(OHSU: Portland, Oregon) -- A recent study, “Telehealth and Healthcare Informatics,” by William Hersh, M.D., professor and chair of the department of medical informatics and clinical epidemiology at Oregon Health & Science University (OHSU), says a 40 percent hike in information technology (IT) workforce will be needed to move U.S. health care toward a paperless system that is able to control costs and reduce medical errors.

If the U.S. health care system moves toward wider adoption of advanced IT systems to control health care costs, reduce medical errors, and improve patient care, it will need at least 40,000 additional health IT professionals—or almost 40 percent more than U.S. hospitals now are estimated to employ.

“The need for IT professionals in health information technology (HIT) settings is large and will increase as more advanced systems are implemented,” says Hersh. “If our data represent a correct sampling of the entire United States, then the current IT workforce is about 108,390 FTE [full-time equivalents]. However, if the U.S. HIT agenda is fulfilled and hospitals move to higher levels of adoption, an additional 40,784 FTE will be required.”

This new information represents an increase of 37.6 percent over the current FTE total. This level of staffing, the report’s authors say, would bring U.S. hospitals up to the advanced level of HIT adoption that has been shown to be associated with quality improvements and cost savings.

“These findings also demonstrate the need to better understand and develop education and training for health IT professionals,” says Hersh. “In addition, further analysis must be done on other health IT professions, such as those who are biomedical informatics professionals as well as those who work in nonhospital settings.”

Extrapolating their findings to Oregon, Hersh and co-author Adam Wright, senior medical informatician in the Clinical Informatics Research and Development Group at Partners Health Care in Boston, determined that even though Oregon has a higher adoption rate of electronic health record systems than the nation as a whole, the state’s health-care providers would need an additional 302 IT staff beyond the 802 currently employed, a percentage increase identical to the national estimate to advance to higher levels of adoption.

The report was based on an analysis of the HIMSS analytics database, the largest and most comprehensive data source of its kind, which contains information from about 5,000 U.S. hospitals. The database recently incorporated its electronic medical record adoption model, which scores hospitals on eight stages of progress toward a paperless record environment. The study posits stage 4 as an advanced level of HIT adoption. Stage 4 includes computerized physician order entry (CPOE) to avoid misinterpretation of handwritten prescriptions, for example, and other forms of clinical decision support that have been show to be associated with improvements in the quality and safety of health care.

Many of the 4,929 hospitals for which an EMR adoption model score was available either didn’t respond to the question of what their IT FTE number was or reported that it was fewer than five. That left 1,318 hospitals with 372,840 licensed beds or 49 percent of all licensed beds in the country. These had an overall IT staffing ratio of 0.142 IT FTE per hospital bed, or a total of 108,390 FTE. Stage 4 hospitals had a higher IT FTE ratio per bed (0.210) than stage 0 (0.082), where HIT applications were very limited. But, paradoxically, they also had a higher staff ratio than stage 6 hospitals (0.196). The report didn’t have an explanation for this deviation. But they based their conclusion that health care systems would need 40,784 additional IT full time staff based on the stage 6 ratio.

“Despite calls for wider use of health information technology to improve health, health care, public health, and biomedical research, there are many barriers to its adoption,” Hersh and Wright say. “Although barriers of finance and implementation issues are most commonly discussed, less attention has been paid to the workforce required to develop, implement, train users of, and evaluate HIT applications.”

HIT systems, if widely adopted, hold the promise of revolutionizing U.S. health care. It’s widely believed that they would improve clinical decisions and thereby reduce medical errors and improve health care quality.

For more information, visit www.ohsu.edu/xd/about/news_events/news/hitworkforce041708.cfm.