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Could the future success of eHealth be threatened by a shortage of qualified workers? Richard Lawrance, CEO of the Health Information Management Association of Australia, believes we need to act now to build and maintain a skilled health information workforce.

eHealth brings the promise of improved patient care and reduced business costs for providers. Reform is already underway, but there’s a risk the benefits will be delayed indefinitely if we don’t educate, recruit and retain more people to manage digital health information.

“There is a growing need for qualified specialists who can code, maintain, store, analyse and distribute information – and they are already in short supply,” says Richard Lawrance, Chief Executive Officer of the Health Information Management Association of Australia (HIMAA).

“If we don’t take urgent action we won’t have the workforce we need to support the ongoing success of digital healthcare.”

Two different disciplines

There are two main areas of specialisation in the health information workforce. One is health informatics.

“Broadly, this is the discipline of working with clinicians, engineers and software providers to develop software and IT support for clinicians,” says Lawrance.

The other is health information management, which covers both health information management itself and clinical coding.

“Health information management professionals plan, manage and maintain health information systems including patient records and clinical and administrative information,” says Lawrance. “The information produced by our service is used for healthcare, education, funding, research and informing management decisions.”

Clinical coders translate clinical documentation about patient care into unambiguous code format. For example, acute appendicitis is represented by the code K35.8.

“Coders capture the information collected during a consultation or hospital stay in precise and accurate detail so they need a deep understanding of medical terminology, disease processes and medical procedures,” says Lawrance.

“We’re already experiencing a massive shortage of people with these specialised skills – HIMAA is the largest provider of education in clinical coding in Australia and we can’t meet half of the demand.”

Australia isn’t the only country under pressure. “In the United States, for example, the problem is so acute that they’re attempting to train clinicians to code,” says Lawrance.

Peak bodies collaborate

The HIMAA has collaborated with four other peak Australian health information professional bodies on a blueprint for action. These are the Health Informatics Society of Australia (HISA), the Australian Library and Information Association’s Health Libraries Australia Group (ALIA HLA), the Australasian College of Health Informatics (ACHI) and the Australasian College of Health Service Management (ACHSM).

Together they have developed three key strategies to help build digital capability within the health and information workforce:

  • A census of the health information workforce and regular collection of data.
  • National capability frameworks to detail the competencies needed by the health Information professional workforce.
  • Education and professional development opportunities, career pathways and rewards, and recognition programs to encourage recruitment and retention.

“One of the main problems we face in deciding on the best course of action is that health information management is a niche profession,” says Lawrance. “Compared with 70,000 medical practitioners and 150,000 nurses our workforce of about 3,000 people is very small. The profession is also poorly defined by employers, with inconsistencies in terms of the scope of practice, job titles, educational paths and credentials.”

Gathering information

The first step in meeting future demand is to determine the current workforce strength.

“The University of Tasmania and the University of Melbourne have already begun to identify a minimum health information workforce data set under their own steam,” says Lawrance.

“This will help us develop a national capability framework and clarify the competencies we bring to our roles but they’ll need much more support from government if they are to complete the job in a timely fashion.”

Education is also a crucial factor.

“At the moment, just five Australian universities offer courses in this area,” says Lawrance. “As a group we plan to work with education providers to ensure their course content remains cutting edge and meets our standard for professional certification and credentialing. We also plan to promote health information workforce careers.”

Employers can take action

Lawrance encourages employers to focus on making health information an attractive option and urges them to consider sponsoring traineeships and establishing mentoring programs.

“Talented people want to know there’s a structured career path,” he says. “We know from working with NSW Health that offering professional development has a very positive impact on retention.”

“Despite the challenges, these are very exciting times. eHealth has the potential to introduce massive improvements in healthcare for employers, providers and patients. We just need to make sure we get the workforce right.”

How employers can avoid future shortages

  • Promote health information as a rewarding career
  • Support trainee programs and ongoing professional development
  • Develop structured career paths for health information professionals
  • In regional and rural areas, contribute to the relocation costs of qualified staff
  • Encourage health information workers to promote the profession to career advisors
  • Employ health information professionals with profession-accredited or approved qualifications.

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