What's Holding Up Those Darned EMRs?

Posted by ED

<ed.note><This is an "ed-itorial" so don't yell at the MBP folks.</ed.note>

<ed.note><Update>: Alton Brantley, MD, PhD, at CCIGroup.org, sent me this very helpful clarification: Ed, The "Health Information Technician" job that you are picking up on is the job description for a person working in Health Information Management which is, today, responsible for handling and codifying paper information. See this. These persons are not informaticists. Informaticists are generally physicians, nurses, and other medical professionals who specialize in understanding medical care processes. They are generally funded at their primary capability level (doctor, nurse, etc).

In a follow up email he adds:

The field of medicine, just like any other discipline, has its own terms. The "Health Information Management" activity used to be known simply as "Medical Records" which was not easily confused with Information Technology or Systems.

There are, in fact, numerous programs to develop health informaticists, funded through the National Library of Medicine. That would be where you should start looking. Generally, one can also get masters degrees in (e.g.) nursing with a focus in information technology and management. The important point is that medical IT is not something one comes at functionally from the technology side. Systems analysts who work in health care settings, over time, learn the applied skills.

Health Care IT is by and large driven by the vendors in the field, as hospitals do not consider developing IT to be part of their core mission. (I've always thought this strange, because many companies such as FedEx are not not IT companies either, but they develop IT systems to drive their business).</Update></ed.note>

Where are the health informaticists necessary to build out the distributed, digital healthcare enterprise? The following is just another factor under the rubric of you get what you incent:

The National Science Foundation’s Federal Cyber Service
The National Science Foundation’s (NSF) Federal Cyber Service Scholarship For Service (SFS) is a unique program designed to increase and strengthen the cadre of federal information assurance professionals that protect the government's critical information infrastructure (NSF, DHS, OPMn NSA, Office of Management and Budget (OMB), Department of Treasury). This program provides scholarships that fully fund the typical costs that students pay for books, tuition, and room and board while attending an approved institution of higher learning. Additionally, participants receive stipends of up to $8,000 for undergraduate and $12,000 for graduate students. The scholarships are funded through grants awarded by the National Science Foundation NSF.

The National Institutes of Health Loan Repayment Programs
NIH Loan Repayment Programs are a vital component of our nation's efforts to attract health professionals to careers in clinical, pediatric, health disparities, or contraception and infertility research. In exchange for a two or three-year (for Intramural General Research) commitment to your research career, NIH will repay up to $35,000 per year of your qualified educational debt. In addition, the NIH will make corresponding Federal tax payments for credit to your Internal Revenue Service tax account at the rate of 39% of each loan repayment to cover your increased Federal taxes. The NIH may also reimburse any increased state or local taxes and/or additional increased Federal taxes (where the Federal tax payments were not sufficient to fully cover your increased Federal taxes) that you incur as a result of your LRP benefits.

Nationwide Health Information Network
So far as I know, Squat.

There is no fedgov educational funding or loan repayment or deferment to "convert" the general post dot com bust out of work IT worker into a health informaticist; and even if there were, they couldn't afford to work in the profession. Please see the following:

From http://www.tnhealthcareers.com/html/him.htm
Health Information Technician – $23,530*
*average median annual earnings

From http://www.usnews.com/usnews/biztech/best_careers_2007/careertable.htm
Clergy - $78,690
Higher Ed. Administr. - $109,557
Management Cnsltnt. - $96,245
Systems Analyst - $70,438

Add to this the pressures to outsource, offshore and down-salary. If you've heard differently, please let me know and I'll post the info here.