Tech worker shortage could hinder path to meaningful use

A shortage of health information technology workers could affect progress toward meeting the government's "meaningful use" requirements in electronic medical record systems for some hospitals and physician practices.

A survey by the College of Healthcare Information Management Executives found that more than 60% of hospital IT executives believe tech staffing shortages, which some estimate to be a shortfall of 50,000 qualified IT professionals, will definitely or possibly affect their chances to achieve meaningful use. Meaningful use is a set of criteria established by the Dept. of Health and Human Services that physicians and practices must meet to receive incentive payments of as much as $44,000 over five years from Medicare, or nearly $64,000 over six years from Medicaid.

While the survey of 182 CHIME members conducted online in September included only hospital executives, some say the shortage also could affect physician practices -- particularly those buying and installing new EMR systems.

CHIME President and CEO Richard Correll said the staffing shortages create two hurdles. One is obtaining certification for systems already in place. The other is having the staff to handle new implementations or upgrades to existing systems.

Larger hospitals had the highest percentage of staff openings and community hospitals were more likely to be fully staffed, according to the CHIME survey. The authors said the larger hospitals are at a disadvantage because they tend to be in urban areas with a more competitive environment.

Derek Kosiorek, a health IT consultant for the MGMA Health Care Consulting Group, said the way the IT staffing shortage affects practices depends on whether the practice already has an EMR and IT help -- contracted workers or in-house IT staff.

"If you have sufficient IT staff, then meaningful use and the software upgrades that go along with it should not affect your operations," Kosiorek said.

He said he is afraid people place too much weight on IT staff. "Achieving meaningful use is not reliant on technology. It shouldn't be reliant on technology. This is how you use a system that has already been approved for use."

Practices that have not yet adopted an EMR system, however, might run into problems with vendors who become overtaxed from demand caused by meaningful use requirements, he said.

Kosiorek said vendor contracts generally have payment schedules tied to implementation milestones. To protect themselves and perhaps ensure that deadlines are met, practices can turn those implementation schedules into conditions of payment. If a practice buys a system not yet certified, it should place deadlines for certification into the contract, he said.

Kosiorek doesn't expect system certification to cause major delays, though. Just three weeks after the Office of the National Coordinator for Health Information Technology named the first two companies authorized to test and certify EMR systems, more than 30 systems received certification. The CHIME survey was taken before the completion of those certifications was announced in September.

A third certifier has been named, and the ONC now has a website of certified health IT EMR systems (link).

The ONC has expressed concern that an IT staff shortage could negatively affect the ability of regional extension centers to help small practices. RECs were created as a resource for small practices that need IT professionals to walk them through the process of choosing and implementing a system. The ONC has implemented four work force development initiatives to address the shortage.