D'Arcy Gue

Yes…It’s Time to Re-Assess Your Healthcare IT Staffing Needs

September 23, 2015

Healthcare IT, IT Project Management 7 Minute Read

Healthcare IT staffing shortages have become a huge challenge for hospitals. According to the U.S. Bureau of Labor Statistics, healthcare IT jobs will increase 15% to 37% by 2020 — much higher growth than in other types of positions.  It has become very difficult to recruit skilled IT personnel, and as pressure continues across the industry to fill positions for critical projects, hospitals’ most skilled team members are often being recruited away by other hospitals and industries.

This extreme job expansion is a direct result of the healthcare industry’s ever-increasing use of electronic health records, data analytics and new technologies. However, before reacting to new projects by simply adding new IT expertise, your hospital should consider performing an assessment of its current overall IT staffing needs, using a “blank slate” approach to fully analyze what may be a very different IT environment than just a year or two ago. You may find labor solutions that have never occurred to you! Read on for our recommended assessment approach — one that could result in major labor cost savings.

Talented, experienced IT analysts and managers are in high demand across healthcare, and also most industries, especially Wall Street and technology firms (think Google, Amazon and others.) Competition for the best and brightest is intense. HIMSS data shows that smaller healthcare organizations find it especially difficult to compete, offering lower average salaries than larger healthcare organizations. In 2013, organizations with less than $5 million in revenue paid average salaries of $106,216 for more senior IT positions; organizations with revenue of $1 billion or more were paying $143,715. Salaries are continuing to increase.

Before spending new dollars, today may be an opportunity for a major — or minor –cost-effective reorganization, which could include cross-functional integration, labor utilization adjustments, elimination of no longer needed jobs, re-training, promotions and / or ?  Whatever staffing plan a hospital may elect, it should be based on an analysis of today’s overall IT environment, needs, and projections — not sticking band aids on one or more immediate problems.

How Much IT Support Does Your Hospital Need?

Unfortunately, little has been published to provide clear benchmarks to guide CIOs. William Hersh, MD, the Chair of the Department of Medical Informatics & Clinical Epidemiology at Oregon Health & Science University studies healthcare IT staffing requirements. He reports on a few international studies that suggest that staffing ratios of one IT FTE per 50 – 60 non-IT FTEs are appropriate. He also reports on a 2008 Gartner Group study and his own research, which suggest that hospitals need .20 FTEs per patient bed to function effectively with fully implemented electronic medical records. It can be argued that these metrics may not be appropriate in today’s highly wired hospitals, but they do serve as limited benchmarks.

Unfortunately, it’s not easy to apply even these limited benchmarks to the modern healthcare organization. There are huge variations in appropriate staffing levels, based on the complexity of the technologies implemented, the stability of the systems, and ongoing project demands. To determine an estimate of resource requirements, each facility has to perform its own staffing analysis.  Here’s how to get started:

healthcare IT staffing

Assess Healthcare IT Staffing Needs

Begin with a baseline estimation of your operating resources. These are resources dedicated to operation and maintenance of your IT systems. This list might include personnel performing the following functions: Service Desk, Desktop Support, Networking, Data Center, Security, and Database maintenance. It’s also important to consider the myriad of small tasks that crop up such as adding new users, adding physicians to the billing system, quarterly edits to the coding rules, and so forth. These are all functions that would cause the operations to stop, all at once, or more slowly, as various components fail, need adjustment or become out of date. If you’re not sure about the resources required to maintain your applications, your vendors should be able to provide some baseline numbers to begin your projections.

Be especially careful to include all of your IT resources that work outside their normal scope of activities. It’s common, for example, for analysts also to provide additional coverage to the Service Desk in peak hours, and even more common for users to reach out to favorite analysts outside the Service Desk system, and get “off the books” service.  Our Service Desk Costing Report describes this issue and provides solutions to address the problem.

Next, estimate your project resource requirements. This is the number of people you need to do the projects you have planned. This is an area where there’s some flexibility.  Hospitals in today’s environment cannot afford the resources to do every project they want simultaneously. Many hospitals (and not all of them small) are stretched just to cover the bare minimum – regulatory requirements like ICD-10 or Meaningful Use / MIPS and systems that must be replaced because they are end of life.

Also consider the strategic domain of the CIO and the IT leadership committee – and the challenge of choosing which projects add the most value to the department, organizational goals, and the bottom line. Again, your software vendors can be of great help in providing estimates on project hours required to perform particular installations or upgrades.

Six Ways to Smooth Out Staffing Estimations

1. Every new project should include an assessment of changes in the baseline support resource requirements. Major new systems, such as a new EMR, can require significant support, including a peak in support calls after go-live. Even smaller projects can have an effect. Although you probably won’t add a new resource because a new project adds .10 FTEs to your baseline, those tenths of a person add up over time and need to be accounted for.  Otherwise your staffing levels will drift from operational reality, and performance issues will arise.

2. Optimization efforts help. Many organizations discover that their systems do not work as smoothly as one would expect of modern IT solutions. Whether this is a result of install configuration issues, user workflow, interface problems, or any other reason, many IT shops spend so much time on completing day-to-day operations that they don’t have the time to improve systems to resolve their issues. Systems and process optimization is the low hanging fruit when it comes to improving operations, decreasing operational staffing needs, and improving financial return on system investments. In the long run, optimization successes may reduce IT support costs.

3. Many resources are not interchangeable. Every IT executive understands that a database administrator and a nurse informaticist cannot change places.  Nevertheless, it’s extremely common for IT departments to have one or two key resources that need to be involved in almost every project, plus coordinate a significant number of operational responsibilities. Great care must be taken to avoid overworking these individuals; otherwise, overall department and systems performance will suffer.

4. Compare existing process maps to actual work processes. If you don’t have the former, you have a challenge — but it is one you should take on, at least using appropriate sampling. There may be many opportunities for streamlining that can be identified.

5. Compare current work practices to industry best practices, and document inefficiencies. Again, it is possible that a thorough comparison is impractical…after all, your IT department is having staffing problems that may make this difficult! Nevertheless, some reality checking in key areas, against best practices, could be eye-opening and provide a big return on your time investment.

6. Conduct workload assessments. If yours is like many IT departments, some employees are engaged in non-value-added work that could be permanently removed from their daily activities. Understanding when and where these activities are conducted, and eliminating them, could help free up time to take on new responsibilities.

Obviously, a thorough staffing assessment is more than a 1-2-3 endeavor. If you haven’t performed an IT department staffing assessment in the last two or three years, it’s probably time — especially if you are pulling together labor estimates for upcoming projects. The results could point to staffing gaps that  may change shape or magnitude from your present perspective — and be manageable with fewer calls to  $20,000+ per pop recruiters. Our bet is that you can lower your staffing budget!

If you need help, contact us. With our focus on business value, we can help you design a staffing plan and project portfolio that maximizes the use and value of your staff.


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