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2/16/2012
03:05 PM
Paul Cerrato
Paul Cerrato
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Do Health IT Hires Need A Clinical Background?

The debate on which qualifications an IT job candidate needs to work in a hospital or medical practice rages.

If you've kept up with the news in recent months, you're aware of the shortage of qualified IT professionals to fill positions in hospitals and medical practices. The U.S. Bureau of Labor Statistics predicts that jobs in health informatics will jump by 18% by 2016 and expects there will be shortage of about 50,000 health IT workers over the next five years.

Few people challenge those statistics, but what's upsetting job candidates is that many health IT managers only want people with a clinical background.

Essentially, the debate revolves around this issue: Is it easier to teach an IT generalist the clinical principles needed to work in a hospital or practice, or teach a clinician the general IT principles?

[ Is it time to re-engineer your Clinical Decision Support system? See 10 Innovative Clinical Decision Support Programs. ]

Juliet Daniel, MD, senior director of medical informatics for Community Health Systems, which is responsible for more than 130 hospitals in 29 states, thinks the latter. During a phone interview, Daniel said it's important for someone working in health IT to "understand what it's like to use an EHR" from an end user's perspective. "Healthcare and clinical workflow are just so important, and if you're an IT person and don't understand it, it's hard for you to be influential."

At the managerial level, a clinical background certainly has advantages, especially if you're in a liaison position, as Daniel is. She spends part of her time translating the IT department's capabilities and limitations to clinicians who want to tweak the IT tools so they improve patient care. A comparable position at a company in another industry might be business analyst.

But Daniel thinks the preference for clinical training should even extend, for example, to the IT staffers who set up a clinical database. Building electronic order sets for a CPOE or modifying an order to fit the hospital's drug formulary is best handled by someone who understands clinical workflow, in her opinion.

I'm sure many experienced generalists would question that point of view and, in fact, I recently spoke with the CIO of a major health system who takes just such a contrary view.

During a phone conversation with Larry Stofko, until recently the CIO of St Joseph's Health System in Southern California and now executive VP for its Innovation Institute, he explained the partnership that existed between himself and his clinical counterpart, CMIO Dr. Clyde Wesp. Although Stofko and his managers were responsible for IT systems and Wesp for the clinical application of that technology, several of their managers have moved back and forth between the two groups.

Someone on the generic IT side who had an affinity for physician relationships, for instance, might shift to the CMIO's group to work on IT projects directly related to patient care. A clinician doing clinical data quality and analysis might transfer to the IT organization to run a data warehouse. One caveat Stofko was quick to mention about hiring someone with no medical background: St. Joseph's runs an informal "week in the life of a clinician" program to give IT pros a better understanding of patient care.

So is it easier to teach an IT generalist the clinical principles needed to work in a hospital or practice setting, or the other way around? St Joseph's has proved you can move people in either direction, regardless of their background. The bottom line: If a job candidate has drive, a high IQ--and an affinity for healthcare--there are almost no limits on what he or she can accomplish.

Healthcare providers must collect all sorts of performance data to meet emerging standards. The new Pay For Performance issue of InformationWeek Healthcare delves into the huge task ahead. Also in this issue: Why personal health records have flopped. (Free registration required.)

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JonathonT
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JonathonT,
User Rank: Apprentice
11/29/2012 | 4:53:53 AM
re: Do Health IT Hires Need A Clinical Background?
I'd recommend that you look into CPT codes, ICD-9 codes, and ICD-10 codes, and the differences between them. You don't need to be an expert, but it might help if you are conversant and can mention a few codes from memory and what they reference. That might catch the interviewer off-guard just enough to impress them. Typically, the codes are among the very few things that will be standard across different medical facilities, making this the most "portable" suggestion.

I'd also recommend that you look into the workflows and features of some specific medical workflow software, such as Intersystems Cache. See if you can find some walkthroughs or video how-tos for the software. Look for workflow patterns. Naturally, you'll want to be as conversant as possible on your core competencies, but expanding into their realm will help show them that you are willing to grow for them and address their needs.

I would also recommend learning about encryption software and other ways of protecting privacy data, in the name of HIPAA compliance. Especially focus on data protection on tablets and other portable electronics. Most doctors are chomping at the bit to use their iPads at work for convenience, and most IT shops are dreading the additional support. Data security and portable electronics haven't completely intersected yet, so learning more about both will make you more valuable. Patient Record protection and compliance are always popular subjects in Healthcare because they can directly affect the bottom line.

--- Jonathon
DJonesIT
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DJonesIT,
User Rank: Apprentice
11/28/2012 | 10:15:32 PM
re: Do Health IT Hires Need A Clinical Background?
Gentlemen and ladies, as a neophyte and a latecomer to this conversation I would not want to pose any position but to ask a question. What are the steps for an IT person like myself to make the transistion to Healthcare I.T. I have a very good understanding of the EHR and CPOE processes and the interworking of Healthcare, but I do understand that my knowledge is minimal as far as the clinical workflow of the Healtcare industry. How would I go about obtaining knowledge and/or skills in this industry ( i.e education/classes/resources/tools etc). I have a Bachelor's in Computers Systems and would like to further my education in the Healthcare I.T. industry. Please advise. Thank you in advance.
jaysimmons
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jaysimmons,
User Rank: Apprentice
9/8/2012 | 10:00:36 PM
re: Do Health IT Hires Need A Clinical Background?
I have never fully understood why Healthcare thinks it's so radically different from any other industries. Good IT professionals have consistently proved they're agile enough to move between industries. IT professionals are in IT because they love technology and it shows in the work they do. When these IT people take the time to understand healthcare, they tend to be absolute dynamite.
Jay Simmons
Information Week Contributor
jazzy99
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jazzy99,
User Rank: Apprentice
3/20/2012 | 2:52:46 AM
re: Do Health IT Hires Need A Clinical Background?
I think it is absolutely critical to have a core group of people that have not only clinical and organizational knowledge but also the technical knowledge. There are numerous examples in my career of critical errors being avoided because I could articulate what the clinicians wanted and needed to the IT staff and also engage the clinical staff at a different level than any IT staff member could that did not have a clinical background.
AustinIT
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AustinIT,
User Rank: Apprentice
2/20/2012 | 5:20:57 PM
re: Do Health IT Hires Need A Clinical Background?
Sorry cxf but I disagree with ya. First of all, healthcare is now going through what the manufacturing industry went thru during the build out of the Internet from the 90's forward... in that they networked their information silos, essentially created the digital age, and modernized their supply chains. Healthcare is now undergoing that same sort of renaissance. They are migrating from using paper charts for record keeping. And, they are networking their high tech silos so that information can be collected, distributed, and analyzed at a higher level.

Juliet is right in pointing out that the applications being used in the medical field DO require a significant amount of clinical knowledge in order to support them from an IT perspective. I've been there done that so I agree with her.
cxf
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cxf,
User Rank: Apprentice
2/20/2012 | 2:15:56 PM
re: Do Health IT Hires Need A Clinical Background?
Juliet Daniel is off her rocker. This is the same industry that's saying they'll be short qualified nurses as well. Look, if the healthcare industry is 50k people short of qualified IT staff, then that's on them. There are no areas in healthcare that aren't under extreme operational duress today. Healthcare finance has been an issues for three decades, but again, it's an issue that resides squarely with healthcare. Healthcare in general is in shambles and the more Juliet Daniel boasts about the kind of experience IT staffers need, the more she makes the case that healthcare is in need of people that don't have medical experience.
Chris Spera
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Chris Spera,
User Rank: Apprentice
2/20/2012 | 1:46:31 PM
re: Do Health IT Hires Need A Clinical Background?
I have worked in an IT shop in a hospital as Integration Test Manager for EHR implementation for a MAJOR hospital in Chicago. I can say with 100% accuracy two specific things about IT and hospitals.

1. You do NOT need to have a clinical background to work IT in a hosptial
2. If you don't have a clinical background, you need to at least be willing to learn what the EHR end user ie experiencing, or you won't be effective in supporting what they do and what they need.
3. If you don't have a clinical background, you need to know how to communicate and talk with clinical professionals. Its different than dealing with other your regular lot of IT user. Medical professionals are not IT savvy.

This is a tough nut to crack, however, as there are very few IT superstars that are also clinical superstars.
Mike_Acker
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Mike_Acker,
User Rank: Apprentice
2/18/2012 | 2:03:31 PM
re: Do Health IT Hires Need A Clinical Background?
Read carefully: If you are an IT person and you want to work in a medical facility understand clearly: The Medical people run the place.
JonathonT
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JonathonT,
User Rank: Apprentice
2/18/2012 | 1:28:42 AM
re: Do Health IT Hires Need A Clinical Background?
When I worked IT in a healthcare environment, it seemed to be more about the medical personnel not wanting to go into any great depth when they described IT tools that they wanted. If that carries over to even a fraction of the medical facilities that want IT personnel with clinical backgrounds, it seems to be a bit of laziness. After all, we all want to be able to focus on our core discipline (in the medical personnel's case, medicine), and not be stuck in meetings, drilling down to fine detail on a needed report or hardware configuration.

With that said, I had known a few doctors who delved into IT and built their own tools, so I think there are some rare people who can fulfill this requirement. However, those people are rare and can be high-earners, enjoying an even greater number of roles they can choose as their core discipline, depending on compensation and stress factors.

Bottom line: I think clinical IT needs to have two types of positions available: regular IT workers and IT/Clinical hybrid superstars. Naturally, the vanilla IT worker will outnumber the hybrid IT worker. Everybody wants superstars, but that can be costly to fill your entire department with them, and nearly impossible to find many hybrid workers in a specific area, when the vanilla workers that are lining up for interviews can handle the "normal" IT stuff.

--- Jonathon

cloudfilesecurity.biz
AustinIT
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AustinIT,
User Rank: Apprentice
2/17/2012 | 8:28:31 PM
re: Do Health IT Hires Need A Clinical Background?
The issue is more nuanced than described by the author and the comments thus far.

The question is: What part of IT would you expect a clinician who is crossing over to handle? And vice-versa for IT crossing over?

It is unlikely that there is enough talent available such that they can handle both clinical and IT at a deep level within both fields. I would use a pure IT person to deal with infrastructure and probably train a clinician to handle light IT on the applications and medical interfaces. I myself come from pure IT and have trained on the clinical aspects needed to support my clients. From my perspective, it would be easier to cross train someone on the clinical side on what they need to do or to communicate what needs to be done.
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