be health professionals looking to move into the growing IT field. He says there also will be IT professionals from other industries looking for work in the newly expanding health IT arena.

Training already is under way online and in brick-and-mortar classrooms.

"The acuteness of the stimulus package requires that we build this new 'mini-army' quickly," Hersh said, adding, "They will come from short-term training and re-training programs."

One example is the 10x10 program offered by AMIA. With a goal of training 10,000 health care professionals in applied health and biomedical and health informatics by the year 2010, the program is national in scope and includes several educational partners.

Oregon Health and Science University was AMIA's original partner and so far more than 600 people have completed the four-month course through the Portland campus. Coursework is an adaptation of the online introductory course in the school's graduate program.

"This program is very scalable and could easily train hundreds or even thousands over the next year or two," Hersh said. "While many of these people will come from the ranks of those experienced in health care who wish to move their careers in this direction, it may well be that veteran IT professionals willing to learn the intricacies of the health care setting are also likely to be able to succeed. Many of them, of course, have been laid off from IT jobs that are unlikely to reappear, especially in the financial industry."

JoAnn Klinedinst, vice president of education for the Healthcare Information and Management Systems Society, said HIMSS is forming a workforce development group dedicated to providing a forum bringing stakeholders together to address the opportunities and challenges of meeting new health IT work force demands. The group will be formally announced at the HIMSS conference next month.

"HIMSS believes that sources of [health IT] workers, both implementers and end users of health care information technology, will include the displaced worker; our veterans; those currently working in health care who desire a role centered on health care information technology; sources from other industries that provide similar core competencies on topics like quality assurance, management engineering, process improvement, project management; and our high schools and vocational schools," Klinedinst said.

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MORE ON THE WEB

Lots more here:

http://www.ihealthbeat.org/Features/2009/Where-Will-MiniArmy-of-Health-IT-Workers-Come-From.aspx

Unsurprisingly, this report made me think just where we might be in Australia if ever there was a decision to move to a serious, properly funded, implementation of a National E-Health Strategy as has been recently developed by Deloittes.

I suspect we would not be in too good a shape. However it is a little hard to be sure and I have not seen any credible statistics published for Australia.

In the US the Obama Health IT Stimulus package is said to require an additional 200,000 professionals of various types for its implementation. If we assume the US is about 5% of the effective size of Australia that amounts to about 10,000 being required.

There is also a report from the British Computer Society from 2006 entitled:

“Eardley T, NHS Informatics Workforce Survey. 2006, ASSIST: London, England” which is available here:

http://www.bcs.org/upload/pdf/finalreport_20061120102537.pdf

Other useful resources are from Bill Hersh MD whose home page lists many works in the area of Health IT workforce:

http://www.billhersh.info/

The outcome of all this work is that using a broad definition of Health IT professional ( covering both Health IT technical staff and Health Information Managers) there is a requirement for approximately Health IT professional one per 50 full time staff.

On the basis that the Australian Health Workforce is about 850,000 – (AIHW, 2009 Report) this comes up with a total figure of about 17,000.

If I do a bottom up estimation of presently available relevant resources I really struggle to see more than 4-5,000 with 10,000 being the absolute upper limit. (HISA has about 1000 people attend the annual conference and that is probably 10-15% of available professionals)

To reach a sensible skill base what this means is that some real advanced planning is required as these people will take at least a couple of years to train.

They will also need a career path, some proper accreditation and professional recognition and so on. More importantly we will also need to develop the teachers in the Universities to deliver the courses – and this area has sadly been rather ignored in the last few years. Health Informatics has hardly been a growth area sadly in our universities with some courses (e.g. CQU) even being wound down!

This is an area that needs to be planned for sooner rather than later in my view.

With the GFC it could be a good time to get some training happening in this area!

David.

2 comments:

Michael said...

In the last two Federal budget submissions by HISA and separately in letters to all relevant ministers from HISA, HIMAA and the Deans of a number of the Universities, there has been a call for urgent action on education and workforce planning.

This is not just to enable new work. There is a real problem with having enough people to do the work competently now.

To take just one area, the whole federal-state hospital funding system relies on data from systems and health information managers and they are scarce now and not being trained in sufficient numbers.

As for the medical workforce it seems we will have to wait for a crisis before any action is taken!

Anonymous said...

I have been working on the NHS IM and T project for the past 4 years as a Business Change Consultant. Some parts of the NHS and the large consultancy companies (though not all) have recognised that the introduction of health informatics systems into the NHS impact on both clinical and administrative processes. This is particularly true when clinicians are being asked to record clinical information in IT systems instead of patient notes.

While it is very well to get people trained up in the traditional "data" and "infomatics" aspects of potential new systems what is crucial is that the health care organisations / GP practices think about what the system will do to their current clinical and admin processes and prepare themselves.

This lesson is only being slowly learnt in the UK and is still not fully understood by IT professionals and external consultants from non-health backgrounds that governments seem intent on asking to deliver this complex health organisational change of implementing electronic healthcare systems.

Lets hope that attention is paid in both Australia and the US of this need and the new workers that people are considering of training have an understanding of the health business change impacts of new IT systems.