Nationwide Health Information Network (NHIN) Workforce Study: Final Report. Literature Review


A brief review of the literature was conducted for this research. As indicated in the Introduction, the recent expert consensus report from AHIMA and AMIA expressed serious concerns about potential shortages of trained HIT personnel.

However, workforce issues have been a concern for a number of years. In 2000, a survey of 18 health care organizations regarding the role of health care informaticians concluded that there was an increasing role for personnel with combined expertise in heath care and IT.[xviii] In 2002, Masys described “opportunities for new kinds of employment in health related professions” based on the growth of health IT.[xix] That same year, the British National Health Service (NHS) released its human resources strategy for health informatics, stating that “to support this level of new investment in technology will require a significant level of recruitment of new staff as well as in the development of existing staff to maximize their contribution.”[xx] In 2003, Australia released a plan for building the capacity of the health information workforce noting “strong anecdotal evidence” of the need for additional trained personnel.[xxi]

In 2006, the NHS issued a follow up report that surveyed their informatics workforce, detailing progress since the 2002 plan.[xxii] That report estimated the NHS informatics workforce to be 25,000 FTEs, with the expectation that substantial additional personnel would be needed over the next few years (although there were no specific quantitative estimates). Challenges to expanding their workforce include problems with recruitment and retention related to both difficult working conditions and uncompetitive pay scales. Hersh[xxiii] reviewed the issue of the health information technology workforce in 2006, dividing it into clinicians, IT professionals, health information management (HIM) professionals, and health science librarians. He noted that there were “no data [that] provide an overall picture of those who work with HIT.” Finally, there has been particular concern about the challenges of recruiting and maintaining the informatics workforce in public health. While a recent report from the Association of State and Territorial Health Officials[xxiv] contains no quantitative current or future workforce estimates, it notes that the “public health informatics workforce... is vital to fostering integration among public health information systems in order to improve the efficiency of public health services and maximize the utility of public health data.”

In summary, despite the continuing concerns about the HIT workforce, no prior studies have developed quantitative estimates of the future need for HIT personnel in the United States.

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