A Career in Healthcare IT: The Buzz, the Background, the Truth

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If you've heard that healthcare IT is the most promising area of job growth in information technology, there's a reason. In recent years, the job growth spotlight has often been targeted at healthcare job growth generally and healthcare IT job sector growth specifically. In fact, a recent career trend report (PDF)  ranked a career in healthcare information technology the number-one "hottest" career. There are reasons for that "hotness," and chances are you've read about at least some of them.

The Race for Electronic Health Records—and What It Means for IT

The tremendous growth in the healthcare IT job market is due to a perfect storm of factors, says Eric Marx, VP of healthcare IT services for IT staffing and recruiting firm Modis. The first driver is the scramble on the part of hospitals and physicians to meet deadlines demonstrating meaningful use of electronic health records, such as the implementation and use of e-prescribing and the ability of IT systems' to electronically send EHR data to public health agencies.

Under the American Recovery and Reinvestment Act (ARRA) of 2009—or the stimulus package—the Health Information Technology for Economic and Clinical Health (HITECH) Act set aside $19 billion for hospitals and physicians who demonstrate meaningful use of electronic health records, a feat that will prove difficult for many, says Marx. The earlier the adoption, the greater the incentives. That's the carrot. On the other hand is a stick, with laggards subject to financial penalties. On top of that are deadlines and goals around developing EHRs for each person in the United States and developing a nationwide health information technology infrastructure that enables health information to be used and exchanged electronically.

The second significant push behind healthcare IT job growth is the tenth revision of the International Statistical Classification of Diseases and Related Health Problems, or ICD-10. ICD-10 affects coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just for those who submit Medicare claims. In simple terms, says Marx, the codes that denote diseases and conditions are becoming way more specific, and the potential combination of numbers is exponentially increasing. Think Y2K for the healthcare sector.

And it's coming soon. The deadline for ICD-10 is October 1, 2013. By that time ICD-10 codes must be used on all HIPAA transactions, such as insurance claims, for transactions to be approved.

But there's more. That deadline is preceded by CMS Version 5010, which contains the revised set of HIPAA transaction standards that accommodate the ICD-10 codes. According to the Centers for Medicare and Medicaid Services, every standard is updated, from claims to eligibility to referral authorizations. The deadline for Version 5010 is January 1, 2012, with the goal of creating a smooth transition to ICD-10 and to provide enough time for testing.

Preparing for ICD-10 and Version 5010 includes a lot of work for most health organizations: the potential of updated software to install, staff training, changes to business operations and workflows, internal and external testing, reprinting of manuals and other materials, and more. In other words: Mountains of work to do in a short amount of time. To make this transition happen, the healthcare industry needs skilled IT people. Lots of them.

Marx points to a third factor driving growth in the healthcare IT job sector, one that you've likely heard more about: healthcare reform. Sweeping healthcare reform legislation President Barack Obama signed into law last year, particularly the Patient Protection and Affordable Act (PPACA), is further driving advancement in the area of healthcare information technology. The law contains provisions for expanded Medicaid enrollment, which will have a deep impact on state healthcare IT infrastructures.

In short: This unique convergence of events is creating notable growth in the healthcare IT job sector. The jobs are there. Getting one, on the other hand, may be much more difficult than it would seem.

Landing a Healthcare IT Job: No Easy Task

Not surprisingly, a concentration of healthcare information technology job growth surrounds EHR implementations and other healthcare-specific IT skill sets. Marx says that hiring managers are especially focused on recruiting those with specific healthcare vendor experience, such as Epic, Cerner, or Meditech. Hospitals and healthcare organizations "need people who can hit the ground running, and they are willing to pay a premium to get that. Right now, they just don't have the luxury of training someone."

In other words, the same factors that are driving the growth in this sector of the IT job market are also barriers to entry. Like employers in many other sectors, says Marx, healthcare IT employers are looking for job candidates with direct, specific experience. They have a laundry list of criteria and they're looking for candidates who match that list exactly.

Shahid N. Shah, CEO of IT consulting firm Netspective and a healthcare IT and medical device integration expert, for one, thinks such an attitude is unwise on the part of the healthcare industry, and that it needs to change soon. "Everyone says we have this dearth of healthcare IT workers, but we've got plenty of people," he says. "That is, if you're open to taking IT workers outside of healthcare with transferable skills."

Shah, who blogs at The Healthcare IT Guy, firmly believes that general IT skills gained from experience other than a healthcare setting are also useful. For example, those who have experience with large-scale ERP or CRM implementations possess many transferable skills. IT workers with compliance experience, especially in the financial, insurance, and retail industry, also have valuable transferable experience that hospitals and healthcare organizations need.

A third group that would fit well in a healthcare IT environment, says Shah, are those in security IT. Hospitals and healthcare institutions, which he says are lagging behind industries known for tight security, such as the financial industry, have a great need for people with experience in perimeter intrusion protection and firewall management. Even better those IT security skills translate extremely well. For example, an infrastructure engineer's duties are almost exactly the same from setting to setting, regardless of industry.

Shah says that insisting on the laundry-list approach when looking for job candidates is a big mistake on the part of hiring managers; it creates an artificial shortage and essentially ensures that you won't find enough people. He points out that only a few positions need such specific healthcare IT experience. For example, IT folks working inside an application, such as those who are configuring or programming it, do need deep, direct knowledge. But just as in a corporate setting, lots of IT workers who don't have deep technical knowledge of a given system can support its implementation.

Is a Career in Healthcare IT Right for You?

A career in healthcare IT can be financially lucrative—for those working around the hotspots of clinical application areas, says Marx, and especially for those who are willing to travel. ("Clinical" refers to the areas of IT most directly affecting patient care, versus more peripheral support areas such as payroll.) But if that's why you're targeting this new career area, you may be setting yourself up for a disappointment, he says. For professionals moving from corporate or other sectors of IT, the leap to healthcare IT can be tough, for all the reasons discussed above. It may take years to get to the position you're targeting.

In fact, both Marx and Shah point to what may seem like a "softer" reason to target a career in healthcare IT: the satisfaction you can get from knowing that what you do every day helps save lives and promote health. For many, that impetus is much richer than the typical business focus on generating revenue or selling more stuff. There's also the opportunity to help push forward an industry that is far behind other forward-thinking verticals, such as financial and retail organizations.

That said, Marx points out the conditions may not be to your liking. If you're used to a comfortable corporate setting, the conditions surrounding a healthcare setting may feel chaotic and rough in comparison.

In addition, healthcare IT generally does not favor those who do not communicate well or who do not see IT as a tool that must meet the needs of end users. Marx points out that this is one reason that transitioning into healthcare IT is generally easier for those with direct patient-focused experience, even a non-IT healthcare worker, than it is for those making the transition from corporate IT. Communication in a healthcare setting is paramount. IT can affect life-and-death situations, a fact that is not usually the case in a general IT setting. There can be no disregard of end user needs. Doctors, nurses, and other clinical workers who need to use any given technology must be considered every step of the way.

Helen Figge, senior director of Career Services for HIMSS, the largest not-for-profit organization focused on healthcare IT, also points to the different environment. “Healthcare IT is all about supporting the patient and those that deliver care to that patient.” She says that although healthcare IT does apply many of the same process improvement concepts enterprise IT workers expect, a traditional corporate IT structure can give greater emphasis to concepts such as process improvement gained through Six Sigma and lean management activity with less emphasis on their “human” impact.  In healthcare IT, that “human” factor is front and center. “In the end, healthcare IT is all about the patient in support of high quality care delivery,” she says.

Still, Figge points out, someone in healthcare with little or no IT experience (i.e., those coming from the clinical side) faces his own challenges. Career switches are not easy for anyone. This is why it’s important to look at your individual skill set: What are your strengths? In what types of settings do you excel? To transition to healthcare IT successfully, you need the core strength of adaptability, Figge says. The healthcare landscape is experiencing exponential change, particularly in the area of technology. If you have your eye on a career in healthcare IT, you’d better be ready to adapt to support the primary goals of patient care and health.

“In general, an IT worker who is a phenomenal communicator and is great about gathering requirements—let's say someone who is a good business analyst type—is going to do better at this transition than someone who wants to keep his head down and just focus on the technology,” says Marx.

Making the Transition to a Career in Healthcare IT

Despite the difficulty of making a switch into healthcare IT, there are things you can start doing to make it happen.

Learn how a healthcare setting works. Do your homework. You need to understand the processes that go into healthcare. For example, Shah says, it's imperative to understand clinical workflows. To begin this learning, read books on the subject, many available from and published by HIMSS. In addition, he says, do informational interviews, network, join health IT organizations, talk to recruiters, read industry publications (such as Healthcare IT News), visit discussion boards on healthcare IT subjects (even those for doctors and nurses)—basically do anything and everything that helps you learn the lingo and landscape. And if possible, volunteer in a hospital or other healthcare IT setting, say both Figge and Shah. Such up-close experience is invaluable.

Research jobs. This may be obvious, but it's worth pointing out: If you're simply choosing a job title based on what you do now, you're going about it the wrong way, says Shah. You need to do your research to find out what your ideal jobs are called in the world of healthcare and how your current skills answer the needs recruiters and hiring managers have, as well as what you need to add to your skill set. Tailor your resume around the language and needs of the healthcare industry, says Shah. "If you haven't covered the right keywords, then shame on you."

Be ready to explain how your personal skills transfer to healthcare IT, especially where that may not be obvious to a hiring manager or recruiter. For example, someone with experience helping a business move from paper to digital in another industry can be a major asset in a healthcare setting; you just need to convince hiring managers of that.

In keeping with the patient-centered focus, be sure to emphasize your skills in communication and other soft skills. Says Marx, "If you look at what makes employees great, it often has more to do with soft skills—for example, a manager's ability to guide a team, communicate vision, and inspire."

Be flexible. Marx and Figge also emphasize the need for flexibility in transitioning to healthcare IT from general IT, and that may very well mean a step (or two) backward to put you on the right path. Yes, you’ve worked hard to get where you are, but if your goal is to move into a healthcare setting you may need to consider taking a pay cut or a less senior title.

What this means specifically is that you should be open to healthcare IT opportunities that may seem farther away from the clinical area than is your ideal. Hospitals need many of the IT support that any other organization does, says Marx. People need to get paid, have computers that work, and so on. Be open to those other healthcare-setting opportunities. "The important thing is to get your foot in the door," says Marx. "Once you're on the inside, other opportunities will come along."

In addition, he believes, once the most-pressing deadlines are met, such as ICD-10, the "hot" healthcare IT areas will expand. "An entire industry is trying to get to next level of collecting, disseminating, and sharing information," he says. "A lot of value next level will be around the massive amount of information that will be collected." He predicts areas such as business intelligence, data warehousing, and simply making systems talk to each other will become increasingly valuable.

In other words, if you're interested in a healthcare IT career switch, it can be done. No one is saying that making this transition will be easy. But making this career switch is like any other, says Marx. "Anybody who really wants to go in a certain direction can figure out how to get there."