Thursday, September 13, 2012

Health IT Job Creation Predictions Come True: More Than 60,000 Since 2008

Back in 2008, when searching to find an estimate of the magnitude of health information technology workforce (HIT) needs, I came up empty-handed, which led me to try to answer the question myself. The best source of data I was able to find was the HIMSS Analytics Database. I knew that this was not the ideal information source, i.e., it was self-reported data not really aiming to capture detailed HIT staffing information. While the analysis did make some adjustments to the data that passed muster with peer reviewers, it gave us an estimate of a need for approximately 41,000 additional people needed as electronic health record (EHR) adoption advanced to the level associated with improved clinical outcomes, which coincided with use of clinical decision support and computerized provider order entry. This was based on best research at the time [1] and still holds true today [2]. This corresponded to Stage 4 of the HIMSS Analytics EMR Adoption Model (EMRAM). (This was before the era of "meaningful use," although the following year, HIMSS Analytics noted that EMRAM Stage 4 was approximately the level needed to meet the early conceptions of what meaningful use would be [3].)

I had the opportunity to present the results of my research at a briefing on Capitol Hill in the spring of 2008, with their publication later that year at the AMIA Annual Symposium [4]. I believe I can argue without too much bravado that this was one of a few happenings that put HIT workforce on the map, leading to its inclusion in Section 3016 of the Health Information Technology for Economic and Clinical Health (HITECH) Act of the American Recovery and Reinvestment Act (ARRA) of 2009.

Acting on the Section 3016 statute in the HITECH Act, the Office of the National Coordinator for Health IT (ONC) followed through by combining my data with other sources to come up with an estimate of HIT workforce needs to meet the coming incentives to implement meaningful use. They estimated more than 50,000 new HIT personnel would be required in addition to those already working in the field to achieve the goals for meaningful use [5]. This led to the specific programs created under the ONC Workforce Development Program [6].

While it will take much longer to know how successful the ONC-funded programs will be, or what the long-term HIT job market will look like, the recent release of an ONC Data Brief bore out an estimate of the jobs [7]. Proving early estimates quite prescient, the ONC analysis found that indeed, employment in HIT has increased by over 60,000 between 2008 and 2011, as shown in the figure reproduced from the Data Brief below. The total employment in HIT, according to these government figures, was 362,265 in 2011.

It has been quite rewarding to be part of this national effort to identify, develop, and observe the outcomes of these efforts to achieve one part of the informatics agenda. Although the future is uncertain, as the course of technology, healthcare reform, and government programs is unpredictable, with the interaction among the three of them even more unknowable. However, the need for skilled informatics professionals will continue to be an important part of the HIT landscape [8].


1. Chaudhry, B., Wang, J., et al. (2006). Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine, 144: 742-752.
2. Buntin, M., Burke, M., et al. (2011). The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Affairs, 30: 464-471.
3. Davis, M. (2009). The State of U.S. Hospitals Relative to Achieving Meaningful Use Measurements. Chicago, IL, HIMSS Analytics.
4. Hersh, W. and Wright, A. (2008). What workforce is needed to implement the health information technology agenda? An analysis from the HIMSS Analytics™ Database. AMIA Annual Symposium Proceedings, Washington, DC. American Medical Informatics Association. 303-307.
5. Conn, J. (2010). 50,000 new health IT workers might be needed. Modern Healthcare. May 25, 2010.
6. Hersh, W. (2012). Update on the ONC for Health IT Workforce Development Program. HIMSS Clinical Informatics Insights. July, 2012.;src=cii20120709.
7. Furukawa, M., Vibbert, D., et al. (2012). HITECH and Health IT Jobs: Evidence from Online Job Postings. Washington, DC, Department of Health and Human Services. Data Brief No. 2, May, 2012,
8. Leviss, J., Gugerty, B., et al. (2010). H.I.T. or Miss: Lessons Learned from Health Information Technology Implementations. Chicago, IL. American Health Information Management Association.

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