JUL 03, 2012Comment
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Health informatics jobs are on the rise, and all types of health care workers must have highly specialized digital fluency.

A recent report commissioned by Jobs for the Future found that job postings for health care informatics increased by 36 percent from 2007 to 2011, compared with a 9 percent growth in all health care postings, and 6 percent increase in all U.S. jobs.

This trend suggests an area of job growth not fully reflected in some labor data. Jobs for the Future, which is a national nonprofit that works to align education for low-income populations with high-demand careers, puts the findings of the report into context:

The U.S. Bureau of Labor Statistics (BLS) tracks just one type of health informatics position - medical records and health information technician - that accounts for only 60 percent of health informatics jobs. It ignores the growth in positions like supervisor and manager, auditor and compliance review staff, and clinical documentation and improvement specialists. At the same time, these positions have become more skilled, with entry-level jobs upgraded, lower-skilled positions shrinking, and greater clinical knowledge required for higher-level jobs.

The growing demand for highly skilled health informatics professionals reflects the fact that computerized technology is transforming the front lines of health care.

Medical informatics has a history that can be traced back to the 1950s, but only in the last decade or so has the Electronic Medical Record (EMR) become commonplace in community hospitals. As EMRs become standard practice, the technological foundation is in place to support a growing array of computerized systems and high-tech tools that "talk" to those systems. In addition to the informatics specialists who are needed to manage computerized systems, this transformation is affecting health care professionals across the board, in every specialty and at every level, who must master and maintain specialized digital skills in addition to their clinical skills.

For a real-world example of how quickly and dramatically computerized technology is changing the front lines of health care, consider Shawnee Mission Medical Center, a 504-bed hospital in Johnson County, Kansas, that serves the Kansas City metropolitan area. Shawnee Mission is big and busy, with nearly 700 staff physicians and more than 2,800 associates providing care to 20,000 inpatients and 200,000 outpatients each year.

The hospital implemented its EMR system in 2005, with steady additions and refinements over the next few years as the hospital laid the groundwork for the high-tech future. Now that future is here, with a tidal wave of new technologies. During the past year, Shawnee Mission has added and integrated a series of computerized systems and tools that are changing how doctors, nurses and other staff are tracking and maintaining clinical information.

Last August, the hospital made the switch from handwritten paper orders to Computerized Provider Order Entry (CPOE). All orders are now entered electronically, with the process supported by a best-practices module that assists doctors in creating an evidence-based, customized plan of care. Orders can be entered from anywhere with an Internet connection, and the system is supported by another tool that provides templates for progress notes.

Three months later, in November, Shawnee Mission began using Interdisciplinary Plan of Care (IPOC). Nurses use this system to develop a patient's plan of care, including all the specialists involved in that plan, such as dieticians and physical therapists. As with the CPOE system, nurses create a plan using a best-practices module and use the system to track progress against the plan and make adjustments.

In February, Medication Positive Patient Identification (mPPID) was added to the hospital's expanding technology toolbox. The rolling computer workstations that nurses take from bedside to bedside now include an mPPID barcode scanner. Medications are dispensed to nurses from a machine, based on the physician's orders. At the bedside, nurses scan the patient's armband and scan the barcode on the medication to verify it matches the medication and dose prescribed.

But wait, there's more. With all these systems in place, the hospital can upgrade to "smart" equipment that communicates real-time patient information to those systems. In March, all the hospital's IV pumps were replaced with next-generation smart IV pumps that are wirelessly connected to the server. Nurses choose IV drugs from the pump's library of drugs, and the pump helps calculate the flow rate. The pump constantly transmits data to the server, so that nurses can run a report at any time to see the progress of an IV.

In April, the hospital started using new 12-lead EKGs that transmit results to the server, providing another piece of real-time diagnostic data that can be viewed remotely. In addition to providing up-to-the-minute patient data, smart equipment like this enables sophisticated tracking and trending of data for internal reporting and regulatory purposes (which leads us right back to the big demand for health informatics specialists).

All these computerized systems and tools offer many advantages, including increased patient safety and more efficient communication between providers. But implementing all these high-tech tools at Shawnee Mission required extensive training and teamwork. For health care professionals who are digital immigrants (meaning they didn't grow up in the digital age), the integration of all these tools into their practice requires the cultivation of a robust set of digital skills, as well the ability and willingness to learn and adapt as technology evolves.

Today's health care workers must be trained not just to use today's computerized tools, but also to have sufficient digital fluency to integrate upgrades and new tools into their workflow. The time has come when everyone involved in patient care, at every level and in every department, must interact with technology every day. Even for digital natives who are joining the health care field, health technologies aren't something that can be can be learned haphazardly or by trial and error. These technologies require highly specialized, up-to-date digital fluency.

AMY SOUTHERLAND

Amy Southerland is a freelance writer based in Washington, DC. She specializes in writing about the nonprofit sector, with a focus on education, philanthropy, social justice and sustainability issues.