Health information workforce faces drastic shortfall in supply: summit

The health information workforce is facing a drastic shortfall in supply in the face of inconsistent data on demand, a forum on workforce shortages has heard.

The forum, staged during a workforce summit held in Sydney last week, also heard that as many as one in three health facilities in Australia are facing vacancies for clinical coders that they cannot fill, and one in five are facing the same challenge with health information managers (HIM).

New Zealand was also represented at the summit by ACHI fellow Karen Day, from the University of Auckland.

The forum heard that actual data on which to base forward planning, as recommended by Health Workforce Australia in a health information workforce report in 2013, has been disputed.

The summit, organised by the Health Information Management Association of Australia (HIMAA) in conjunction with the Australasian College of Health Informatics (ACHI) and the Health Informatics Society of Australia (HISA), heard there was a need for ongoing research on health information workforce supply and demand in consultation with industry.

HIMAA acting president Jenny Gilder said the data on the health information management profession’s two occupations, which formed part of the HWA report's recommendations, was at odds with data from substantive workforce research conducted by the Australian Institute of Health and Welfare (AIHW) in 2009.

“Census data between 2001 and 2011 indicates a growth of 70 per cent in HIMs in the period, from 865 to 1473, yet the AIHW’s 2010 report places [a full-time equivalent] figure of 630 HIMs right in the middle of the period between a 2006 census figure of 1255 and the 2011 result,” Ms Gilder said.

“This casts doubt on the HWA HIW report’s recommendation two, that a combination of existing data gathering institutions, including the ABS and AIHW, should be approached to improve workforce data collection.”

Ms Gilder said indicative membership research conducted by HIMAA in December 2014 showed that there were unfilled clinical coder vacancies in a third of Australian health facilities, and HIM vacancies in one in five.

Coder demand is rising for 62 per cent of respondents to the HIMAA survey, but supply is poor in 53 per cent, the research found. HIM supply is rising for 45 per cent of respondents where supply is poor for 51 per cent.

HIMAA CEO Richard Lawrance said it appeared that supply is not meeting demand, with HIMAA-trained entry-level clinical coding graduates between 2011 and 2015 totalling 726 – less half of the minimum requirement forecast by the AIHW for the 2010-15 period.

“And HIMAA is the largest supplier of VET level clinical coding graduates in the country,” Mr Lawrance said.

“This, coupled with a reluctance of employers to accept that clinical coding graduates require on-the-job induction, even though internship is accepted for almost every frontline therapeutic position, has further limited clinical coder supply.”

The forum agreed that definitional clarity was required before an appropriate data set could be developed for ongoing workforce research.

The forum also discussed how core health information management skills were the foundation from which specialisation and diversification could then occur.

HISA treasurer Phil Robinson and ACHI president Klaus Veil provided examples of people with HIM and clinical coding skills who then reached senior and executive levels in the health system, often involving a health informatics pathway.

HISA CEO Louise Schaper also presented on the Certified Health Informatician Australia (CHIA) program, which a number of health information management professionals have completed.

The peak bodies also agreed that a united voice was necessary to lobby for change, which was supported by Mr Veil and Dr Schaper.

"There is no doubt that we collectively feel that there is a problem; but we need to take an evidence-based approach that is supported by a common voice of the health information community,” Mr Veil said.

“We believe there is a real risk that the benefits sought from the recently re-booted My Health Record cannot be realised due to workforce limitations."

Dr Schaper said the health informatics workforce was vital in the digital age. “We welcome and encourage [the Australian Health Ministers' Advisory Council's] prioritisation of addressing the information needs of the current and future health workforce.”

NZ's Dr Day said there was a potential solution for workforce supply at the university level. The alignment of NZ's national health strategy and its national health IT plan, which targets the development of health informatics capability as a key to success, provides a structural pull factor into which the academic providers of workforce capacity-building can supply.

Posted in Australian eHealth

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