As a result of “The Affordable Care Act” and ensuing healthcare reform, we’ve all heard a lot about the push for increased mobility.  With the adoption of EMR’s we’ve also seen an increase in Healthcare IT, including the use of tablets and smart phones by doctors, mobile health applications are on the rise, and patient portals will soon be in full swing.  Data is moving around rapidly and with ease – available where it’s needed most, at the drop of a hat – not unlike the professionals who implement the technology in the first place.  Along with a changing data landscape is a changing talent landscape, evolving from lengthy, permanent, legacy employment to increased project work and short term consultant demand, with national scope.  The requirement for “on demand” resources dispatched to all parts of the country has created a new population in Healthcare IT.  These are the new nomads of IT, brought on by the rush to EMR implementation and training and the short term, yet intense, nature of that environment. Rather than hiring a full time staff person as part of the team, many providers and the integrators they engage are calling upon a group of implementation professionals who largely live out of their suitcases and are training doctors in North Carolina one month and coaching ambulatory nurses in Texas the next.  These are not small teams who are tackling these challenges; at times a “go live” team can require as many as 150 to 400 Healthcare IT consultants who are there for four to six weeks doing training, desk side, elbow to elbow support and troubleshooting and, once complete, they are on to the next implementation. Often they are specialists in Epic, Cerner, McKesson, or the many other EMR brands and they go where the projects are.  There are several reasons for this: shortage of qualified professionals, increased consultant specialization, and national adoption of Electronic Medical Records (EMRs).

Shortage of people – increased opportunity nationally, and increased demand, results in increased pay, driven by the urgency of the needs when they arise.  Clients are willing to pay more for top tier Healthcare IT talent, to get things done right and on time, and are willing to pay for travel to get the best people there.

A 2010 survey by CHIME found that 59% of respondents reported shortages on their I.T. staffs. Two years later, with focused attention on implementing EHRs at the nation’s hospitals, the 2012 CIO I.T. staffing survey found that 67% of respondents are experiencing shortages.

Increased demand for specialization – people trying harder to attract talent away from other facilities. The "War for Talent” is alive and well in Healthcare IT, and you are frequently seeing people who had been stable at one provider for multiple years suddenly, since the inception of the Affordable Care Act and its requirements, move from one position to another several times. An experienced Epic or Cerner certified person is highly sought after and well compensated for their experience. Providers are using creative methods of attracting top talent over and above the obvious, money; they are offering partial work from home arrangements and flexibility in hours.

Retention of I.T. staff is a growing concern; in 2012, 85% of respondents indicated they were worried about retaining I.T. staff, compared with 76% in 2010. Current concerns about retention may reflect apprehension over the increasing number of I.T. projects, which include EHRs, ICD-10 planning in advance of the eventual use of ICD-10 codes, HIE initiatives and other efforts that involve IT and impact hospital operations, according to CHIME.
In the 2013 HIMSS Workforce Survey 31% of the respondents stated they had delayed critical IT programs due to a  shortage of staff and 19% said they were considering doing so.

National systems – large national and regional provider organizations such as Kaiser Permanente, Tenet, and Catholic Health West require large scale implementations that take years and millions of dollars in investment along with very large numbers of highly skilled individuals. This causes a dramatic reduction in available and trained people for the remainder of the healthcare ecosystem.

The result of all this is a new category of Healthcare IT worker who has their bags packed, ready to go across the country at a moment’s notice to execute a go live, get the provider staff up to speed, and be back on a plane to another location. These new nomads may be coming to a hospital or health system near you and without their expertise we wouldn’t be making the progress we are in EMR adoption.