Let me be frank. Managing hospital IT is NOT an easy feat. Whatever solution you pursue, you’re likely going to face difficulties. Regardless of hiring an internal team of experts, augmenting your team with outsourced solutions, or completely outsourcing your IT support, your hospital faces multiple challenges in managing your technology needs, budgeting for needed upgrades, ensuring your projects are getting handled and managed in a timely manner, and keeping up with growing concerns facing healthcare technology (compliance and security for just a start).
Deciding among all the different options can be more frustrating than you’d ever imagined. With all sorts of buzz words being used by salespeople, very unique and specific expertise each and every potential employee might highlight on their resume, different philosophies to managing technology and varying capacities at multitasking the gamut of technology hospitals demand (from medical billing to radiology imaging to cybersecurity) a team of technology specialists—in-house or outsourced—may be quite hard to find or too expensive to retain.
The thought of posting ads that will actually attract the right type of person to move into your town, crossing your fingers that the one guy in town with an aptitude for tech will accept your offer, or having to sort through misleading or skeptical advertisements and marketing gimmicks outsourced IT vendors often use to get a foot in the door—might make IT overwhelming.
Where to start when figuring out what to do? What are your options?
Hiring internal team members
I’ve got to admit, I often hire up in my company and find that when I am able to find team members interested and excited to grow with me, they often turn out to be the best fits for new positions. These are the people that accept obstacles as mere challenges and forge goals to get them to meeting (and often exceeding) my expectations.
I’m sure you appreciate this from staff in your hospital as well. Many of the roles in administrative positions in your organization likely are from either vertical or horizontal moves. You probably have staff that are willing, able and very capable of growing to the needs and demands of your hospital.
One of the greatest pieces of advice ever given to me: be slow to hire and quick to fire. Slow walk new candidates to make sure they’re a good fit with your culture and people. Then be quick about getting rid of the people that actually don’t fit in before a disaster forms. The problem in rural America? Your workforce may not have sufficient people to risk a good new hire getting snatched up elsewhere or there being no one else in the pool with required skill sets. Regardless, I would rather have team members working with me—even when I’ve had a difficult time hiring at points in growing my business—to hire misfits even though they might have the skills I’m looking for.
I do know a few hospitals where nurses have taken over all technical roles for a hospital—HIPAA compliance officers, IT directors, IT administrators and IT support staff. What often happens when nurses and other staff without critical experiences working in IT? They often need advice from more experienced experts. They might not know how to organize or handle the huge amount of work that IT support teams often are able to prioritize, delegate and filter.
I’m not saying that nurses or other administrative workers are not organized. Rather that IT support management requires very unique ways of management to ensure that the variety of tasks are getting done, validated and recorded. And part of making technology support habitual—ascribing to very specific routines to ensure that your data management and security needs are being met every single day (and night)—is to have people in these positions with a passion for technology and the means to engage and support the rest of your teams.
Without a doubt, your team is very willing to help the rest of your hospital teams. They understand the importance to keeping hospital IT up and running 24/7 and appreciate the consequences of not being up. In fact, they all have probably experienced ramifications of outages and can empathize with outages or computer headaches faced by their peers when trying to support them.
The issue with horizontal hires from within your hospital?
The biggest issue is training and supporting them —your internal hires—while maybe able to navigate your EHR platform or solve simple technical glitches on the fly, they remain inexperienced in handling the heavy lifting in IT. Many of the tasks—many of which may seem mundane or routine—actually require a large attention of detail and skilled workers that understand what they are doing or looking for. Tasks that require a high acuity of expertise range from routine server maintenance, router monitoring, restore testing, backup and disaster recovery, help desk support issues, process optimization, projects for updating equipment, software installs, software integration—the list goes on and on because in IT most problems are unique or nuanced. Every user has unique habits and behaviors while online and good IT professionals need to dissect those behaviors in order to know how to specifically resolve an issue. As I’m sure you’re well aware, treating the symptoms to a problem only get you so far. You need to problem solve and figure out what the root cause of a problem is.
The issue with having inexperienced support helping your team with critical information systems? You are relying on people that might have no experience detecting or dissecting issues to get to root causes (it’s not their fault—they simply lack the knowledge that would have empowered them to get to the bottom of issues). Instead, you might have people with their hearts in the right places, but simply can’t figure out problems that seasoned IT staff would be able to get to the bottom with little effort.
The problem with simply dumping IT on someone internally? Most likely, those folks you are persuading to take the position have limited training, they are not passionate about technology enough to actively keep up on latest tech innovations. You are also losing very capable team members for positions where they won’t make as great of contributions to your hospital and its patients.
Hiring and recruiting a dedicated IT staff
In a perfect world. That’s what many administrators have told me they’d prefer hiring professional and expert healthcare IT staff. In a perfect world, they’d be able to find, hire and recruit a team of healthcare IT professionals that could solve just about every issue faced at their hospitals.
In this ideal situation, you’d have a dedicated team on site that is able to focus solely on your hospital’s needs and best interest. Sounds great, right?
This hypothetical IT team would know every user by name, be a local fixture in your community and have the trust of every single user. They honestly have your best interest at heart because they are a part of your community and your identity.
In a few cases, I’ve occasionally seen “God send” IT directors—folks that really have a handle on support of their users and have really turned around the state of health record digitization. But these uniquely capable people are typically few and far between—especially in areas of the country with brain drains (especially in the fields of information security and information technology).
While internal IT teams may be the unquestionable ideal, they come with problems of their own.
Outsourcing your IT Support
When considering outsourced IT support solutions, most hospital CEOs, Administrators, or CFOs reach out to companies to get efficient and financially feasible solutions to address their concerns with their current state of IT—maybe after their trusted IT director retires or their staff can no longer completely handle the magnitude of IT responsibilities at their hospital.
The amount of data transmitted through your hospital is so huge that worrying about its management is certainly understandable. Since electronic health information penetrates nearly every aspect of your hospital—from medical records, medical billing and billing codes, electronic monitoring systems (including remote monitoring), the gamut of patient care and documentation, making sure your health information systems and support are well-run is currently a critical and core responsibility for your hospital.
Without a doubt, hospitals need reliable and state-of-the-art IT infrastructures that are well-planned and capable of connecting systems and devices throughout the entire organization in order to live up to hospital needs and demands on IT systems.
But unfortunately for many in rural hospitals and clinics, they lack local professionals capable of fulfilling growing demands laid out by HIPAA and Meaningful Use. There simply are not enough talented local IT professionals willing or able to fill every expertise needed to drive hospital IT initiatives—concentrating on ensuing that your organizational goals are met by technology. How will your IT provide accessibility to your core business needs, while assisting with providing improved healthcare services, enhanced quality and continued efficiencies directed at keeping costs down?
Outsourcing healthcare IT services—especially the range of IT needs and demands required by rural and critical access hospitals—includes a wide array of complex technology services. Just to mention a few of your critical IT infrastructure demands: hosting, network infrastructure, service desk, application support—are all in need across your organization either here or there or on a daily (or even hourly) cadence around the clock.
Such a wide range of needs and demands on IT often makes outsourcing all or part of IT services a no brainer to both save money and ensure work is getting done the right way. On top of making sure your hospital is keeping its procedures in accordance with HIPAA standards and policies, including ICD 10 guidelines increase the workload and pressure on IT to do their jobs well.
But if you already have IT staff that you like or trust, completely outsourcing your IT operations might be out of the question. Having trusted workers on site can be valuable to getting routine issues addressed and user problems fixed. But having an outsourced backup to help with hard to solve solutions or ensure that fundamental tasks that might require more experienced or detailed focus actually get done rather than missed on a To Do list simply because there are only so many hours in the day can be invaluable.
