D'Arcy Gue

A Perfect Storm in Healthcare IT: The Problem of Unmet Staffing Needs

October 5, 2018

Healthcare IT, IT Outsourcing, IT Project Management, IT Service Desk 8 Minute Read

The healthcare IT job outlook is currently a maze of contradictions. Some good news: healthcare is driving jobs growth more than most industry sectors, at the rate of 35 thousand+ jobs per month so far in 2018. Many of these are healthcare IT jobs. Bad news: It is increasingly difficult to find high quality IT talent with expert levels of healthcare knowledge. In addition, financial pressures are complicating the problem as 44% of hospital leaders try to lower labor expenses to reduce operating losses. Also, hospitals continue to be wary of adding to their payrolls in our uncertain political climate. It’s a new perfect storm: healthcare IT labor supply is not keeping up with demand, hospitals can’t afford to pay for new labor to meet the demand, and government is providing more questions than answers. Nevertheless, hospital IT needs must be met, and prudent yet aggressive staffing solutions exist.

IT staffing shortages remain a major challenge for hospitals for all the reasons above and more, even when new hires or replacements are authorized. Challenges include keeping up with today’s lightning advancements in healthcare-related technology, in which required talent is rare. The non-stop invasion of cybercriminals who threaten our patients’ and employees’ information requires highly sophisticated IT security expertise. Data analysts expert in big data technologies are needed to aggregate data from different sources to provide new insights to physicians and enable needed population health management. And, hospitals’ most skilled IT professionals are being recruited away by other hospitals and industries. Meantime, our 77 million baby boomers are deluging our healthcare providers.

How can hospitals successfully overcome this whammy of challenges, avoid a degradation of IT-based services and actually meet their IT-related goals and the expectations of their patient communities?

Here’s a strategic IT planning overview that may be helpful.

  • First, a complete staffing analysis is in order — an assessment of your current overall IT staffing needs, using a “blank slate” hardball approach that ignores assumptions under which your IT department may have traditionally operated.
    • If you really want to make your IT staff the best it can be in our current healthcare environment, look hard at typical cultural prejudices, e.g. allowances for staff popularity, personal / family situations, salary raise expectations, even length of service — unless you can salvage these people with education and targeted mentoring.
    • Determine, based on your hospital’s healthcare objectives and your-IT related gaps, what skills you need and don’t have.
    • Based on your analysis, determine if a major or minor IT reorganization is needed. This could include a cost-effective combination of cross-functional integration, labor utilization adjustments, elimination of no longer needed jobs, re-training, temporary reliance on specialized external expertise, and hiring new staff only if absolutely essential.  Whatever IT organizational plan a hospital may elect, instead of focusing on band-aids for immediate problems, it should be based on analyzing its overall IT environment today in relation to existing and needed technologies, organizational objectives, and financial projections.
  • Steps in assessing IT staffing needs
    • Begin with a baseline analysis of your operating resources. This list might include people performing the following everyday functions: Service Desk, Desktop Support, Networking, Data Center, Security, Application Support and Database maintenance. Don’t forget 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, reporting and so forth.
    • Consider the level of expertise needed for planned IT initiatives or issues, such as implementations of new systems, improved security, data analytics projects, and population health commitments.
    • Consider ongoing IT operations management needs. Ignoring any IT functions could disrupt operations, all at once or more slowly as various components fail, need adjustment, fall prey to criminal attack or become out of date. If you’re not sure of the resources needed to maintain your applications, your vendors should be able to provide baseline numbers to begin your projections. Be especially careful to consider all IT staffers that may work outside their normal scope of responsibility. It’s common, for example, for analysts also to provide additional coverage to the Service Desk in peak hours, and for users to reach out to favorite analysts outside Service Desk, and get “off the books” service.  Our Service Desk Costing Guide describes this issue and offers solutions to address the problem.
    • 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.
    • Interview, interview, interview! If the IT staff’s buy-in and input are not included in the assessment process, it is doomed. Transparent communications and integration of the whole staff in the effort will be the key to success in your analysis and planning. Secretive conversations or requests for unusual reports may very well sabotage this project. Chances are that the frontline staff will have information and suggestions that will have a strong impact on the validity and workability of your final analysis and plan. A plus: if you include your staff in the assessment, the distribution of voluntary input by others will ease your pain
    • Every new project should include an assessment of baseline support resource requirements. Major new systems such as a new EHR can require significant support, including a peak in support calls after go-live. Even smaller projects can have an effect on user needs. 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 away from operational reality, and performance issues will arise.
    • Systems optimization efforts must be a factor. Most organizations discover that their systems do not work as smoothly as promised by vendors. 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 remediate post-go-live systems 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.
    • Many staff resources are not interchangeable. Every IT executive understands that a database administrator and a nurse informaticist cannot change places.  But it’s common for IT departments to have one or two key staffers 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.
    • 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.
    • 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 is likely to be eye-opening and provide a big return on your time investment.
  • Next, estimate your project resource requirements and create a plan: the number and qualifications of people you really need to do your needed management, maintenance and projects. You have some flexibility: you don’t necessarily require resources to do every desired project simultaneously. On the other hand, risks of emergencies must be considered, e.g. security incidents that may require immediate remediation.
  • Special note: today’s CIO must have a respected, strategic position within the hospital’s leadership team in order to contribute top shelf technological knowledge that informs the institution’s IT-related short- and long-term planning and decision-making. The days of IT Directors who simply translate organizational directives into technology solutions are over. If you are a CIO, make sure you are in the strategic executive mix!
  • Where planned projects or non-standard needs are anticipated, consider seeking out external specialized experts who can provide or guide needed solutions temporarily. If you go this route, you can negotiate pricing to avoid budget overload and include a contract proviso that your outsourcer will train in-house staff to pick up the slack when he or she leaves.

If you haven’t performed a “hard ball” IT department staffing assessment in the last two years, it’s time — especially if you are readying for upcoming projects or your hospital risks financial losses if patient revenues decrease. The results could enable reallocation and retraining of staff and be quite manageable without calls to  $20,000+ per pop recruiters. Our bet is that you can lower your staffing budget and create an IT department that shines — but only with diligent and forward-thinking homework.


If you need help, contact us. With our successful 25-year focus on hospital healthcare quality through consulting and full and selective IT outsourcing,  we can help you design project and staffing plans that maximize the performance and value of your IT department. We also provide specialized senior support for new systems projects.


Related Posts