The healthcare CIO's hiring playbook

Who are you hiring, and what are you hiring them for?

The physician shortage has seen its fair share of news headlines. But physicians aren't the only healthcare workers in short supply.

As the health IT field expands and continues to innovate, so do the jobs and positions required to carry out those functions. The Bureau of Labor Statistics reports the job outlook for medical records and health information technicians will grow by 22 percent through 2022, which is double the 11 percent average job growth rate for all occupations. Additionally, more than 80 percent of healthcare providers hired full-time health IT employees in 2013, according to the 2013 HIMSS Analytics workforce survey, and that number is only expected to grow.

However, the labor supply isn't keeping up with the industry. A report from Burning Glass Technologies found job postings for health informatics positions stay open longer than the average job posting, 35 days versus 33 days, respectively. Higher-level health IT jobs, such as medical coding supervisors and health information managers and directors, stay open 10 to 11 days longer than the national average.

Here, three CIOs and a healthcare IT consultant discuss job growth in the information technology field, changing IT worker dynamics and how to hire the best candidate for IT job openings.

Shifting IT worker dynamics
Historically, IT jobs have centered around basic IT functions: implementing systems, informatics and tech support. As these offerings and processes become more engrained in the fabric of hospitals and health systems, they don't require the same level of manpower they once did.

"The areas where you're seeing a little bit of a fade [in IT positions] is the traditional IT jobs," says Bill Russell, senior vice president and CIO of Orange, Calif.-based St. Joseph Health. "You don't need as many people to run a cloud environment as you did in your traditional IT shop in the data center. You don't need to explain technology at workstations because we're designing [models] in such a way that we can run them without a device. You don't need as many feet running around, fixing TVs."

What the healthcare industry does need now are data scientists and data analysts, experts in data exchange, cybersecurity, business analytics, vendor-specific applications and patient engagement.

"There are some jobs that are fading away and some jobs [for which] we just can't find enough people," Mr. Russell says.

Individuals with vendor-specific application skills are also high in demand but low in supply, says Randy Davis, vice president of support services and CIO of CGH Medical Center in Sterling, Ill.

"It's the application-driven knowledge base that is the toughest to acquire," Mr. Davis says. "You can't go to your local community college and get your certificate on Cerner. They don't teach that."

The importance of personality
Even though the technical skills are in short supply, CIOs and IT hiring managers are more concerned with a candidate's personality and whether the candidate aligns with the organization's culture and mission.

That's not to say skills aren't important. A successful candidate balances adequate skills with a personality and vision that seam well with the organization, especially if an organization is in dire need for a certain skill set or a higher-level position to handle a specific issue. While skills are important, simply having them doesn't rule out the personality, says Linda Reed, RN, vice president of behavioral and integrative medicine and CIO of Morristown, N.J.-based Atlantic Health System.

At St. Joseph Health, Mr. Russell says they heavily evaluate a candidate's commitment and vision to hospital values.

"We make sure people connect with our mission and values up front," he says. "If we do, it ends up being a good fit. If we don't, it's just a train wreck waiting to happen."

Ms. Reed echoes Mr. Russell's statement and says successful candidates need to truly understand and internalize what the healthcare organization sets out to achieve.

"We're looking for people that understand this is a customer service position," Ms. Reed says. "We're not a technical company, we're a patient care company. We don't do technology for the sake of technology….We're aiming for the best and safest care for patients."

A candidate's attitude, Ms. Reed says, can make-or-break the hiring decision.

"Skills in a toxic person create a toxic environment," she says. "We can teach you the skills, but we can't teach you the personality."

Mitigating the talent gap
Just because workers are in short supply doesn't mean IT departments can stop operations until job vacancies are filled. A combination of proactive training and strong leadership are necessary for continuity.

Dan Garrett, principal and leader of PricewaterhouseCooper's Health Industries IT Practice, says many health organizations are developing their own training programs to make up for the shortage of workers and desired skills. "People are spending more on IT as a core competency and less on infrastructure," he says. "The CIOs are putting together mentor programs. They're taking advantage of some of the offerings vendors have around technology-specific training and encouraging people to continue to expand their knowledge of the industry and the key areas where technology will make a difference."

Such internal training programs can also ensure the IT department maintains what Mr. Davis calls "bench strength." If a department loses an employee, other members of the department should have the skills and wherewithal to fill in until the department finds the best replacement. "Within the department, having enough knowledge that crosses individuals to allow you [the time to search for and] deliberately find the person that is the best fit for your organization is so important," he says.

Much of this responsibility rests almost entirely on the shoulders of the CIO and manager of an IT department, Mr. Davis says. "The CIO and the manager of an IT department can't absolve themselves of the responsibility of completely understanding the skill sets that are required to make a job or a candidate successful," he says. "That's why [CIOs] get paid the money we get paid. You have to understand it. Once you clearly understand it, it's simply a matter of [if] are you able to wait for the candidate that hits the sweet spot."

Skills vs. training vs. experience
Discussions regarding internal training and searching for the right candidate also highlight questions of internal versus external hiring, both within an organization and within the healthcare industry as a whole.

Each approach has its advantages. "When investing in [internal] training, you get folks that already know your enterprise and your clients, and then they have a newly acquired skill," PwC's Mr. Garrett says. "When bringing folks from the outside, you can enrich your culture and bring in new blood and expertise."

Mr. Garrett says he typically recommends IT departments to give equal weight to internal training and external skills to both attract the best talent and retain top performers. Similarly, one characteristic doesn't outweigh the other, and each candidate's unique assets and skill sets should be assessed in terms of ability to impact business.

Mr. Russell of St. Joseph Health says his department largely tends to promote from within. "I firmly believe that we have a lot of untapped talent within our organization. We want to make sure that, before we start looking for additional talent outside, we're creating opportunities for those people that are internal who can step up," he says.

Mr. Russell, though, came to St. Joseph Health externally, both in terms of organization and the industry. He previously worked as a consultant in a number of industries. He says he was brought into healthcare for the very fact that he wasn't from healthcare.

"If you had to ask the CEO what she was looking for, she would say, 'I was looking for a new set of ideas, a new way of thinking than what I had for the past 20 to 30 years,'" Mr. Russell says, adding St. Joseph Health does recognize the value in introducing new thinking. "On the flip side, healthcare is very complex, and you can't just come in from the outside and start throwing things around."

However, some aspects of healthcare, such as the push for patient engagement, require skills that can fluidly move between industries. "The consumer in retail space is the same patient in the provider space and the same member in the payer space," says Mr. Garrett.

When making hiring decisions, Mr. Davis says CIOs have to determine the benefits of hiring for skills and experience versus investment in training.

"Every organization wants to be, and should be, respectful of internal staff's desire to be promoted within the organization he works for, but outside blood is many times good," he says. "Neither should override the other in considerations."

More articles on IT leadership:

The future of the healthcare CIO: Expanding roles, relationships and opportunities
10 reads for healthcare's executive women
Few business executives see CIOs as strategic partners, report finds

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