Regardless of your political persuasion, the Supreme Court ruling today can only mean more IT work in health care — though that largely would be happening even if the Affordable Care Act were struck down. Either way, providers would continue to digitize records and researchers to study large data sets to develop treatments and improve care.
I saw both disaster and opportunity in this story of a Kansas hospital's EHR implementation gone bad. Girard Medical Center, a 25-bed facility in rural Kansas had an IT staff of two, yet embarked on a $2.9 million project with Cerner Corp. in September 2010. It got in a fistfight with the vendor, though, when functionality it thought would be covered in the contract — attendance-tracking features, lab test functions and electronic billing — were going to add $100,000 to the bill.
Unable to resolve the price differences, the hospital stopped payment and the vendor stopped work and now they're in court trying to sort things out. After paying Cerner more than $1.2 million, the hospital still has no electronic medical record system and still doesn’t qualify for federal monies to pay for one.
Clearly, the hospital was out of its league in working with the vendor. Holly Koch, the hospital’s chief financial officer, told The Wall Street Journal:
It was incredibly complex and difficult to understand. We relied on them to explain to us what the contract represented.
All sorts of alarms went off in my head when I read that. Absent vendor-management specialists or a legal staff well-versed in EHR contracts — and what small organization has those? — this represents a prime opportunity for consultants who specialize in EHR implementation.
As Girard CEO Mike Payne put it:
It means swallowing your pride and knowing what you don’t know and finding someone who does know it.
The health reform mandate for states to set up health insurance exchanges will create more IT work. States such as Kansas and Alabama that had held off on working on exchanges until the Supreme Court ruling now will have to scramble to meet the 2014 deadline. Eight nonprofit organizations, however, have already come up with a consumer interface for the exchanges that can be customized by the states, according to The Washington Post.
Unrelated to health reform, though still federally mandated, providers face an Oct. 1, 2014, deadline to implement the latest coding system, ICD-10. (The American Medical Association, however, is pondering whether organizations should just skip ahead to ICD-11!) Either way, it will create jobs for consultants, IT pros and trainers, according to Dice.com.
And let's not forget jobs in health care informatics, one of the fastest-growing careers around. Job postings for health informatics grew by 36 percent from 2007 to 2011, compared with a 9 percent growth in all health care postings, and 6 percent increase in all U.S. jobs, according to a study by Credentials that Work, an initiative that uses labor-market data to help colleges align their offerings with real jobs.
The job site Indeed lists 4,800 open positions in informatics, 3,500 that mention EHRs and 1,018 involving ICD-10.