Canada faces widespread e-health skills shortage

While the Ontario government is dealing with the political fallout of the eHealth Ontario scandal and Ottawa reviews its funding commitments to Canada Health Infoway, a new research report suggests Canada may need to fill approximately 12,000 IT-related health-care jobs within the next five years.

The Information Communications Technology Council (ICTC) last week published Health Informatics and Health Information Management, a national study of the human resource demands electronic health records (EHRs) and similar projects will place on hospitals, clinics and other organizations. Beyond the hiring requirements – which the report said would vary based on the level of further investment into electronic health information systems – the report indicated that many of the estimated 33,000 people working in health informatics will need to significantly upgrade their skills by 2014.

“It is characteristic of these scenarios that, as the rate of investment increases and the adoption of electronic health information systems both expands and deepens, the proportion of health informatics and health information management professionals who require broader skills also increases,” the report said. “It is likely that these professional development requirements will exceed the resources that are currently available to professional associations.”

ICTC president Paul Swinwood said the report is the first attempt to properly quantify the skill profiles and labour force dynamics surrounding e-health. The next step will be outlining a strategy which ICTC can present to those in health-care organizations, industry associations and academic institutions.

“There is no doubt jobs are going to change. In the old days, a clinician was someone who carry an X-ray down the hall, put it up on a light board and then, if they couldn’t see what they needed to, they went back and ordered another one,” he said, noting that those roles may require expertise in e-health-specific standards such as HL7. “There are few schools in Canada teaching about HL7-level standards.”

Canada’s progress in setting up a national electronic health record has been beset by funding challenges and political upheaval, despite the fact the ICTC report estimates the federal government will have poured $1.9 billion into e-health by next year. In Ontario, a provincial electronic health records initiative was derailed after an auditor’s report uncovered widespread spending abuses at eHealth Ontario, the agency established to oversee it. such a system by 2015 now seems farther away than ever. Canada Health Infoway has already admitted its goal of offering a pan-Canadian EHR by this year will not be reached, while eHealth Ontario is slated to offer a provincial EHR by 2015.

Swinwood insisted that the investment and efforts so far have not been wasted, and in fact should be further developed as the HR needs around e-health escalate. “The thing we’ve lost in all the scandal in Ontario is that the engine has been built,” he said. “Now it’s a matter of setting up the on and off-ramps.” Besides dealing with security and privacy concerns, more focus will need to placed on integrating various EHRs together, he said.

Unless the forecast job vacancies are filled and the existing workforce retrained, the report paints a dire picture of unexpected delays, cost over-runs and risks to patient safety and care. “In the absence of system-based human resources planning, the demand and supply for the professional skills required to implement major capital projects are almost never in balance,” the report said.

Swinwood said some of the projected hiring needs might be met in part by fast-tracking skilled immigrants into the Canadian health-care market, but professional development of the current workforce may be more challenging.

“Re-skilling or training tends to be the first or second thing that gets cut in times of restraint,” he pointed out.

The report also recommends building on existing certification programs, as well as expanding co-op and internship programs to accelerate the integration of recent graduates into health informatics jobs.

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