Is Healthcare IT Hiring Part of the Problem with Healthcare?

I’ve been thinking quite a bit lately about hiring in healthcare IT since Healthcare IT Central joined the Healthcare Scene family. Recently I started thinking about the way we hire people in healthcare IT. Here are two facets of what we hire in healthcare:

  • We hire those who know healthcare.
  • We hire those who know old technologies.

When you think about the health IT software world it includes things like MUMPS, Fax Machines, and lots of client server. Where else in technology do you find that combination of old technology. Or as I read on Twitter today, “Why do we think that client server is going to survive in healthcare? Didn’t Microsoft show us how that was a failed long term strategy.” Ok, that wasn’t an exact quote, but you get the gist. Plus, I don’t want to dwell on client server vs cloud systems here either (I’ve got a great post coming where we can do that). I just want to illustrate that healthcare is home to a lot of old technology (see the pager if you need added evidence).

Now think about the people we have to hire to work on these old technologies. Do the innovators and creators of the world want to work on old technologies? Of course, they don’t. Sure, there are some exceptions, but they are exceptions. As a rule, the really innovative, creative thinkers are going to want to work on the latest and greatest technology.

This tweet from Greg Meyer (@Greg_Meyer93 if you prefer) highlights the divide really well:

The reality of healthcare is that we have an industrial workforce and industrial products. Should we expect creative results? Maybe we need to switch up how we think about hiring and how we approach technology if we want to really disrupt healthcare. Or maybe healthcare will just get so bad and so far behind that it will create a gap that will allow someone from outside healthcare to enter and disrupt it all.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

13 Comments

  • Healthcare is getting disrupted now, it is not sometime in the future. Retail clinics, urgent Care veneers, concierge medicine, medical tourism, ACOs are all the disruptions that are happening here and now. A number of these are from outside the traditional US Healthcare industry.

    But it is not the newer technologies that are disrupting it, but newer business models. Adopting newer technologies is going to save some of the players from extinction.

  • Aditya,
    Usually, some of the best disruptions are a combination of new technology with a new business model. They often go hand in hand.

  • I don’t disagree with your premise here in general, but healthcare IT has some challenges:
    > Big business (hospitals) don’t want to change fast
    > Private practice docs don’t want to spend the money on tech
    > There are lots of regulations and fierce fines for screwing up (also known as barriers to entry)

    As much as we’d like to think that we are hiring “innovators and creators” when hiring an IT person…we aren’t. We are hiring someone to make sure our stuff works, no matter how antiquated it is.

    The EHR vendors are the ones who should be hiring the innovators and creators, but they aren’t either, for the most part.
    My experience with dealing in the trenches with a dozen various EHR vendors is I’m truly amazed they have survived.
    Questionable sales tactics.
    Horrible implementation processes.
    Lackluster support (especially after the implementation period).
    Hair hurting upgrade processes (yes even on cloud-based EHRs).

    This all goes back to a basic belief I have, which is, there needs to be real demand from docs. Instead this was all forced upon them.

    Docs view an EHR as a necessary evil rather than a valuable tool.
    This is not how innovation is born.

  • New technology is always raw and unstable when it is first introduced to commercialization. By the time it evolves to something that is stable and mature enough to be generally accepted by CTOs, and is no longer considered bleeding edge what happens? It becomes old technology because a new innovation has surfaced to replace it.

    Without the people that know and support the old technology you cannot transition to the new technology. So you need to double your IT staff because you will need experts from both camps to secure a safe and “painless” transition. Then when you finally complete the transition to the new platform years later it becomes legacy.

  • Its almost an axiom that large established industries, especially highly regulated ones, never are able to innovate rapidly enough or make internal changes aggressively enough. It always takes disruptive outside pressure to force paradigm shifts. Look at telecom, banking, transportation, music, etc., etc.

    Just like these and many other industries who have seen their establish business models blow apart, healthcare organizations will hold on to their tried and true but sadly outdated practices until external innovators, economic imperatives, consumer pressures or government mandates force them to change.

  • “Why do we think that client server is going to survive in healthcare? Didn’t Microsoft show us how that was a failed long term strategy.”

    … but then someone else has you by the short and curlies when it comes to data ownership/extraction/use.

    Remember, “Possession is 9/10ths of the law.”

  • Does anyone here remember ‘no one ever got fired for buying IBM’? Hospitals and practices resist change, resist outsiders, figure they know it all themselves. They ignore a huge supply of good IT and project talent now begging for jobs with the huge downsizing of banking post the Bush recession, and have no interest in learning how other industries tackle their IT issues. In particular, other industries have put huge efforts into such issues as usability, data sharing and mining, reliability, disaster recovery and the like.

  • @ Sue Ann: You are correct Ma’am. With the cloud, you don’t really own your data. Even the Woz says so.

    @R Troy: Yep, why take a risk, it might cost you a job. On the labor front, that huge supply if IT talent will get bigger (and push wages further down) if the powers-that-be get their desired changes to immigration.

  • John,

    For the life of me, I don’t understand why supposedly pro labor members of Congresss – either house, support the ongoing H1B and related frauds that have killed so many US jobs, plus still do nothing to eliminate the tax advantages of moving US tech jobs overseas.

    But I’m even more perplexed by HealthIT executives who ignore a plentiful supply of seasoned IT people – programmers, project leaders, analysts and more who understand privacy, security, inter-connectivity, GUI design and far more who could bring such value to the HealthIT world. I met a recruiter and project manager from a major hospital group (actually met them a few times through my PMI chapter) who would probably love to hire a number of us who they know they could use, but clearly are not allowed to hire outside the ‘field’. And I watch as this group struggles to get its hospitals and practices all aligned on one unified ‘system’ with all providers on board. It’s not the money, it’s that it is a huge job and they can’t get the staff they need.

  • John,
    I agree that it’s the vendors that need to do it, but this post applies to them as much as the rest of the industry.

    Sue Ann,
    I’ve thought about making a certification for cloud EHR vendors to certify that the users can get a copy of their data so they have “possession” of their data.

  • In my experience of attempting to help good, but “non healthcare background’ed” people get jobs in healthcare settings like hospitals and clinics, is the following. Organizations do not want to take chances on new unknown entities that have high cost to vet in order to get them security clearance and to insure they can touch PHI without going nuts with it and put the hospital at risk. I find this in trying to place interns or temporary workers all of the time. It is just not worth the expense to a hospital if the person is not a known entity hence they only hire people who have already been around and are more than likely not innovation and have had their heads into deep specific projects.

  • Many banks have long been doing background checks on IT staff. Plus there at least was attempt by ONC, however poorly executed, to teach IT people from other ‘worlds’ the basics of dealing with HealthIT; nice idea, needs to be redone. And hospitals in a region could get together and provide such training in a cost effective manner, and could provide internships to actually get people used to workin in HealthIT. Far better then their constant moans and groans that they can’t get IT staff. Plus, they need to look at each candidate to see what they can do. Using myself as an example, I’ve been in and around hospitals for decades, have made a point of studying their IT issues, have plenty of understanding of the work flow, have known basic HIPAA for years, and have even dealt with JCAH. Oh, and financial IT people have long had to deal with Personal Financial Information, just as sensitive as PHI. The problem is that organizations see this as purely black and white; either you are 100% of the ‘right’ background, or you are 0, and if 0 you are useless, regardless of training and ability.

  • I’ve been in a Healthcare Informatics AS program nearing completion and as a potential hiree I’ve noticed the new HIT credentials aren’t represented in job descriptions. They used to be HIMpro but have been replaced by CHTS. With the industry not knowledgeable in what the training and education entails there will be a continued shortage.
    I’ve studied older systems and obtained Comptia A+, as well as studying Cloud and Mobile technology. Throw in all the coding, billing, TPA, and other acronyms, this program has it all to serve the industry once word gets out about CHTS. good article.

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