Workforce training and allocation for modernization of HIT

The most recent issue of Hospital Pharmacy (Vol 45, No 1, 2010) has an article by Fox and Felkey that discusses the demand that the ARRA will place on the current and future HIT workforce. According to the article “the workforce to shepherd implementation, training, and support [for the modernization of heath care delivery] simply does not exist today; consequently, we could face a situation where health systems and clinics are financially ready to adopt HIT but do not have the personnel to carry it out.” I believe this is absolutely true and have alluded to it in the past (here and here).

More importantly, the shortage of HIT personnel will be further exacerbated by the need for clinicians to enter the technology field. The article supports this thinking by saying that “some experts have suggested that clinically-trained individuals are more suited to the design, selection, implementation, and management of HIT because they have a fundamental understanding of the processes of health care delivery. Alternatively, individuals trained in IT are more technically inclined, but lack firsthand experience with health care delivery systems” Another truism and a problem that is certainly not unique to the HIT field. Companies like Microsoft, Google, GE, Siemens, etc hire pharmacists and other clinician for their unique experience in the health care industry.

Clinical informaticians typically fall into a job because of interest in the technical side of a discipline like pharmacy, medicine or nursing. While the clinical skills and ability to solve problems in a abstract and/or logical fashion are there, many clinicians lack the experience of dealing with the technical aspects of the job.

Personal experience has shown me that no project is perfect and each decision tree during various stages of the process can result in a host of different outcomes. I’ve been involved in a couple of million dollar projects since taking my current position, and there are things that I would have done differently during the implementation phase of those projects had I been able to look into the future; not currently possible. But now that I have that experience I can look to the past for answers to similar issues on future projects; possible.

What’s the solution? That’s the million dollar question, literally. Classroom instruction cannot replace the experience of actually doing something, but it can provide a foundation on which decisions can be built. The same is true for all education. My pharmacy education hasn’t made me a pharmacist; my license to practice and years of experience have. However, without the foundation of the pharmacy education I wouldn’t have been able to become a pharmacist. While the clinical informaticist cannot be expected to learn how to implement specific pharmacy automation and technology through classroom instruction, they can be taught to understand workflow design, basic database structure and design, etc. They can also be introduced to current automation and technology trends and how they make pharmacy practice smarter, more efficient and safer. Of course not all pharmacists need this knowledge, so perhaps it's time to consider a formalized career path following the PharmD degree. Just a thought.