Literature Review: Building Health Information Technology Workforce
Introduction
Health information technology is an aspect of healthcare that involves the exchange of health data and information via an electronic platform or in an electronic environment. In its broadest form, health information technology encompasses the technology that is used for various operations management, administrative and even direct clinical functions in medical institutions. One of the most recognizable elements of health information technology is the electronic health records commonly abbreviated as EHR. An electronic health record refers to a record of a patient’s health information that includes medications, immunization, radiology reports, laboratory data, patient demographics, vital signs amongst others. These records are generated and stored on an electronic platform, therefore ,allowing easy exchange of information between various health institutions or individual physicians where the patient may be seeking medical help. In line with the research questions stated earlier, a comprehensive literature review of published data on the topic at hand was necessary. The aim of the literature review is to provide preliminary answers to some for the research questions stated. In addition, the literature, will come in handy in the conduction of the research itself as it will help to answer some of the persistent questions about the research topic. Health Information Technology is an area of heath that has been the center of lot research as scholars try to demystify its credentials as well as it applicability and relevance in the health sector. The sources to be reviewed were selected after a comprehensive search process of several renowned online databases and libraries. These databases include EBSCO, JSTOR, PROQUEST, CINAHL, Purdue Online Library amongst others. Each source was careful analyzed for its relevance to the research topic. In addition, to maintain the validity of the research and to ensure that the data collected was accurate and not dubious, only peer reviewed articles were selected. Articles from unproven and unreviewed authors and researchers were immediately disqualified. The articles selected were comprehensively for their content in relation to the research topic. Special attention was particularly given to the articles that involved primary research. Here, research design as well as the methods utilized in this primary research was carefully analyzed.
In recent years, healthcare industries across the world have invested significantly into health information technology in an effort to acquire the highest brand of clinical technology that will provide the best tools to efficiently and effectively treat and heal patients (Girosi et al, 2005). However, the incorporation of IT into health is a relatively new feature and is, in fact, in its infant stages. Consequently, the healthcare industry relatively lags behind other industry sectors such as banking and logistics when it comes to incorporation of this into their core activities. Consequently, many governments across the world have enacted several reforms in the healthcare sector that advocate for the incorporation of technology into the health sector (Girosi et al, 2005).
Perhaps, the best place to commence on this literature review is with exploration of the status of HIT adoption in the world. In “The use of health technology in seven nations” (2008), the authors, Jha, Doolan, Grandt, Scott and Bates explore the initiation, execution and the performance of health technology in several nations across the world. The authors of this article sought to explore how health technology has been adopted in several nations and make comparisons. The researchers sought to establish the various elements of health in these countries where information technology has been successfully adopted. The countries being explored were mainly industrialized nations where it was naturally expected that health technology was a significant component or element of their healthcare structure. The countries that the authors looked at were the United States (US), Canada, Germany, the United Kingdom, the Netherlands, Australia and New Zealand. The objective of the research conducted by the authors of this article was to assess the adoption and use of HIT in these countries. The research particularly concentrated the rate of health information technology use in hospital settings as well as ambulatory care. In terms of research design, the researchers’ utilized combination of both literature reviews as well interviews with various experts and individual nations to determine the use and adoption of key health information technologies.
This is indeed one of the most outstanding things about this research article. The authors did not just conduct primary research but also supported this primary research with already documented research data. Therefore, we can be rest assured that the information that they got is quite accurate. The results of this research indicated that four nations out of the seven examined had an almost universal usage of electronic health records among the countries’ general practitioners. It was also found that the use of electronic health technology in some countries such the Canada; ambulatory care was less than that in hospital settings (Jha et al, 2008).
However, the single most important outcome of this research was that although these countries had indeed achieved high HIT adoption levels, there is still a lot that needs to be done.
Health information technology has the capability as well as the ability to improve the efficiency, the quality and the safety of health care (Buntin et al, 2011). The diffusion of heath information technology is relatively low but as mentioned earlier, more and more investments are being pumped into this sector. The main drivers of IT investment are the promises of efficiency and quality gains. The barriers that are however plaguing the full adoption of IT are the complexity and the costs of implanting the information technology. Implementation of IT is usually a very complex process that often necessitates some significant cultural and work process changes. However, when fully implemented, it accrues to several benefits with one of them being efficient savings. These efficient savings are realized when IT is used in healthcare to similar or functions using very little resources. If HIT is fully adopted, there will be massive savings, both in outpatient and inpatient care that could total up to about 77 billion dollars annually (Buntin et al, 2011). The largest savings will mainly emanate from a reduction in hospital stay, (which will result from increased safety as well as better coordination and schedule) decreased administrative time for nurses as well as more efficient and effective drug utilization (Buntin et al, 2011).
The other benefit is increased health safety and reduction of potentiality for errors (Girosi, et al, 2005). Health information technology tools will help to reduce unintentional harm that may done to patients because of medical treatment. This is because the IT equipment can for instance warn a doctor about a dangerous outcome resulting from the interaction of different drugs.
Current research indicates that is currently a shortage of professional when it comes to the health information technology sector. It has been found that although any health institutions are willing to adopt health technology, one persistent problem has been the lack of adequate professionals in the sector (Bollinger, 2013). A study conducted by Hersh and Williamson (2007) revealed that current programs in medical schools have not incorporated information technology into their curriculum. Most of them emphasize on pure medicine and as a result, most of the students who graduate are not technology savvy and cannot help in the implementation of healthcare technology, in the health sector. In addition, the lack of professionals in Healthcare Information Technology can be attributed to poor efforts by healthcare authorities to encourage people to pursue Heath Informatics as a professional discipline. The same study by Hersh and Williamson (2007) reveals that a majority of people do not even know that Health Informatics exists as a course. In addition, the discipline is often seen as being ambiguous given that it incorporates two fields into one, which is information technology and health. Most people prefer to concentrate on one career field which is either heath or information technology. Very many people are unwilling to combine the two disciplines that compromise health informatics. As a result, this has resulted into a situation where very few professionals exist in the field of Health Information Technology. This situation has led to a relative slowdown in the implementation of health information technology in health institutions (Hersh and Williamson, 2007). Health institutions do not see any need of purchasing costly health information technology equipment only for them to be wasted because there are no adequate personnel to oversee their implementation or even to see a smooth running of things. The trickiest part particularly comes in the conversion of old paper records into digital or electronic records for example. It is an extremely strenuous activity and without the expertise of health information, technology professional, it may fail to be actualized. Hersh and Williamson at the end of their study states that if health information technology is to be fully adopted across health institutions, then there must be more professionals who can oversee a smooth transition into healthcare that has its foundation in information technology (Hersh and Williamson, 2007).
Several studies have been conducted on how a workforce of Health Information technology professionals can be built. According to Hersh (2010), one of the key ingredients for the effective implementation of health information technology is the presence of skilled professionals. Professionals do not necessarily mean a new brand of individuals with expertise in health information technology who have been gloomed in college. Individuals existing within the current health care workforce can also be taught to be experts in health information technology. Hersh and Right contend that in America, the number of HIT professionals is wanting. The two gathered data from the HIMSS Analytics Database and extrapolated the data to come to a conclusion that in the United States, the number of IT professionals is only about 108, 390. This is a relatively low figure for a country that has population of about 300 million people.
Another researcher, Blanchard (2011) lays down several strategies of how to build a workforce of professionals of health information technology. First, the government should invest massively in health information technology education. Medical schools should incorporate aspects of health information technology into their curriculum (Blanchard, 2011). In addition, some of the technological equipment should be present in the schools so that students can become exposed to the, interact with them and learn how to use them. This will ensure that once these students graduate, they fully wary of technology and van be easily assimilated into the HIT sector without requiring much training (Blanchard, 2011).
In addition, the current medical workforce also needs to be trained on matters of health information technology (Bollinger et al, 2013). Health institutions cannot just rely on new blood to oversee their efforts to incorporate HIT into their activities. The health institutions should provide various training and development sessions for their current work force where they can be trained on technological aspects. In time, the existing workforce might even prove to be better in thee terms of combining health and IT because of the experience that they gained on health matters over the years (Bollinger et al, 2013). Studies show that this group is ever willing to learn. This will is further motivated by the fact that the existing workforce may view their jobs to be in danger because of the batch of fresh graduates who possess a great deal of IT knowledge and capabilities. They may wish to give themselves job security by learning about health information technology (Bollinger et al, 2013).
Most of the studies on Health Information technology have tended to focus on the applicability of health information technology on a wide scale. The studies have tried to establish the key objectives of making the utilization of Health Information technology a broad aspect. As mentioned earlier, widespread utilization of health information technology will of many benefits. First, patients and physicians access to health information will be facilitated. For example, a patient who travels to another side of the country and visits a doctor therefore can easily access his medical information from his doctor through the electronic health records.
Studies show that widespread implementation of health information technology will lead to an improvement of integrity in the health sector (Bigelow et al, 2005). The attainment of healthcare integrity, as a result of healthcare technology will lead to the elimination of a couple of health hazards that include:
- Insufficient data and information about drugs that a given patient is taking
- Insufficient information about drugs that have been subscribed by a particular physician
- In sufficient information regarding a patient’s history
- Misreading’s of prescriptions
- Incorrect giving of prescribed dosages
- Duplicate or incorrect patient payments
- Inaccurate or incorrect payments amongst others
As mentioned previously, most of the research on health information technology has tended to ignore the salient parameters that are necessary in building the appropriate human capacity. Most research has tended to focus on aspects such as staffing ratios, leadership, job roles, competences and educational qualifications as well as gap and growth. Hersh (2010) explores this issue in the article. Hersh notes that research on building an effective human workforce has been neglected. He cites a survey, which he conducted and found that out of 100 research that have health information technology as the subject, only 5% even touch on the issue of human workforce or even the issue of shortage of professionals in the field. He states that this factor could have probably contributed to the observed shortage of health information technology professionals. Simply, put, failure to put attention into the issue through research has directly translated to the observed trend in the real sector where the number of health professionals who have expertise in the implementation and control of health information technology is very low.
However, the little amount of literature that focuses on the issue of literature on the workforce has given several suggestions on the strategies that should be put in place to contribute towards building of a larger HIT workforce (Bollinger et al, 203). As mentioned earlier, one of these is the incorporation of IT training programs into health training institutions like medical schools. The other is the initiation of training and development programs among the current health force (Bollinger et al, 2013). These training programs should be designed to educate the existing workforce about technology and make them conversant with the health information technology that a given health institution hopes to incorporate into its structure or activities (Bollinger et al, 2013).
However, current literature seems to suggest that are various impediment or barriers that seem to derail the process of implementing health information technology in the health sector. Health information technology is essentially designed to improve the delivery of health services. Therefore, when the implementation of this technology is affected by various factors, it translates into a reduction of quality in the delivery of health services to the population at large. Girosi et al (2005) studied in their research article quotes some the barriers to the implementation of health technology that have been quoted by many health care providers.
The first barrier is that of cost (Girosi et al 2005). Implementing a full functioning health information technology system is usually a complex and expensive activity. When committees sit down to plan the budget of implementing health information technology in a given setting, they may realize that the cost of implementing such a system is too large and too wanting. For instance, research shows that to implement an electronic health records system that is fully functioning for a year costs about $150,000 (Girosi et al, 2005). This is a very large figure and accordingly, there are very few institutions that may willing to dedicate such a huge sum of money and cost to a system that they are not even sure may bring them recognizable benefits.
The other barrier has actually been explored earlier and it is the lack of an adequate workforce. An adequately skilled workforce is required for a HIT system to be implemented and ensure that it is functioning properly (Taylor et al, 2005). However, as research has proven, there is a huge inadequacy in the health sector in terms of a competent health information technology work force. This has been a barrier to the implementation of the technology (Taylor et al, 2005). It is unimaginable to try to implement a system when there are no adequate professionals to oversee its implementation or even evaluate the system to show its functionality potential.
According to Taylor et al (2005), it is critical that the entire health fraternity in collaboration with the government puts more emphasis on the widespread implementation of healthcare technology because as observed, there are very many benefits that will accrue after its effective implementation.
In conclusion, it is very clear that there is a lot of literature available on health information technology. However as observed, literature on issues of the HIT workforce is somehow limited as compared to other parameters related to health information technology such as staff ratios, educational requirements and competencies. As it has been observed in one of the literature pieces explored in this paper, this can be seen as to have had an influence on the fact that the number of professionals that have expertise in health information technology is limited.
However, this research hopes to add to the little literature on HIT workforce that is available. This is by examining other parameters critical in the building of human capacity of the HIT workforces so make sure that not only balanced skills in the HIT sector are available but to also make sure that a number of competencies, as well. The research will build on the literature that has been explored above and in the end; a plausible recommendation will be given.
References
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Blanchard, M. (2011). 126. Navigating the Digital Disconnect: Understanding the Use of Information Communication Technology by the Youth Health Workforce to Improve Young People's Mental Health and Wellbeing. Journal of Adolescent Health, 48(2), S83-S83.
Bollinger, R., Dossal, A., Patel, K., Mckenzie-White, J., Settle, D., Ngatia, P., et al. (2013). Leveraging information technology to bridge the health workforce gap. Bulletin of the World Health Organization , 91(11), 890-891.
Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The Benefits Of Health Information Technology: A Review Of The Recent Literature Shows Predominantly Positive Results. Health Affairs, 30(3), 464-471.
Girosi F, Meili R, and Scoville R. (2005). Extrapolating Evidence of Health Information Technology Savings and Costs, RAND Corporation, MG-410-HLTH.
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Jha, A., Doolan, D., Grandt, D., Scott, T., & Bates, D. (2008). The Use Of Health Information Technology In Seven Nations. International Journal of Medical Informatics, 77(12), 848-854.
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