Information technology is definitely the current “it” topic in healthcare. Supporters have touted its ability to do everything from increasing efficiency, safety, and favorable outcomes to decreasing costs, redundancy, and adverse events. As the benefits of health information technology (HIT) have become apparent—winning converts to the cause and expanding tech budgets—the rapidly growing, dynamic HIT industry is creating numerous exciting opportunities for physicians who are interested in moving beyond clinical practice.
Why would doctors, having gone through a minimum of seven years of postgraduate education and training, often followed by several more years of advanced medical training (in some cases bolstered by an additional graduate degree such as a MBA or MPH), seek a job in HIT? Judging from my own experience and discussions with many colleagues in the field, the routes to our current roles in HIT have frequently been somewhat circuitous. There do, however, seem to be several shared motivations: a strong sense of purpose, idealism, and a passion and vision for improving healthcare.
My own passion for HIT was ignited in the mid ’90s when I was working in a practice that had a rudimentary electronic medical record. Despite the limitations of the system, I perceived the transformative possibilities of HIT. Living in northern California at the time, I had many opportunities to become engaged in system development, as there were several HIT software vendors that were based there. I went to work for a small HIT software vendor. At the time, there were only three physicians employed by the company: a physician who worked full-time in sales, flying around the country demonstrating the system at sales calls; another who worked part-time in sales and part-time in development; and me. I was initially engaged to develop end-user, computer-based training systems, then moved to product management within the marketing department. This was an incredible education in the entire HIT vendor software development, sales, and implementation process. I was exposed to all facets of the business: helping to prepare the vendor responses to healthcare provider request for proposals, the software development process, implementations, and system data model design with the goal of data retrieval and “reusable” discreet data to be captured within the system’s database.
After several years working in the industry, I returned to the provider world, where I could be directly involved in HIT projects designed to improve healthcare delivery, conduct research to determine if the implementations were effective, and develop models of HIT implementation that could transform healthcare. I have continued to focus on the interface between software and the end-user’s workflow—designing and implementing software that truly supports end-users in their work and that makes the right thing to do also the easy thing to do. One example of this type of work involves systems designed to improve the process of prescribing and administering medications by alerting the prescribing physician to possible drug–drug or drug–allergy interactions, inappropriate dosing, and other potential adverse events. Such a system would also alert the administering nurse if there is any reason for the drug to be withheld.
I have continued to be involved in HIT while also working as a healthcare provider, participating in electronic health record (EHR), personal health record (PHR), and other e-health services implementations, as well as conducting grant-funded research in HIT. I continue to be committed to my original vision of using HIT tools to fundamentally improve healthcare. The HIT industry has seen exponential growth in the past 5-10 years, and this growth is reflected in both the expanding number and diversity of jobs available to physicians in this industry. The industry forecast is for continued significant growth and the development of additional positions to meet the demand created by clinical system initiatives. These initiatives have already had an enormous impact on nearly all healthcare constituencies and will continue to provide a fertile market for physicians with information systems expertise.
The following are several key venues and positions for “tech doctors.” We have separated the list by healthcare constituency group and ranked the jobs in each group according to influence and compensation level: the most influential and highest-salary jobs within each constituency group are listed first, followed by the more entry-level positions within that constituency.
These positions pertain to the implementation, optimization, and maintenance of HIT systems within a healthcare delivery organization. They are based within the organization and do not generally involve extensive travel, beyond presenting at industry meetings and participating in vendor-user groups and forums. Salaries vary depending on the particular responsibilities, size of the organization, and geography, but generally are not as high—with the exception of CIO—as sub-specialty physician salaries.
Chief Information Officer (CIO)