Thursday, December 13, 2012

The Hottest Specializations in Health Informatics

In my book The Sequel: How to Change Your Career Without Starting Over, I wrote about how it is often possible to move from one occupation to another that uses knowledge of the same field, but in a different way. For example, a teacher might move into educational sales. An entertainer might move into booking gigs for entertainers. A chemist might move into technical writing about chemistry-related topics. One kind of sequel career that I did not mention was managing information about the field with which you are familiar.

Every occupation generates information, and often it is possible to make a living by organizing that information and serving as a conduit for it. A stellar example is Michael Bloomberg, who earned his billions by realizing that the best business to be in was information about business. As his Wikipedia entry notes, “His business plan was based on the realization that Wall Street (and the financial community generally) was willing to pay for high quality business information delivered as quickly as possible and in as many usable forms as technically possible (such as graphs of highly specific trends).”

Health care is our biggest and fastest-growing industry, and it generates terabytes of information daily. As a result, health informatics has become a fast-growing field. The data wizards at Burning Glass, whom I mentioned in last week’s blog (and who are another example of spinning data into gold), have measured a 36 percent increase in the number of job postings for health informatics careers in the period from 2007–2011. This dwarfs the 9 percent increase in health-care job listings, not to mention the 6 percent growth of all job listings. (See the PDF of their report, “A Growing Jobs Sector: Health Informatics.”)

The field is still small compared to the nursing occupations, but Burning Glass found that job postings for health informatics now represent the eighth-largest share of health-care occupation postings. The fastest-growing specializations in this field are the occupations that require high levels of skill. For example, the number of job postings for medical coders—who usually need the Certified Coding Specialist credential—increased by 31 percent over the time period Burning Glass studied. Demand for these workers is being pushed by the switch to electronic medical records and the increased complexity of turning doctor visits into bills submitted to insurers, including Medicare.

But health informatics is about much more than billing. The Affordable Care Act, otherwise known as Obamacare, has created incentives for hospitals and physicians to avoid the expense of follow-up treatments and readmissions. This, is turn, encourages health-care providers to coordinate treatment and monitor its quality. Other uses of clinical data will be for rating health-care providers and for determining which interventions are most effective. Taken together, these uses of data create a need for workers—clinical documentation and improvement analysts—who have experience with clinical care and who understand the data that clinical care generates. Burning Glass found a 124 percent increase in job posting for this specialization 2007–2011. This is career seems a natural doorway through which nurses can move from providing health care to manipulating data about health care. Their key to this door might be to get certified as a Registered Health Information Technician. In fact, 37 percent of RHITs surveyed by the American Health Information Management Association received their certification with less than 1 month of coding experience, 74 percent of them held an associate degree, 16 percent held a bachelor’s degree, and only 4 percent had no more education than a certificate in coding (PDF).

Burning Glass also found rapid growth in the job postings for supervisory positions in this field: 46 percent growth for medical records and coding department supervisors/managers, 53 percent for health information managers.

Contrast these high-skill specializations with medical records clerks, which had a decline of 46 percent in the job postings 2007–2011. Within this field, medical records clerks would be considered low-skilled, but consider that they are in the middle range of skills when viewed within the full range of health-care occupations. (Home health care aides, for example, would be found near the bottom.)

What these examples show about the health-care field is that it resembles so many others: The workforce is being hollowed out as high-skill and low-skill jobs grow, while middle-skill jobs shrink or, at best, stagnate. The low-skill jobs barely pay a living wage, if that. High skills now are necessarily to gain even a toehold in the middle class.

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