Hospitals' move to e-files spurs a labor shortage

Massachusetts is among the leaders nationally in the use of electronic patient records and computerized drug prescribing. But its workforce is not keeping pace: The state lacks enough people who know how computers work and who understand how doctors diagnose and treat diseases.

It is a unique blend of skills that is increasingly in demand as the health system gets wired.

"Most of the hospitals we work with are having a hard time finding people," said Micky Tripathi, chief executive of the Massachusetts eHealth Collaborative, a nonprofit corporation funded by Blue Cross and Blue Shield of Massachusetts that is computerizing the entire healthcare systems of North Adams, Newburyport, and Brockton.

The eHealth Collaborative is a national model, and Boston's high concentration of teaching hospitals is heavily computerized. But shortages of qualified personnel in healthcare information technology, Tripathi said, "are acute at almost every level."

John Glaser , vice president and chief information officer for Partners HealthCare , the largest hospital network in the state and the parent corporation for big Harvard Medical School teaching institutions, said the lack of skilled people is slowing projects and forcing Partners to turn to expensive outside consultants.

The explosion of computerization in patient record-keeping means hospitals are not only competing with each other for talent, but with start-up companies that sell the computer systems off the shelf to physicians.

"We're all collectively really going hard at this stuff," Glaser said. "The demand for those folks has grown remarkably in the last couple of years."

Some schools are looking to fill the gap.

Northeastern University, for instance, is launching a graduate degree program to train people how to manage clinical healthcare using computers, which begins in September.

At a less advanced level, Framingham State College is considering launching a certificate program in medical records information, which would begin in September 2008, at the earliest.

Tripathi said the Framingham State program would help physicians who are struggling to catch up with electronic record keeping; it would allow them to designate someone in their office to be in charge of the new systems, and send them for training.

Northeastern began studying the labor issues associated with electronic medical records in the fall of 2005, when it convened groups of chief information officers for various health systems to discuss the problem. Dr. Stanley Hochberg , the assistant professor and program director of the Northeastern program, said the shortage of workers was a constant theme.

Northeastern will enroll between 20 and 30 students in September in the program, called a master of science in health informatics. With a June 1 deadline, Hochberg said he has interviewed 130 prospective students in the past three months. Most applicants are mid-career professionals with seven to 12 years of experience in either clinical settings or information technology, he said. They included nurses, pharmacists, and computer scientists.

"We are going to teach some basic physiology and aspects of illness and health to the technical people," he said, "and we'll have a set of courses that weave technology and health together."

Electronic patient records and prescribing systems can increase efficiency and effectiveness of care and reduce the chance of medical errors and dangerous drug interactions. Once the data are entered, physicians and hospitals can rank patients based on their health, and focus on those who need the most primary care.

Diabetes is an example. By keeping track of the sickest patients, and periodically reminding them to eat well and monitor their blood sugar, doctors can help them stay out of the hospital and delay the onset of additional health problems.

Records can be transmitted to emergency rooms and hospitals, or can be downloaded by patients. For patients taking multiple medications, computers can alert doctors and nurses to potentially dangerous drug interactions.

Training programs like Northeastern's already exist in Oregon and Alabama, but this will be the first in the Northeast, Hochberg said.

Christopher Rowland can be reached at crowland@globe.com.