CHIME survey shows vacancies trending upward

ANN ARBOR, MI  - The demands of meeting meaningful use measures within the HHS's established timeframe has industry CIOs strapped and left facing serious IT staff shortages, according to the findings of an October CHIME survey. 

Officials say survey findings underscore the urgent need for an industry-wide solution, as staff shortages continue to climb, with some 67 percent of industry CIOs reporting IT staff deficits  -  up from 59 percent in 2010. And what's worse, as many experts argue, CIOs won't be seeing relief in the near future. 

"Even with two years of focused attention on implementing electronic health records at the nation's hospitals, in response to federal incentives, it's clear that staffing is a significant concern for IT executives," says Randy McCleese, vice president of information systems and CIO at St. Claire Regional Medical Center and CHIME board member. "Staff needs aren't likely to abate over the next couple years, as CIOs continue to push to achieve meaningful use targets and switch to ICD-10-compliant applications." 

Alan Kravitz, founder and CEO of healthcare IT consulting firm MedSys Group Consulting, agrees. If everything continues on its current path, he says, "It will most likely get worse before it gets better."

He explains the reasoning in terms of Economics 101  -  supply and demand. "If you've got the masses in need of a certified EMR going to the Epics, and Cerners and McKessons of the world, you've got too much product being sold, and if you've got too much product being sold at one time, just as if you were in an auto store trying to buy tires, and then 500 people came in to buy the same set of tires, well then there's going to be a problem putting the tires on the car."

Additional survey findings echo Kravitz' point, as more CIOs reported staff shortages this year across all health systems. Some 82 percent of CIOs at academic medical centers; 59 percent at community hospitals; 69 percent at hospital/clinic models, and 58 percent at multi-hospital systems all reported staff deficits.

Respondents also indicated their need for specialists capable of implementing and supporting clinical applications, such as electronic medical records (EMRs) and computerized provider order entry. Some 74 percent of respondents to the CHIME survey indicated they most need clinical software implementation and support staff. 

With these numbers only increasing, at the end of the day, Kravitz adds, "Something's gotta' give." Either the CIOs have to recognize that they're going to have to ask for the help, or the government needs to give them more room to breathe in terms of meaningful use. 

Despite the ominous numbers from the report, some CIOs are ahead of the game with meaningful use and are not currently witnessing the sweeping deficits occurring nationwide. 

George McCulloch, deputy CIO at Vanderbilt University Medical Center, for example, counts himself lucky. "We're really far down the road on a lot of technology components," he says. The Medical Center writes some of their own software and has had certified physician order entry and other advanced health IT systems for 10 years now. 

McCulloch says one solution for other struggling CIOs may be to hire experts outside the healthcare industry, particularly for nonapplication-based needs. "On the infrastructure side, we've certainly taken people outside the industry," says McCulloch. He explains that up to 50 percent of IT staff at Vanderbilt University Medical Center are not from healthcare backgrounds.  

Although McCulloch remains relatively unaffected by the staff deficit epidemic, he knows his group is the exception. 

Retention of IT staff is also a growing concern among CHIME member respondents. Some 85 percent indicated they were worried about retaining IT staff, compared with only 76 percent in 2010. 

McCulloch says current concerns about retention may reflect apprehension over the increasing number of IT projects, which include EMRs, ICD-10 planning, health information exchange initiatives and other efforts surrounding IT and hospital operations. "Retention is important because information systems need constant care and attention once they're implemented," he adds. "Clinical systems are complex, are regularly being updated, and new clinical staff must be trained to use them as well. Being able to retain IT staff familiar with an organization's systems is crucial for CIOs."

It's not all bad news, however, for healthcare CIOs, as findings point out. In this year's survey, fewer respondents (59 percent) are concerned their staffing challenges will negatively impact their organizations' chances to receive HITECH stimulus fund payments, compared to 70 percent in 2010.

Moreover, despite the ominous shortages across the board, survey findings also reveal some 71 percent of respondents reporting vacancy rates of less than 10 percent in their IT departments, suggesting that departments across the country are far from vacant. 

Survey respondents indicated that their strategies for dealing with shortages haven't changed significantly since 2010  -  the approach most often mentioned is hiring third-party consultants, although a slightly lower percentage of respondents said they were using consultants in 2012.

As a consultant, Kravitz recommends this and has seen staff numbers bounce back for healthcare CIOs. However, whether or an organization opts for consulting, or hires staff outside the industry, if meaningful use measures remain the same, it's still going to be difficult, he says. "There's not a great solution. A people shortage is a people shortage. You can't create people."