With healthcare organizations required to meet compliance standards and use specialized systems offered by software vendors, healthcare is becoming increasingly beholden to IT providers. In order to meet these demands, they require people with the talent to handle these tools, but rarely have the budget to attract or retain them. Is there a staffing crisis in healthcare IT? How will this knowledge be developed and retained internally? Considering the investment challenges and the equal shortage of clinicians from other parts of the organization, how do we work to solving this staffing shortage?

Contributor

• • Eric Brosius, VP for Technology Services, Hudson River Healthcare

Download Podcast
Apple Podcast, Google Podcast, Spotify, Pandora, iHeartRadio, SoundCloud, TuneIn, and Stitcher. Find other syndication channels here or search CIO Talk Network podcast on any other app.
Explore More

• Can Your Health IT Deliver Patient-Centered Care?
• Will IoT Improve Healthcare?
• Advice from Healthcare CIOs
• Is There a Staffing Crisis in Healthcare IT?
• Merging Telemedicine and Healthcare Mobility
• Meeting Healthcare Big Data Pre-Requisites
• Healthcare and the Cloud: A Brave New World Without Courage?
• Is Healthcare ready for the cloud?
• Stifled User Productivity and Innovation: Is Corporate IT Responsible?

Transcript

Sanjog Aul [00:00:26]:

Hello, and, welcome to CIO Talk Radio. To learn more about the show, please visit www.ciotalkradio.com. As always, we invite you to join the discussion on Twitter, #ctr live, and look for this show as hashtag health care. Today’s topic is, is there a staffing crisis in health care IT? And our guest for today’s show is Eric Brosius, who is the vice president of technology at Hudson River Health Care. Hi, Eric. How are you?

Eric Brosius[00:00:54]:

Good, Sanjog Aul. How are you?

Sanjog Aul [00:00:56]:

Very good. Very good. So today, we are starting a short series on healthcare, exploring some of the challenges impacting healthcare IT and how, health system business and IT leaders can actually solve some of their problems. Tune in over the, next few weeks, to hear more. But today, we are exploring one of the bigger challenges in health care and IT staffing cry IT staffing crisis. It’s one that extends beyond the IT department and, has become a big strain for those organizations dependent on providers and in need of meeting compliance standards. So let’s explore some of these challenges and, solutions now. So, Eric, as a first question for you, what are some of the challenges, the healthcare IT operations or or whatever the IT department is facing in regards to staffing today?

Eric Brosius[00:01:46]:

Well, my organization being an ambulatory organization, which means we do outpatient, So we’re not a hospital. We’re mostly nonprofit and so we are faced with a lot of challenges that most nonprofits are faced with. We have a more strict budget. We have trouble offering competitive salaries due to being a nonprofit. It seems that in my geographic area, which is approximately between New York City and Albany, in New York, we have trouble attracting quality recruits and historically in my organization and many other of the organizations that I speak with on a daily basis, they tend to the IT department specifically tend to be understaffed for what we’re responsible for, on the data center side and on the help desk side.

Sanjog Aul [00:02:41]:

So when we look at business planning and any of the departmental planning, from the get go, we kinda understand that we have to have appropriate resources, and human resources is one of the resources. So if we say that we have a shortage, was that happening incrementally? It was dwindling, but we couldn’t do much about it, or it was a lack I would not say lack of planning, but maybe we were not able to, get a crystal ball which will tell us suddenly how much load will come in what all from from what all different directions. Where where did this come from?

Eric Brosius[00:03:15]:

I think it’s a to use your analogy, it’s a bit of a crystal ball. While a lot of healthcare organizations do see growth, it’s really hard to project exactly what that growth means to the day to day operations of supporting, providing appropriate patient care. And in my organization, we have grown so quickly, we’ve fallen into a bit of disorganized growth and it’s made it harder for us to staff appropriately. And again, in speaking with some of my colleagues in similar situations, I have found that they also have been under the gun in trying to staff up if they have the budget to do so. So it’s kind of a multifaceted challenge between being able to accurately project what the need is going to be in by quarter by quarter or year by year and having the resources, the financial resources to staff up.

Sanjog Aul [00:04:11]:

Now in that, light, what has been the gap in knowledge so that you could not plan enough or maybe plan a little surplus?

Eric Brosius[00:04:23]:

The biggest challenge is really the communication. Sometimes it’s the communication about when exactly the need is going to actually hit. When do we going to need the boots on the street so to speak to have a Tier one, Tier two IT person to be able to support the addition of another 30 to 40 clinical users in one of our locations or and the additional need to support the back end infrastructure so that we can provide the appropriate level of patient care at the front end?

Sanjog Aul [00:04:59]:

So when we say that there is a challenge or there’s a shortage, that’s, of course, against a specific expectation we had. If this if we had a certain level of coverage in terms of staffing resources, we would have been delivered been able to deliver a specific level of service. So what’s that benchmark are we comparing to?

Eric Brosius[00:05:21]:

It’s really a rough SLA for that we deal with. And we try to keep a certain number of agents in my organization and kind of benchmarking through other organizations of approximately one agent or one technician for about every 75 users. So it’s not always the exact perfect ratio. But as an organization grows, those 75 users, if half of them are extremely computer savvy, it’s not necessarily the right ratio, but we’re not always gaining computer savvy end users. So if there’s someone who is slightly new to computers and there are still people that are new to the computer world, we need to do more hand holding and then that ratio gets skewed because we end up spending more time, for example, on the phone helping one person instead of the 75 approximately that one technician should be able to handle.

Sanjog Aul [00:06:28]:

So would in in short, you would say that this is a quality service that might get degraded. That’s a risk if we have way too many people being supported by very very few, operational staff. Right?

Eric Brosius[00:06:40]:

Oh, absolutely. And then I think the the side effect is that of the inability to meet that customer service is that the corporate culture and our clientele, they get numb and they feel like the IT customer service doesn’t actually provide them the appropriate service that they need and they stop contacting the help desk, for example.

Sanjog Aul [00:07:05]:

Now if you were to look at this operational side, definitely understand there’s a one on one mapping in terms of there’s a quantifiable way. But where does it impact your ability to do new projects? Because I’m sure health care wants to evolve as a business. Your business leaders would come to you and say, we want to get these x number of projects for which you would need resources. So are you able to kind of get a separate, a budget if you will for those new initiatives because they are not part of your healthcare operations and life is good there?

Eric Brosius[00:07:38]:

Yes. I mean, we do budget. We try to budget by project and so when we do plan for the next fiscal year, we build a budget based upon project. But it’s a very good question because it does put a strain on the staff and the resources that most IT organizations may have at hand. And what where that leads us to and the challenges that we face is that we have an extended timeline for some projects that may take that really would take 6 months or excuse me, 6 weeks end up being 8 weeks or 10 weeks because you just don’t have the FTEs to devote to the project on a full time basis. Or worse yet, you might get projects that get stalled for an extended period of time because of other higher priorities. And so, sorry. Go ahead.

Sanjog Aul [00:08:29]:

Yeah. So to that, when you are saying that there are projects that you have and then you get budgets by the project, does that automatically mean that if I throw money, I’ll get skills, I’ll get bodies, I’ll get FTEs who can actually understand the requirements and be able to deliver on it? Where is the is there a challenge related to that?

Eric Brosius[00:08:49]:

No, absolutely. Just because sometimes you can get funding for a project, it doesn’t mean that it’s a you have the staff on hand to accurately complete the project in a realistic timeframe. So either you’re looking to outsource some parts of it or all of it and then you have to deal with the contractual obligations around outsourcing and other headaches as far as that goes and making sure you’re doing appropriate vendor relations. Historically, I prefer to try to keep things in house as much as possible. I think that full time FTEs have much more passion and feel much more responsible about a project than outsourcing to a vendor. So that’s been my model throughout my career and it’s worked well for me. But then I do backfill as needed to an outside vendor when necessary.

Sanjog Aul [00:09:44]:

So you did mention about, outsourcing Yes. For for various skills and and that’s maybe not your model. But then is it not, is it something that you have to control because of a philosophy or there is a reality that there will be people who would not want to join? Because it could come down to, can you attract the right people? And then can you retain those people after those core projects get done because there there’s nothing exciting, if you will. So what are the the challenges in inducting the right type of people in an organization with respect to health care IT? And what are the retention challenges?

Eric Brosius[00:10:22]:

Well, it kind of gets back to something that we kind of started at the beginning is that there is a challenge in attracting talent in healthcare in multiple ways. One, like I mentioned earlier, it’s a geographic issue. I think separately, again, in the outpatient side, it’s a financial issue. And I also think as you alluded to, it’s hard to keep sometimes to keep subject matter experts’ interests on things after a project is completed. So you have to kind of weigh all of those factors when you’re looking at staffing and where you hope to be in year 2 and year 3 of your long term strategic planning when it comes to IT and where really you can show that there is gonna be a long term need for these subject matter experts so that they will be interested and not get bored and wanna move on to the next bigger and better thing at some other company?

Sanjog Aul [00:11:25]:

So the model which would perhaps work for one company may not work for another. And they may use different, opportunities that may be available in terms of using an outsourcing vendor or or training someone from the from scratch as an intern, and and there may be many such strategies. Now is there a shortage? Is there a shortage in the very talent pool itself or is it just the right way to procure that talent or source that talent?

Eric Brosius[00:11:56]:

First of all, I do I agree. There are different philosophies. I did just want to echo your statement and I couldn’t agree with you more. In other organizations, the outsourcing model may work better for them. I just find that trying to do as much in house works better with my management style. But to answer your second question, I do a lot of the vetting of CVs that come into my organization and I do feel like there is a shortage of quality, not just IT talent, but overall talent as far as what we look for at Hudson River Health Care. And it may not be a specific Cisco engineer or a systems admin, but it’s an overall lack of IT depth in the resumes that I see on a daily basis, at least again, at least in my geographic area. And I know I’ve spoken with other colleagues who are much more Upstate in New York and they are in similar situations and even more so they’re having much more difficulty attracting talent because nobody wants to relocate to Upstate New York.

Sanjog Aul [00:13:06]:

So now interestingly, you say this that in that whole region, you see other people having the same problem. Is there an implied, level or standard that you feel they should be? Because you mentioned they don’t have the required depth. Is it something you were expecting a person to be fully cooked as if they were cookie cutter for your organization? Or there is another standard which otherwise is difficult to meet and we have this constant challenge?

Eric Brosius[00:13:30]:

I think that it comes into almost a personal preference, and that you’ll find people, in in similar situations as I am who are looking for as many certifications as possible. So that you have a CCNA who is going to be able to handle your entire Cisco infrastructure. And my belief is while those certifications have value, I’d like to see somebody who is much more well rounded and preferably have some level of a bachelor’s degree. And I think that shows that they have a more broader depth of ability to retain and learn knowledge to get into to get into those other areas that carry over and allow them to be able to communicate effectively, write effectively and be less siloed. And I think when you get and especially in a non profit, you have to have people that can handle multiple responsibilities. So you have to be able to branch out and not be siloed, not just be a Cisco network engineer. So those are the kinds of people that I historically look for when I am attempting to recruit and hire because I think that they add more value in the human resources side of an organization and ultimately that’s where I see the immense value when it comes to staff is it’s in the human being themselves, not necessarily what degree they have in their certification. It’s about what they can bring, what they can retain, what they can be taught and what they can learn and where they can grow.

Sanjog Aul [00:15:09]:

Let’s take a quick break, listeners. We’ll be right back. And then look at the specific skill sets that may be needed across industry. Because if suppose we were to, make an attempt to solve this problem, if it looks like it’s a pervasive problem in the health care industry where the IT workers are somehow not meeting the standards and there’s not enough people there and then there’s a tough problem of of attracting and retaining them, What is it that we have to do in order for us to discover where the pain points are and and where we can start solving it? So please stay tuned, listeners. We’ll be right back.

Speaker 0 [00:15:47]:

HP is proud to sponsor this program. Find out how the HP as a service solution for SAP HANA can help you gain instant impactful business results without capital investment by logging on to hp.com. Transform information into intelligence and a competitive advantage with a full spectrum of SAP HANA products and services from HP, a global SAP hosting partner.

Speaker 0 [00:16:18]:

Bosch Software Innovations is proud to sponsor this program. Visit www.bosch-si.com/connectedmanufacturing to find out how Bosch can help you improve your operational performance and become a manufacturing industry leader in a connected world. Change the way you predict, manage, and produce outcomes. Bosch Connected Manufacturing.

Speaker 0 [00:16:50]:

HP is proud to sponsor this program. Tap into our expertise, innovation, and services to bring your most important workloads to the cloud. You are listening to CIO Talk Radio with Sanjog Aul. To learn more about the show, please visit www.ciotalkradio.com. If you have a question or comment, call toll free at +1 (866) 472-5790. That number again is +1 (866) 472-5790. Now back to the show. Here’s Sanjog Aul.

Sanjog Aul [00:17:34]:

Welcome back. So let’s explore what’s the ecosystem looking like. So are there some similar skills or, competencies that are expected by a health system or a provider or insurance company or anyone in that ecosystem, which we suddenly are creating a competition for. And secondly, the type of skills we want to see develop. Then there are technical skills which could very well be transferable across any industry. Then there could be the business skills or or or that specific health care related understanding that you expect the person to have when they’re going about doing their job and for similar roles. So if you were to start looking at plotting this on a map, if you will, which ones would be plotted as reds?

Eric Brosius[00:18:19]:

I think a big need with where IT and healthcare is headed is a lot of the information exchange between disparate systems and that has kind of created a almost a specialty IT siloed individual, that I’ve seen over the last decade where you have all of these disparate systems that suddenly have to be able to exchange very specific information and you’ve seen a growth in HL7 interface engineers and HL7 interface programmers to be able to take specific transactions and specific data from one system, feed it through an interface engine, maybe massage the data to some extent to meet your needs and pass it along to whether it be an insurance company or a payer or another health system, whether it be a hospital, an inpatient system or an outpatient system. So when it comes to on the IT scale side, this level of interoperability has created almost a relatively new position in healthcare. It’s not just a server systems admin, security person. It’s not just a Cisco engineer. It’s not just desktop support, but it’s really this highly specialized data engineer that can understand what’s happening in multiple databases even though they may have not written the database or know all of the ins and outs of the code of the front end application that touches it. So it’s a really interesting, yet very, very vital piece in healthcare that I think has really just grown over the last few years.

Sanjog Aul [00:20:04]:

When you look at the changes, the way the healthcare as an industry is morphing, which is coming because you talk about meaningful use, you talk about accountable care organization, the other aspects of the new healthcare reforms that are being put out there, does that have a direct bearing on the shortage that is getting created in terms of healthcare IT workers?

Eric Brosius[00:20:26]:

It does. And it’s a really interesting question. And I was and as I’ve been thinking about it, what this means in regards to healthcare IT. And you have a lot of smaller practices historically, 1, 2, 3, or 4 provider practices that have a small amount of users but it maybe have been using some kind of electronic health record system that due to meaningful use and other requirements have trouble operating as a standalone company anymore. So you see these larger organizations, these multi conglomerate healthcare organizations, some for profit, some not for profit, take them over and they end up getting folded in to another electronic health record system. And the stressors that I’ve seen with this personally and tangentially throughout my geographic area and speaking with other people in healthcare is you’re adopting other people’s equipment, other people’s other organizations electronic health records and so you’re stuck with older technology and maybe a software application that you don’t want to support. So you’re challenged with what to do with all that clinical information because you have to retain it for at least 7 years. So either you have to retain it electronically in this old EMR system that may be antiquated and you’re not going to use in in the in the larger organization, or you have to migrate all of that data out of one database and into your, enterprise wide solution. And that again is almost creating a specialty niche in the IT industry where you have to have someone that can understand and sometimes the vendors can’t. They can’t take their somebody else’s data and put the round pick in the square hole and make it fit into their clinical application. So you’re ending up keeping things on paper or keeping old legacy systems around for 7 years just to be able to retain for the data retention policies.

Sanjog Aul [00:22:33]:

So when you explain this whole ecosystem change, and I’d love for you to continue in terms of sharing the challenges. The question that comes up is, if something is an exception, would that be not better served by someone on demand, like having a contingency pool versus trying to expect someone who would be ready to roll and try to bring them on our payroll?

Eric Brosius[00:22:58]:

When it comes to that kind of specialty data migration purposes, yes. That would be hard to justify a full time FTE to staff year round. I think but and again, so that’s a special thing and happens anytime you may have an acquisition or a merger of some sort. So it is kind of an exception. It is a one off instance, but it creates for management some level of headaches. You’re taking on clinical information that you may not understand and you may not see how it fits into your system. I think the bigger challenge is you’re taking over maybe a new site. You have to look at and justify or look at in all of the equipment in this practice to make sure that it’s meeting the standards of your EMR, not the existing EMR that that location may have used. So you have to budget potentially to have to come in and replace their entire infrastructure to meet your standards, to meet meaningful use standards as far as being secure. And there are other headaches there that now your staff is now taking on growth and exponential of workstations and another potential 10 to 30 to 40 users as far as being able to support. And if you’re not thinking about meeting that growth from a support standpoint, both from a help desk and from an infrastructure standpoint, you’re going to miss something and you’re going to end up with a performance issue or some other larger headache after the fact. And if you’re not looking at the whole picture and that kind of gets back into something that I have seen and spoken to colleagues about where due to short staffing and it puts a strain on new projects and where you can see you have a much more shallow technical plan because you’re not able to invest the time and see the big picture and all of the yellow and red flags and looking at a project of that depth and breadth.

Sanjog Aul [00:24:58]:

Would you say there is any pride in us trying to keep all of this in house? So we’ve already discussed outsourcing, but things like new computing paradigms like cloud and others. And then you’re using some specialized skills to kind of get them in a flow and then you are kind of off the hook, if possible, from a chronic healthcare IT staffing challenge.

Eric Brosius[00:25:22]:

I’m sorry.

Sanjog Aul [00:25:23]:

Is that possible?

Eric Brosius[00:25:25]:

Yeah. I think historically and I think I’ve experienced this with the providers themselves, the physicians. They historically, if they’ve been early adopters in IT and using electronic medical record systems, they wanted to be able to control their patient data. They wanted to protect their patients’ privacy. This is my information and I want to keep it within my four walls, not only for my benefit, but for my patients benefit. And that has I don’t want to call it justified paranoia, but I think that has definitely lessened over the years as the technology has grown. But another benefit to that comfortableness of exchanging and sharing patient data is the most important thing, which is providing better patient care, because now you’re able to hopefully exchange some of your information as your general practitioner, as your internist with your cardiologist or your pulmonologist and all these specialists. So you’re not seeing multiple you’re not having to go get multiple blood tests for the same to have the same blood draw. You can share your blood test results so that you’re not having to go through multiple tests, having to go through multiple MRIs or multiple x rays. So I think historically there has definitely been that challenge of no this is mine and I need to keep it on prem, I need to keep it within my four walls so that I can touch it, I can feel it to now where providers are getting more comfortable with allowing their information to be stored in the cloud and access it through the Internet and be able to look at themselves in the mirror on a day to day basis. And then you get into other things with performance and having to be reliable on the Internet that causes other technological headaches. But as far as operationally, I think we’ve kind of gotten past a lot of providers feeling that need to keep their data close to them.

Sanjog Aul [00:27:36]:

Now when you did speak about the different challenges and to some extent those, you know, the health care providers as they go about trying to deliver health care, there have been some challenges solved. But given the chronic issue of some of these areas that we just discussed, what’s the end impact? Because the best business cases developed when you show to the management, because my shortage in in health care IT or related worker or workforce, I’m not able to deliver this quality level or even from the, you know, to a very fundamental level, not even able to offer this level of care, which will make us competitive. So if you were to look at the business loss, goodwill loss as a result of us not having the right level of people, what would those be?

Eric Brosius[00:28:27]:

Well, it can be something as simple as maybe a patient not getting the reminder that they need a flu shot because of some system glitch or some performance issue to something potentially as serious as a lab results not coming back in a timely fashion that could be potentially life threatening. And it sounds and I don’t mean to sound melodramatic, but when it comes to patient health and some serious, serious blood test is something as simple as a lab result not coming back in an timely fashion could be a matter of catching something serious early enough or not. And frequently, I don’t feel that it’s that extreme, but it can go from something so minor to something that’s severe.

Sanjog Aul [00:29:21]:

Let’s take a quick break, listeners. Let’s discuss when we come back the severity of these issues because if these issues are really serious and it’s impacting the business to a degree where the executive management will wake up and say, okay, we got to invest in it as the the same way wake up and say, okay. We gotta invest in it as the the same way they do it for a

Sanjog Aul [00:29:39]:

compliance issue, then we will have our resources. The fact that it has been mentioned over and over that there are resource constraints, That means either the problem is not big enough or perhaps the business case development is is not done in a way which the the people at the top understand because the goal here is to solve the problem. So let’s explore how do we go about understanding, articulating, and presenting that to the executive management so that these health care resource issues with respect to IT staffing could actually be solved. Please stay tuned, listeners. We’ll be right back.

Speaker 0 [00:30:22]:

HP is proud to sponsor this program. Tap into our expertise, innovation, and services to bring your most important workloads to the cloud.

Speaker 0 [00:30:34]:

Bosch Software Innovations is proud to sponsor this program. Visit www.bosch-si.com/connectedmanufacturing to find out how Bosch can help you improve your operational performance and become a manufacturing industry leader in a connected world. Change the way you predict, manage, and produce outcomes. Bosch connected manufacturing.

Speaker 0 [00:31:05]:

HP is proud to sponsor this program. Find out how the HP as a service solution for SAP HANA can help you gain instant impactful business results without capital investment by logging on to hp.com. Transform information into intelligence and a competitive advantage with a full spectrum of SAP HANA products and services from HP, a global SAP hosting partner. You are listening to CIO Talk Radio with Sanjog Aul. To learn more about the show, please visit www.ciotalkradio.com. If you have a question or comment, call toll free at +1 (866) 472-5790. That number again is +1 (866) 472-5790. Now back to the show. Here’s Sanjog Aul.

Sanjog Aul [00:32:08]:

Welcome back. So in the previous two segments, we did discuss the challenges. The maybe the genesis of those challenges, why are they happening, and what could be the impact. Now if we are still facing those issues, perhaps the case that has been made to solve those issues in front of the people who are supposed to provide you resources or change the things for you may not be compelling enough. And this is just a hunch. We got to explore this more. And what else can we do to make sure that it is not seen any less than in a compliance issue for which we immediately put everything that we have to to get over? So, Eric, in your view and in the conversations that you had with people, is this truly a huge problem or you’re still being able to get by so we are just kind of, having this as a nagging pain? I

Eric Brosius[00:33:01]:

I would definitely classify it as all organizations are getting by and we have that nagging pain. And the analogy that I have used historically over the last decade or so in my last 3 or 4 positions has been I find that we tend to be much more reactive to issues than being proactive. So we respond to something as simple as having a hard drive running on a disk space instead of having a monitoring system in place to let us know that it’s running low on disk space. So the challenges that you see here is this an end user sees a problem, they contact us, we fix it versus we know there’s a problem, we fix it and the end user doesn’t even know what there was a problem in the first place. And so that’s I think probably the biggest challenge of being short staffed and competency challenged in an organization is being able to be proactive and do certain things that you kind of think are no brainers, but they take time, they take overhead. In the long run, they make everybody’s lives better, but you still have to invest and get them in place initially. And it’s that initial 6 month project that you just can’t do because you spend every day putting out fires.

Sanjog Aul [00:34:24]:

Now if we are going to be doing this and that even the topic today was is there a staffing crisis in healthcare IT? What would be your one word answer?

Eric Brosius[00:34:35]:

Yes.

Sanjog Aul [00:34:36]:

It is. And while you just said that we are getting by and we are doing so, we are going about creating value for our patients and anyone who we serve, but still if you call it a crisis, where is the corresponding effort to get over that crisis?

Eric Brosius[00:35:00]:

Right. And and I and I would call it a crisis and I would agree we are getting by, but getting by in health care isn’t good enough. Because it does getting by in healthcare could affect a patient’s health and well-being. And that one patient that is harmed by getting by is not acceptable. Now again, may sound somewhat melodramatic, but I think a lot of people in healthcare, be it IT or our providers feel very strongly that this is our mission and this is what we have to be able to provide, whether it be from 9 to 5 or 7 to 9 or 24/7, whatever the case may be. So we are getting by, but it’s just not good enough and in healthcare where it potentially could be a serious life or death situation. And, so yeah, I do think it is a crisis. And as far as getting the necessary resources, I think there are a couple of things. One of the biggest things that you can try to do as a person in my position to upper level management is you have to be able to sit down with them and explain to them just how important it is that you have the resources to back up that mission. And thankfully, over the years, I’ve had some success in not expanding IT departments and making them bloated, but getting 1 or 2 key FTEs that really make a significant difference when it comes time to being able to make put projects in place and make them more make us more proactive and supporting our end user population than being reactive and just putting out fires. And there we can go down that road, but there’s a couple of different things there that I have found that is successful in being able to do so.

Sanjog Aul [00:36:54]:

We can talk and perhaps shout at the top of our lungs, who needs to listen to allow you the the resources, the blessing, and sponsorship to make this change happen?

Eric Brosius[00:37:09]:

Well, sometimes there’s a couple of things that that I have seen, a couple of of of methods that I have found to be very, very successful. In my organization, we have had such a lot of growth over the last 2 years that we’ve added approximately 300 to 500 front end users over this timeframe. And it’s easy, it’s a bit of an easy argument but you still have to make it that to be able to support that many more people, you have to be able to add on the back end and not just in IT, in finance and accounting and payroll, in all areas of the organization. And that just doesn’t always happen because it gets lost in the growth. So you have to be able to go to whether it be your Chief Operating Officer or your Chief Financial Officer or even the CEO depending upon the size of your organization and be able to show that we’ve added X amount of locations and 200 to 300 more end users and that means 200 to 300 more PCs that need to be replaced every 3 years or needs to be updated every other month and you have to be able to show the needs and be able to provide the appropriate business argument and justification to be able to get even just one or two FTEs to support your growing organization. It seems like a very simple argument, but you have to be able to back it up with some factual information. And that’s where things like help desk metrics come in very, very vital to an IT organization to be able to show that a call center may receive 300 calls a day and on average the end user is on hold for 5 to 10 minutes. And what you’ll see is that after a 5 to 10 minute hold time, they’ll hang up. And so you want to try to have an average hold time of approximately 2 minutes. Anything longer than that, you’re going to lose the end users’ patients and then you have an unhappy end user who, one, thinks that the IT department let them down and or two, can’t do their job. And when they can’t do their job, that affects potential patient care and morale. And you you end up having to fight a much larger corporate climate battle than you really need to be facing.

Sanjog Aul [00:39:29]:

When you just gave this, answer, the good part was that there is a growth. But at the same time, we hear 300 to 400 people were added because they were adding value and so that those resource were made available to the business as such to create value for the patient. Now there, you’re adding 300 to 400 people, but here, we have struggle justifying adding 1 to the support. Do you think that is because we are trying to be a cost, or is there a value in us trying to present things differently or do things differently because of which, they will see that there is actually some innovation happening? They’re able to serve more customers and with fewer health care staff, if you will, and that would justify you adding more people and you’ll get funded for that?

Eric Brosius[00:40:17]:

I think it’s a case by case and organization by organization situation. I feel like I’m blessed in my current organization where they do see the value in technological innovations and not necessarily in 2013 maybe, but in 2014 they did see the value in being able to add FTEs and that helps with that support model and we were able to recruit and retain some FTEs this year. I know inpatient systems in my area, I communicate with other IT directors and other help desk managers that just can’t get the funding to increase their staff. And so they are faced with the old, analogy of doing more with less meeting very, very high level compliance and regulation issues with less and less competencies on staff. So you’re looking to either outsource and pay a significant amount of money to an outsource vendor or you’re having systems admin people doing help desk level work or having these kinds of odd cross training where you have help desk people maybe having to do things that they’re not necessarily qualified for in that moment because you don’t have the people to you can’t hire a VMware engineer off the street. And so you have people that are either overqualified people doing things that they’re underqualified to do or vice versa.

Sanjog Aul [00:41:59]:

Let’s take a quick break, listeners. When we come back, how about taking a fresh look at the talent strategy that we may have incorporated, which could be putting us in these, troubled times, if you will? What if we say, let’s keep only people who understand health care and IT and as business analysts and any type of pure technical work could be put out there where on demand we can scale up and down and shown that as a direct I would not call it an outsourced model, but something which is an on demand IT. Because if we try to keep our fixed cost, that looks like a huge number every time. And, when we want to increase it, we we already are putting that as the baseline. So anyone would raise their eyebrows to say, you want to add even more to what you already have? So if we can show a way to lean down our IT staff, would that be a strategy? Or what other ways we can get creative and rethink the way we are staffing our own health care IT organization for us to actually get over this crisis. So please stay tuned, listeners. We’ll be right back and explore.

Speaker 0 [00:43:10]:

Bosch Software Innovations is proud to sponsor this program. Visit www.bosch-si.com/connectedmanufacturing to find out how Bosch can help you improve your operational performance and become a manufacturing industry leader in a connected world. Change the way you predict, manage, and produce outcomes. Bosch Connected Manufacturing.

Speaker 0 [00:43:42]:

HP is proud to sponsor this program. Tap into our expertise, innovation, and services to bring your most important workloads to the cloud. HP is proud to sponsor this program. Find out how the HP as a service solution for SAP HANA can help you gain instant impactful business results without capital investment by logging on to hp.com. Transform information into intelligence and a competitive advantage with a full spectrum of SAP HANA products and services from HP, a global SAP hosting partner. You are listening to CIO Talk Radio with Sanjog Aul. To learn more about the show, please visit www.ciotalkradio.com. If you have a question or comment, call toll free at +1 (866) 472-5790. That number again is +1 (866) 472-5790. Now back to the show. Here’s Sanjog Aul.

Sanjog Aul [00:44:57]:

Welcome back. So if you have a problem and with whatever we have done, that problem is not going away, perhaps it’s a time for us to go back to the drawing board. So, Eric, if you were to reassess and redefine and rethink the style and strategies, which could perhaps help us in getting over this hump, what would you think, where would we start and what would be your vision regarding that?

Eric Brosius[00:45:22]:

So I can talk about what I’ve done in the last few organizations and one of my strengths in growing IT departments with the appropriate business knowledge to back up the organization. Instead of trying to find a specific skill set on the street, whether it be a systems admin or a Cisco engineer or VMware specialist, I have had a lot of success in recruiting people who ran out of college or young in the workforce. Then they come in and start at a Tier one level answering the phones at the help desk. And when they show the competency and the drive and the initiative that they can handle increased responsibility, they work their way up through the organization. One, I think it benefits them a lot because it gives them some career path that shows that they can grow themselves if they show the aptitude. And it helps you find what I like to call the rock stars. And you see these young people who just eat, sleep and drink technology and it doesn’t necessarily isn’t necessarily specific to healthcare, but then you can start grooming them and take 6 months and give them a little VM training and give them a little Windows training and they can grow so that you can actually do more with less because they know your infrastructure, they know your enterprise, they know your organization and they’re able to meet all your needs with a much thinner organization. The obvious side effect of that is that takes time and you need a little bit of time to be able to do that because you can’t go out on the street and just staff and recruit and hire all of these kind of high level specialists without breaking the bank. And I have found over the last 3 years here just at Hudson River Health Care, this has been very, very successful and a lot of people it creates a great sense of loyalty and morale within the organization, which helps attract more and more candidates in the long run because word gets out and people, you know, they network, they have friends and they know that this is a good organization to come to work for and that you can grow in and you can gain skills and eventually while it may hurt my organization, eventually you want these people to move on to bigger and better things because then that shows as a manager you’re doing your job and growing the most important aspect of any business, which is the human being that’s working in that business and the human resource part of it. So you’re creating more well rounded employees that see value in themselves and return that value to the organization. I have multiple, a handful of people that have followed me from organization to organization because they’re comfortable working for me and working for the environment that that gets created. And and that gets out and the people inside this organization and outside the organization see that people talk and that and that growth really matters when it comes time to recruit. So you’re not recruiting the competencies because they’re not there. You can’t find the that attractive candidate that can meet those two needs that you need. So you have to kind of take a step back, maybe take a two lumps, a few lumps on the road to get there. Bring somebody in young and say they have the right soft skills, they have the right ability to learn, they have the right ability to communicate both written and orally and you can ask them to work an extra 2 hours at night studying MCSE or CCNA and then they get the hands on practical practice of doing that theory study the next day and you can just see how that makes them grow from one day to the next And then in a short period of time, maybe 6 months and 1 year, you have an employee that is almost invaluable to your organization, but it does take a little bit of time.

Sanjog Aul [00:49:36]:

On one hand, you mentioned that health care IT or or or everyone, including your own organization, will need to be reactive because you do not know what’s coming down the pike. And if we try to get the individuals who we want to train and and groom them to our standards, it extends the time to value, means the time when you bring them into when they can truly be productive. How do you balance these two?

Eric Brosius[00:50:03]:

Well, again, wonderful question. And the best way to do that I have found is you start them at Tier one level. So you start them at the entry level to see how they interact with the end users, how do they communicate with somebody who’s frustrated and can’t do their job And can see the big picture and comes and can come to mid level and upper level management within the IT organization. And they’re making recommendations and they’re making suggestions on how to improve things. And I have seen with quality recruits that they do come to you and say, hey, we can do this better. There’s this new tool that will help. And so I find relatively quickly and in a relatively short period of time in 6 months, you can see the value in what I look for in that rockstar category of okay, this person is going to be a resource that I want to invest in an asset to the organization versus somebody who may be just happy being that Tier one person, they love talking to the end users and they’re just happy to answer the phone triage and support that immediate need. And that’s great because we need those people too. And they’re happy at the level that they are. So it’s about knowing and seeing what return they have to the organization. And I feel like you can kind of determine that in a 3 to 6 month period of time.

Sanjog Aul [00:51:35]:

And you’re offered that luxury by everyone around you that you go about doing what you’re doing in terms of talent development, and they’re not truly being productive, but you’re building a pool for the future. So you are you are able to and in your specific case, I’m asking, you are able to and anyone who else has tried the business is willing to give the leeway or the time or luxury of that time till they create value?

Eric Brosius[00:52:00]:

Yes. We this organization has been because I feel as part of our mission, we do value our employees. It’s not about being able to come in the door and one month later making a drastic impact. And when it comes to evaluating somebody at the entry level, I think that a 3 to 6 month evaluation period is not an unfair and unrealistic evaluation period.

Sanjog Aul [00:52:26]:

So when it comes to the type of, talent that we need and the core competencies which you will have, as you mentioned, that specific skills can be taught later, what would be the core skills that anyone who is trying to staff in in their respective organization, the healthcare IT worker they should look for?

Eric Brosius[00:52:44]:

Again, I can speak to what has really worked for me over the last 10 to 15 years. And it’s a strong, it’s a strong basic general knowledge, you know, they have shown the ability to earn a bachelor’s degree, of some sort because that shows that they’ve gone through certain core competencies just to earn that degree. And I’m not saying this will work for everybody. Some people rely heavily on certifications and that works out well for them. I know what has worked for me and it’s been very, very successful for me. And then added on to that, there’s those basic core competencies, again, the ability to read and write and speak and communicate. Then you start adding on essentially what they what they’re interested in. And and you find people that really do just live, eat and breathe technology. They go home and they tinker. They, you know, when they were five, they took apart their toaster, their mom’s toasters. And and they they just keep learning and growing and have that that, you know, almost that their hobby is also their job. And because they love the technology and those are the people that I have found that just become invaluable assets to an IT organization because they want to absorb everything and they want to learn everything and that you can teach them anything.

Sanjog Aul [00:54:06]:

What is your appeal to your business leaders? Or what should be, that any healthcare IT leader ask their business leaders to say, help me help you?

Eric Brosius[00:54:19]:

And you know, that’s it’s another great point that I’ve spent it’s been a challenge in my career is injecting myself into other business units in this organization and many others because you get too many people that don’t understand where IT comes into place and so they may go off on a side tangent and then you have to be the bad guy and say no we can’t do that because of this compliance or that regulation or this limitation. So I’ve tried very hard to try to get ahead of those kinds of needs and separate projects and mission driven statements that aren’t that are absent of IT, but IT is a big part of. So that’s a bigger corporate learning or corporate culture change. It sometimes it takes years to try to say, you may not want to do this or get too far down this road before you introduce this project to IT so that we can start having a collaborative effort and not a scrambling to try to meet something that we just can’t do.

Sanjog Aul [00:55:24]:

One final question. What’s your message to other healthcare IT leaders who are trying to grapple with this IT staffing crisis?

Eric Brosius[00:55:33]:

Well, the first thing is I think we’re all in the same boat is that nobody is dealing with something unique. It’s about how you handle it. And I know what has been successful for me and my organization and I collaborate and communicate with other for profit IT healthcare leaders that have different issues. And I think sometimes they have bloat issues. I know in dealing with and collaborating with some colleagues who are inpatient where they’re dealing with older less nimble systems in the health information systems that they’re just they have bloat, they’re very slow to change, they’re very slow to react to the ongoing technology needs. So there’s always a challenge and there’s always a creative solution and it’s not necessarily a one size fit all solution. You really need to know your organization, the strengths of the people that work with you and the strengths and the people that you work with in administration to make sure you’re meeting the goals of the organization that you’re working for.

Sanjog Aul [00:56:36]:

On behalf of the show and our listeners, I’d really like to thank you, Eric, for sharing your thoughts on how organizations, health care organizations, can effectively handle this IT staffing crisis. Thank you so much again.

Eric Brosius[00:56:48]:

Thank you for your invitation.

Sanjog Aul [00:56:50]:

Thank you so much. And, listeners, hope you enjoyed the conversation. And, please like us on Facebook, search for CIO Talk Radio, and be sure to follow us on Twitter. Thank you again for listening to CIO Talk Radio. This is Sanjog Aul, your talk show host till next week. Take care, and God bless.