2017 himss leadership and workforce survey leadership... · findings from the 2017 himss leadership...
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2017 HIMSS
Leadership and
Workforce Survey
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2017 HIMSS Leadership and Workforce Survey
Table of Contents 1. Executive Summary ................................................................................................... 2
2. Methodology/Respondent Demographics ................................................................. 3
Position-Level ......................................................................................................... 4
3. Key Observations and Implications ........................................................................... 5
DEMOGRAPHICS ............................................................................................................. 5
IT Oversight/Influence ............................................................................................. 5
Tax Status .............................................................................................................. 6
LEADERSHIP SURVEY..................................................................................................... 7
Clinical IT Priorities .................................................................................................. 7
IT Executives .........................................................................................................14
IT Budget Projection ...............................................................................................16
WORKFORCE SURVEY ...................................................................................................18
Workforce Size - Current .........................................................................................18
Workforce Vacancy .................................................................................................18
Workforce Size – Change Past Year .........................................................................19
Staffing Activity – Past Year ....................................................................................20
Workforce Size – Projected Change Coming Year ......................................................22
Workforce Challenges – Source ...............................................................................23
Workforce Challenges – Impact ...............................................................................23
Workforce Solution – Use of a Search Agency ...........................................................25
Workforce Solution – Outsource Work ......................................................................26
Workforce Solution – HIMSS Resources ....................................................................27
4. Conclusion ................................................................................................................ 29
5. About HIMSS ............................................................................................................ 30
6. How to Cite This Study ............................................................................................. 30
7. For More Information ............................................................................................... 30
APPENDIX A – Provider Survey ................................................................................... 31
APPENDIX B – Vendor/Consultant Survey .................................................................. 37
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1. Executive Summary
The 2017 HIMSS Leadership and Workforce Survey reflects the perspectives of U.S.
health IT leaders on a myriad of topics influencing the health IT industry. Weaving together key
components from two historically seminal HIMSS research efforts (the annual HIMSS
Leadership Survey and the biennial HIMSS Workforce Study), the present report provides
a robust profile of health IT priorities as well as their linkage to various health IT strategic
initiatives (e.g. employment of select IT leaders) and industry economic measures (e.g.
workforce projections).
Based on the feedback from 368 U.S. health IT leaders (210 from a healthcare Provider
organization; 158 from a healthcare IT Vendor/Consulting organization), the findings yield a
few notable themes:
1. Health IT leaders concur on the top clinical IT priorities for the coming year with
divergent priorities pointing to a “healthy tension” within the marketplace.
2. Vendors/Consultants generally have a “good pulse” on the clinical IT priorities of
Hospital-associated Providers with exciting opportunities to target interests in the non-
Hospital Provider market.
3. Health IT continues to be a “bright spot” in the U.S. economy with select markers
suggesting potential challenges ahead in extending health IT’s footprint beyond the
hospital environment.
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2. Methodology/Respondent Demographics
The robust methodological approach employed suggests the findings in this
report can be considered “directionally correct”.
Findings from the 2017 HIMSS Leadership and Workforce Survey are based on the
feedback from 368 qualified1 U.S. health IT leaders participating in a web survey commissioned
by HIMSS North America, between late November 2016 and early January 2017.
Unique to the design of this year’s survey was the purposeful effort to ensure respondents
reflected an array of healthcare organizations (e.g. health IT leaders in nursing homes).
Individuals responding to the survey invite completed one of two parallel survey instruments
based on the type of healthcare organization most closely reflecting their current employer; a
Provider survey for those employed by a healthcare provider organization and a Health IT
Vendor/Consultant survey for all others.
Provider survey responses were partitioned into one of the following three general care sites in
order to allow for a comparison of provider types:
1. Hospitals and hospital-associated entities (e.g. health system corporate office)
2. Ambulatory organizations (e.g. physician office; freestanding outpatient clinics)
3. LTPAC (Long Term / Post-Acute Care) (e.g. nursing homes)
Over half (57 percent; N = 210) of the 368 respondents included in this year’s study answered
the Provider questionnaire (Graphic 1), with 70 percent of these individuals representing care
settings targeted by the Meaningful Use program (Hospitals and Ambulatory settings).
Graphic 1: Respondent Profile
1 To participate in the survey Provider respondents had to have some level of IT oversight at their
organization and were qualified by asking the extent to which they had “oversight of IT” at their healthcare organization. Of the 430 individuals responding to the survey invite, 61 individuals indicated
they had “no oversight/influence at all” and were therefore excluded from the analysis.
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Position-Level
Respondents overwhelmingly represent the leaders of health IT within their
respective organizations.
Respondents to both the Provider and the Health IT Vendor/Consultant survey instruments
were asked to indicate which of the following three position-levels best described their role
within their organization:
1. Executive Management
2. Non-Executive Management
3. Non-Management
Nearly 85 percent of all respondents reported to be in a management role, with over 47 percent
associating themselves with an “Executive Management” position. Interestingly, the
participation rate of Executives from Vendor/Consultant organizations (56 percent) was notably
higher than their peers from Provider organizations (41 percent) (Table 1). Drilling deeper into
the Provider respondents reveals that Executives from Ambulatory (48 percent) and LTPAC (51
percent) settings were more likely to participate in the study than those from a hospital-
associated environment (34 percent)
Table 1: Position-Level
Executive Management 56% 41% 34% 48% 51%
Non-Executive Management 28% 44% 43% 39% 48%
Non-Management 17% 15% 23% 13% 2%
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
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3. Key Observations and Implications
DEMOGRAPHICS
IT Oversight/Influence
Observation: Securing IT representatives in the non-Hospital Provider
market was a challenge.
Implication: Efforts to advance health IT in the non-Hospital Provider
market will be a challenge without clearly defined IT leaders.
The one survey participation “qualifying” question presented exclusively to Provider respondents
concerned the individual’s level of IT oversight within their organization. Respondents were
presented with four statements and asked to select the one best describing their situation.
Individuals selecting the following descriptions were allowed to complete the survey:
1. Primary oversight
2. Some oversight
3. No oversight but have some influence on the use of clinical IT in our organization
Individuals indicating “no oversight/influence at all” were excluded.
Of the 271 individuals from a Provider organization responding to the survey invite, 61 (23
percent) were excluded from the study. Yet the exclusions were not uniform across provider
type as evidenced in Table 2. Over one-quarter (26 percent) of Ambulatory contacts and more
than one-third (36 percent) of LTPAC contacts were insufficiently qualified to meet the minimal
IT oversight/influence criteria to participate in the study.
Table 2:
Primary oversight 24% 27% 38% 13%
Some oversight 32% 39% 17% 28%
No oversight but have some influence on
the use of clinical IT in our organization 22% 23% 19% 22%
No oversight/influence at all 23% 11% 26% 36%
Healthcare Providers LTPAC Hospitals Ambulatory
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Tax Status
Observation: In general, Hospital and non-Hospital Provider respondents
represent organizations with remarkably different business
drivers.
Implication: The profit motive may play a more significant consideration
for non-Hospital Providers in decisions involving clinical IT
than for Hospital Providers.
Respondents to the Provider survey were asked to identify the tax status of their organization.
While the aggregated responses reveal that over half (59 percent) classified their organization
as a “not-for-profit” entity, the responses varied remarkably by the type of organization
represented. Hospital respondents (72 percent) are heavily represented by “not-for-profit”
organizations whereas Ambulatory (55 percent) and LTPAC (51 percent) respondents tip
towards a predominantly “for-profit” profile (Table 3).
Table 3: Tax-Status
Not-for-Profit 59% 72% 45% 41%
For-Profit 30% 12% 55% 51%
Government 10% 15% 0% 5%
Healthcare Providers LTPAC Hospitals Ambulatory
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LEADERSHIP SURVEY
Clinical IT Priorities
One of the unique features of this year’s Leadership and Workforce Survey surrounds the
approach employed to address the prioritization of clinical IT issues. Presented with a list of
clinical IT priorities, Provider and Vendor/Consultant respondents were asked to indicate the
extent to which each issue would be a priority in the coming year using a seven-point scale (1
= “not a priority”; 7 = “essential priority”). Of significance were the following features:
1. The 18 issues presented to the respondents mirror the education tracks offered at the
HIMSS17 conference
2. Provider and Vendor/Consultant respondents were presented slightly different questions
Providers were asked to identify the clinical IT issues of greatest priority for their
organization in the year ahead
Vendor/Consultant respondents were asked to identify the clinical IT issues of
greatest priority for their clients in the year ahead
This approach yielded a number of significant observations and resulting implications.
Observation: Clinical IT priorities generally fall into high, medium and lower
priorities.
Implication: Clinical IT issues have varying degrees of industry appeal and
efforts/expectations to engage the industry surrounding
these issues should be modified accordingly.
By averaging the Provider and Vendor/Consultant clinical priority assessments to derive an
aggregated score for the two audiences, we notice the priorities can be easily classified into
high, medium and lower priority groupings (Table 4).
Table 4: Aggregated Priority Scores
High Priorities
Privacy, Security and Cybersecurity 5.86
Quality and Patient Safety Outcomes 5.83
Care Coordination, Culture of Care, and Population Health 5.70
Electronic Health Records (EHRs) 5.55
Medium Priorities
Process Improvement, Workflow, Change Management 5.43
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Compliance, Risk Management and Program Integrity 5.38
Clinical Informatics and Clinician Engagement 5.38
Business of Healthcare and New Payment Models 5.33
Health Information Exchange, Interoperability and Data Access 5.33
Clinical and Business Intelligence 5.24
Consumer and Patient Engagement 5.07
Connected Health 5.03
Leadership, Governance, Strategic Planning 5.02
IT Infrastructure, HIT Standards and Medical Device Integration 4.89
Lower Priorities
Human Factors, User Experience and Design 4.62
Career/Workforce Development and Diversity 4.23
Innovation, Entrepreneurship and Venture Investment 3.98
Genomics/Precision Medicine 3.70
Observation: Providers and Vendors/Consultants are generally aligned on
the highest priorities facing those leveraging clinical IT.
Implication: Efforts to address these select clinical IT issues should enjoy
synergies from a broad spectrum of industry stakeholders.
By averaging the Provider and Vendor/Consultant clinical priority assessments to derive an
aggregated score for the two audiences and then rank-ordering this score from highest priority
(1) to lowest (18), the separate top three issues for both audiences percolate near the top of
each priority list (Table 5).
Table 5: Top Shared Priorities
Privacy, Security and Cybersecurity 3 1
Quality and Patient Safety Outcomes 1 2
Care Coordination, Culture of Care, and Population Health 4 3
Healthcare
Providers
Vendors/
Consultants
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Observation: Providers and Vendors/Consultants remarkably disconnected
on select priorities.
Implication: Providers and Vendors/Consultants may be “talking” past one
another on key issues resulting in a considerable amount of
inefficiencies.
By continuing the above analysis looking for issues whose ranking reflect the greatest divide
between the two groups, four issues emerge (Table 6). Of significance is the observation that
all four of these issues appear in at least one of the other’s top five-priority list. Note too the
priority Providers place on EHRs compared to Vendors/Consultants.
Table 6: Divergent Priorities
Electronic Health Records (EHRs) 2 8
Business of Healthcare and New Payment Models 10 4
Compliance, Risk Management and Program Integrity 5 10
Health Info. Exchange, Interoperability & Data Access 9 5
Observation: The varied Provider groups are generally aligned on the
highest priorities regarding clinical IT for the coming year.
Implication: Efforts to bridge the divide between the disparate Provider
groups may be facilitated by focusing on those issues of
mutual priority.
When comparing the rank-order of priorities between the three Provider groups considered in
this report, there appears to be a moderate degree of agreement. Indeed, the top three
priorities for all three groups landed in the top-five priority list for Providers as a whole (Table
7).
Healthcare
Providers
Vendors/ Consultants
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Table 7: Ranked Priorities - Providers
Quality and Patient Safety Outcomes 1 1 3 1
Electronic Health Records (EHRs) 2 2 7 2
Privacy, Security and Cybersecurity 3 3 1 6
Care Coordination, Culture of Care, and
Population Health 4 4 2 5
Compliance, Risk Management and
Program Integrity 5 6 4 3
Observation: The three Provider groups varied in the “intensity”
surrounding the clinical IT issues assessed.
Implication: There appears to be a “hunger” regarding clinical IT amongst
LTPAC providers that the industry should address.
When looking at the average score of the top-five priorities listed above for each provider
group, LTPAC respondents tended to rate these issues higher than the two other Provider
groups (Table 8).
Table 8: Ranked Priorities - Providers
Quality and Patient Safety Outcomes 5.87 5.85 5.38 6.15
Electronic Health Records (EHRs) 5.72 5.83 5.00 5.87
Privacy, Security and Cybersecurity 5.68 5.76 5.62 5.57
Care Coordination, Culture of Care, and
Population Health 5.64 5.70 5.42 5.65
Compliance, Risk Management and
Program Integrity 5.45 5.31 5.32 5.79
Average Score (Top-Five) 5.67 5.69 5.35 5.80
Healthcare Providers LTPAC Hospitals Ambulatory
Healthcare Providers LTPAC Hospitals Ambulatory
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Observation: Vendors/Consultants appear to be more aligned with the
priorities of Hospitals than with the other Provider groups.
Implication: To be a relevant force in advancing clinical IT in the non-
Hospital Provider market, Vendors/Consultants will need to
better understand the interests and needs of Ambulatory and
LTPAC providers.
When comparing the priority assessments of Vendors/Consultants to the three Provider groups,
the “gap” between the Vendors/Consultants’ assessment and the Hospital respondents’
assessment (Graphic 2) is generally narrower than the divide between Ambulatory providers
(Graphic 3) and LTPAC providers (Graphic 4). Note too that Ambulatory respondents were
consistently lower than Vendors/Consultants in their assessment of the clinical IT issues under
consideration. This same pattern did not apply to the Hospital or LTPAC respondents.
Graphic 2: Priority Gap – Hospitals vs. Vendors/Consultants
Gap between Hospitals and Vendors/Consultants Score
Lower Priority
for Hospitals than
for Vendors /
Consultants
Higher Priority
for Hospitals than
for Vendors /
Consultants
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Graphic 3: Priority Gap – Ambulatory Providers vs. Vendors/Consultants
Gap between Ambulatory Providers and Vendors/Consultants Score
Graphic 4: Priority Gap – LTPAC vs. Vendors/Consultants
Gap between LTPAC Providers and Vendors/Consultants Score
Lower Priority
for Ambulatory
Providers than for
Vendors /
Consultants
Lower Priority
for LTPAC
Providers than for
Vendors /
Consultants
Higher Priority
for LTPAC
Providers than for
Vendors /
Consultants
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Observation: The clinical IT priorities of For-Profit providers vary
remarkably from Not-For-Profit providers in a few areas.
Implication: Efforts to engage For-Profit providers on clinical IT issues
should highlight the business model impact for the provider.
Analyzing clinical IT priorities by Provider tax status yielded a remarkable, albeit not too
surprising finding. While the vast majority of clinical IT priorities for For-Profit (FP) and Not-For-
Profit (NFP) respondents were similar to one another, these two groups diverged from one
another in three areas (Table 9). Of these three issues, the two most varied priorities
(“Innovation, Entrepreneurship and Venture Investment” and “Business of Healthcare and New
Payment Models”) concerned “business model” issues.
Table 9: Clinical IT Priorities BY Tax Status
Innovation, Entrepreneurship and Venture
Investment 4.13 3.59 0.55
Business of Healthcare and New Payment Models 5.44 4.91 0.53
Process Improvement, Workflow, Change
Management 5.67 5.27 0.40
For-Profit Not-For-
Profit Difference
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IT Executives
Observation: Hospitals tend to have a more populated IT Executive profile
than Ambulatory and LTPAC providers.
Implication: Efforts to advance health IT in non-Hospital Provider settings
may be hobbled by the lack of IT champions.
Provider respondents were asked to identify which of the following three IT executives were
employed by their organization:
1. Chief Information Officer
2. A senior clinical IT leader (e.g. CMIO, CNIO)
3. A senior information security leader (e.g. CISO)
To no surprise, a higher percentage of Hospital respondents (87 percent) reported that their
organization employed at least one of the identified IT executives than the other Provider types
(Table 10). Of the three IT leadership roles considered, the most commonly cited role was Chief
Information Officer (60 percent). Perhaps most notable is the relatively high percentage of
Ambulatory (32 percent) and LTPAC (32 percent) organizations reporting their organization did
not employ a dedicated senior IT executive.
Table 10: Employed IT Executives
At least one of the following 73% 87% 58% 54%
Chief Information Officer 60% 78% 45% 32%
A senior clinical IT leader (e.g. CMIO, CNIO) 48% 65% 29% 27%
A senior information security leader (e.g. CISO) 32% 41% 23% 21%
None of the above 20% 10% 32% 32%
Healthcare Providers LTPAC Hospitals Ambulatory
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Observation: Organizations with a senior clinical IT leader vary from other
Providers in a few notable areas.
Implication: The specific impact senior clinical IT leaders have in the
organization is not immediately clear but worthy of exploring.
Analyzing the respondent’s clinical IT priorities by the presence of a senior clinical IT executive
within the organization yields notable differences in select areas (Table 11). Most notably
surrounds the elevated priority of Clinical and Business Intelligence for organizations with a
senior clinical executive.
Table 11: Clinical IT Priorities BY Presence of Senior Clinical IT Leader
Clinical and Business Intelligence 5.49 4.83 0.66
Electronic Health Records (EHRs) 6.00 5.47 0.53
Consumer and Patient Engagement 5.32 4.83 0.48
Presented with a seven-point scale (1 = “Strongly disagree”; 7 = “Strongly agree”), providers
were asked to indicate the extent to which they agreed their clinicians (medical staff and
nursing staff) had a favorable attitude towards the deployment of clinical IT in their respective
organization (Table 12). While Providers as a whole were generally more positive surrounding
the nursing staff’s assessment of clinical IT, the medical staff in organizations with a senior
clinical IT leader were notably more satisfied with clinical IT than other provider organizations.
Table 12: Clinician Satisfaction BY Presence of Senior Clinical IT Leader
Medical staff 4.98 5.05 4.92 0.13
Nursing staff 5.14 5.10 5.18 -0.08
Difference Clinical IT
Leader
No Clinical IT Leader
Difference Clinical IT
Leader
No Clinical IT Leader
Healthcare Providers
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IT Budget Projection
Observation: The majority of Providers and Vendors/Consultants project
their IT budgets to INCREASE this year, although Providers
were not as uniform in their projections as
Vendors/Consultants.
Implication: Health IT continues to be a “bright spot” in the economy.
Both Providers and Vendors/Consultants were asked to indicate if their respective organization’s
IT operating budget was projected to increase during the next fiscal year. As depicted in Table
13, the majority of respondents from all audiences responded positively. That said, Providers
(56 percent) were generally more muted in their optimism than Vendors/Consultants (87
percent).
Table 13: IT Budget Projection
Increase 87% 56% 57% 55% 57%
Stay the same 5% 19% 17% 26% 18%
Decrease 4% 12% 18% 7% 3%
While the majority of Hospital Provider’s project an increase in their IT budget projection this
year, it is worthy to note that these findings represent a decrease of 11 percentage points from
the 2016 HIMSS Leadership Survey findings (Table 14).
Table 14: Hospital IT Budget Projection – 2016 vs. 2017 Comparison
2016 2017 Change
Increase 65% 57% -8%
Stay the same 21% 17% -4%
Decrease 7% 18% 11%
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
Hospitals
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As would be expected, IT budgetary projections do appear to have an impact on a Provider’s
clinical IT priorities. By separating Providers into two groups based on their IT budget
projection (Increase/Stay the Same and Decrease) and then comparing priority scores, the
priority assigned to the Electronic Health Record presents the most striking difference. Providers
projecting a “decrease” in their IT Budget assign a much lower priority to the EHR than those
expecting to “increase” or at least maintain their current IT budget (Table 15).
Table 15: Provider Clinical IT Priorities BY Projected IT Budget
Electronic Health Record 5.86 5.16 0.70
Difference Increase/Stay
the Same Decrease
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WORKFORCE SURVEY
Workforce Size - Current
Observation: A remarkable percentage of Ambulatory and LTPAC Providers
report having no FTE IT workers.
Implication: Efforts to advance clinical IT in non-Hospital Provider
environments can be challenging when there is no dedicated
IT workforce.
When asked to indicate the number of full-time equivalent (FTE) IT workers employed by their
organization, hospital-associated respondents tended to report the largest workforces (Table
16). While not surprising, the disconcerting finding involves the relatively high percentage of
Ambulatory (16 percent) and LTPAC (13 percent) providers reporting no FTE IT workers.
Table 16: Workforce Size – Current
1-5 FTE IT staff positions 20% 11% 16% 37%
5-20 FTE IT staff positions 18% 17% 32% 11%
More than 20 FTE IT staff positions 44% 64% 26% 16%
None of the above 6% 0% 16% 13%
Workforce Vacancy
Observation: The majority of health IT employers have positions they are
looking to fill.
Implication: Health IT continues to be a “bright spot” in the economy.
All respondents were asked to characterize their organization’s current IT staffing occupancy.
The findings suggest the demand for health IT workers is strong as evidenced by the fact that
Healthcare Providers LTPAC Hospitals Ambulatory
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only 32 percent of Vendors/Consultant organizations and 38 percent of Provider organizations
claim they are fully-staffed (Table 17).
Table 17: Workforce Vacancy
We are fully staffed 32% 38% 29% 48% 49%
We have open positions to
fill 61% 43% 61% 32% 14%
Workforce Size – Change Past Year
Observation: The majority of health IT employers grew or at least
maintained the size of their IT workforce.
Implication: Health IT continues to be a “bright spot” in the economy.
Both Providers and Vendor/Consultants were asked how the size of their current IT workforce
compares to their workforce twelve months ago. While the majority of Vendor/Consultant
respondents (61 percent) claimed their workforce increased in size, Providers were not as
definitive (Table 18). That said, the majority of organizations grew or at least maintained the
size of their workforce.
Table 18: Workforce Size – Change Past Year
Increased 61% 42% 53% 39% 24%
Stayed the same 17% 28% 17% 36% 44%
Decreased 15% 12% 17% 3% 8%
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
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Staffing Activity – Past Year
Observation: The majority of health IT employers successfully filled at least
one health IT position this past year, with IT support roles
dominating as the most commonly filled positions.
Implication: Health IT continues to be a “bright spot” in the economy.
Both Providers and Vendor/Consultants were asked if they hired a health IT worker during the
past year, and if so, to indicate the type of worker hired (NOTE: Given the fundamentally
different functions these two audiences play in the health IT industry, the types of roles
presented to the respondents were reflective of the hiring organizations).
As depicted in Graphic 5, the majority of Providers (61%) and Vendors/Consultants (79%)
report to have hired at least one FTE health IT worker this past year. We do see a notable
variance in the hiring experiences by Provider type though. Hospital-associated respondents (80
percent) were much more likely to report their organization hired a health IT worker than
Ambulatory (58 percent) or LTPAC (27 percent) respondents.
Graphic 5: Staffing Activity – Past Year
As a general category, the most common type of health IT roles hired by Providers this past
year can be classified as IT Support positions (e.g. Help Desk; Clinical Application Support). The
propensity for IT Support personnel was consistent across Provider types (Table 19).
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Table 19: Provider Positions Filled – Past Year
Management 63% 70% 33% 59%
Development 28% 32% 11% 24%
Implementation 47% 56% 17% 29%
Support 93% 98% 83% 77%
While the percentage of Hospitals having hired IT staff this year (80 percent) is similar (81
percent) to the results obtained in the last HIMSS Workforce Survey (published during the end
of 2014), an analysis of specific IT roles reveals some interesting shifts (Table 20). With the top
three most commonly sought roles being Project Manager (57 percent), Help-Desk (56 percent)
and Clinical Application Support (55 percent), the current demand for Project Managers “sky-
rocketed” (increased 22 percentage points) compared to the 2014 findings.
Table 20: Top Hospital IT Positions Filled (Past Year) – 2014 vs. 2017 Comparison
2014 2017 Change
Hospitals (hired at least one IT worker) 81% 80% -1%
Project Management 35% 57% 22%
Help Desk 57% 56% -1%
Clinical Application Support 64% 55% -9%
IT Management 45% 46% 1%
Clinical Informaticist/Clinical Champion 29% 45% 16%
Systems Integration 22% 39% 17%
System Design and Implementation 29% 34% 5%
The Vendor/Consultant industry appears to be in a period of transition. While the vast majority
of Vendors/Consultants (79 percent) report to have hired at least IT related worker this past
year, the activity level is down noticeably from the levels reported in the 2014 HIMSS Workforce
Survey (91 percent) (Table 21). The most common class of worker hired by
Vendors/Consultants this past year can be classified as Field Support Staff roles (50 percent).
Yet it is the decline in the percentage of Sales/Marketing personnel (37 percentage points)
which perhaps presents as the most telling regarding the state of this industry.
Healthcare Providers LTPAC Hospitals Ambulatory
Hospitals
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Table 21: Top Vendor/Consultant IT Positions Filled (Past Year) – 2014 vs. 2017
Comparison
2014 2017 Change
Vendors/Consultants (hired at least one IT worker) 91% 79% -12%
Field Support Staff (i.e. Systems Implementers) 75% 50% -25%
Support Staff (i.e. HR, Finance Team, Web Team) 73% 42% -31%
Sales/Marketing Team 78% 41% -37%
Executive Team 60% 39% -21%
Workforce Size – Projected Change Coming Year
Observation: The majority of Vendor/Consultant organizations are
projecting a positive growth in the size of their workforce
while Providers have a more muted view.
Implication: Vendors/Consultants and Providers will have remarkably
different health IT staffing needs this coming year.
Both Providers and Vendor/Consultants were asked how the size of their current IT workforce is
expected to change in the next twelve months. Interestingly, Vendor/Consultant respondents
(66 percent) were much more positive about their workforce growth than the Providers (31
percent) (Table 22). With the vast majority of audiences projecting their workforce to grow or
at least remain the same, Hospital-associated respondents (36 percent) were more favorable
about their workforce growth than Ambulatory (26 percent) or LTPAC (22 percent) respondents.
Table 22: Workforce Size – Projected Change Coming Year
Increase 66% 31% 36% 26% 22%
Stayed the same 16% 36% 32% 48% 38%
Decrease 4% 10% 16% 3% 3%
Vendors/
Consultants
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
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Workforce Challenges – Source
Observation: Providers are primarily challenged in the recruitment and
development of IT workers.
Implication: Providers may be most receptive to efforts to support their
internal IT staff recruitment and development activities.
The focus of the Provider’s survey turned to the challenges organizations may face in
overseeing a health IT workforce. Respondents were presented with a list of five issues known
to challenge an organization’s health IT staffing/workforce efforts, and asked to rate the extent
to which issue presented as a challenge the past year. By rank-ordering the issues (1 = most
challenging issue) for each Provider group we note a fairly high-degree of consistency as the
top two issues for all audiences involved employee recruitment and development (Table 23).
Table 23: Workforce Challenges - Source
Developing the skills of current IT staff 1 1 2 2
Recruitment of qualified IT workers 2 2 1 1
Retention of qualified IT staff 3 3 4 4
Managing the performance of current
IT staff 4 4 3 3
Retirement of “baby boomer” IT staff 5 5 5 5
Workforce Challenges – Impact
Observation: Over one-third of health IT employers are negatively impacted
by health IT staffing challenge.
Implication: The sense of urgency to address health IT staffing concerns
varies by Provider type.
Both Vendors/Consultants and Provider respondents were then asked if their organization had
been negatively impacted by a workforce challenge during the past year. Over one-third of
Healthcare Providers LTPAC Hospitals Ambulatory
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Vendors/Consultant (37 percent) and Provider respondents (36 percent) claimed their
organization was forced to place on hold or scale back an IT project or initiative in the past year
(Table 24). Providers were more likely to place on hold a project (32 percent) than
Vendors/Consultants (26 percent). The pervasiveness of the impact in the Provider market
appears to be more acutely experienced in hospitals (47 percent).
Table 24: Workforce Challenges - Impact
Negatively Impacted - Yes 37% 36% 47% 39% 14%
Place on Hold 26% 32% 44% 29% 12%
Scaled back 30% 30% 40% 32% 10%
Of interest is the Hospital response to staffing challenges. A comparison of the current results
to the 2014 HIMSS Workforce Survey suggests Hospitals are accelerating their willingness to
place projects “on hold “ (9 percentage point change) (Table 25).
Table 25: Top Hospital IT Positions Filled (Past Year) – 2014 vs. 2017 Comparison
2014 2017 Change
Place on Hold 35% 44% 9%
Scaled back 38% 40% 2%
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
Hospitals
25 | P a g e
Workforce Solution – Use of a Search Agency
Observation: Over 40 percent of Vendors/Consultants and Hospitals having
filled at least one health IT position this past year used the
services of an executive search agency; utilization rates
notably lower in other Provider settings.
Implication: The non-Hospital Provider market presents as a growth
market for search agencies as the use of IT expands in these
environments.
One of the industry solutions to assist health IT employers in overcoming workforce recruitment
challenges is to leverage the services of an executive search firm. Of the Vendors/Consultants
and Providers claiming to have hired at least one health IT worker this past year, 46 percent of
Vendors/Consultants and 37 percent of Providers used a search firm (Table 26). Of interest is
the decline in the usage of staffing agencies by Vendors/Consultants (-11 percent) and
Hospitals (-11 percent) when comparing the current study results to the 2014 HIMSS Workforce
Survey.
Table 26: Workforce Solution – Use of a Search Agency
Used a Search Agency (2017) 46% 37% 41% 28% 24%
Used a Search Agency (2014) 57% - 52% - -
Change -11% - -11% - -
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
26 | P a g e
Workforce Solution – Outsource Work
Observation: Outsourcing work to an external health IT vendor or
consultancy is a common practice leveraged by all Provider
groups.
Implication: Outsourcing organizations play an important role in assisting
organizations address workforce challenges.
One strategy healthcare providers can pursue in meeting their IT staffing needs is to outsource
select tasks to an external company. This strategy appears to be widely embraced by provider
organizations. In fact, 60 percent of healthcare provider respondents indicated their
organization outsourced at least some of their IT staffing needs to a vendor or consultant rather
than hiring the workers directly (Table 27).
Table 27: Workforce Solution – Outsource Work
Outsourced Work - Yes 60% 65% 71% 44%
The most common class of health IT roles outsourced by Providers this past year were IT
Support positions (e.g. Help Desk; Clinical Application Support). The propensity to hire IT
Support personnel was consistent across Provider types (Table 28).
Table 28: Type of Work Outsourced – Past Year
Management 45% 45% 18% 61%
Development 31% 36% 18% 29%
Implementation 50% 49% 36% 61%
Support 82% 81% 77% 86%
When analyzing the specific IT positions outsourced by Hospitals this past year, the most
commonly outsourced role was Project Manager (40 percent), followed by Programmer (36
Healthcare Providers LTPAC Hospitals Ambulatory
Healthcare Providers LTPAC Hospitals Ambulatory
27 | P a g e
percent) (Table 29). These two roles, along with Help Desk, reflected the greatest shift in
demand when compared to the 2014 HIMSS Workforce Survey findings.
Table 29: Top Hospital IT Positions Outsourced (Past Year) – 2014 vs. 2017
Comparison
2014 2017 Change
Project Management 25% 40% 15%
Programming 19% 36% 17%
Clinical Application Support 30% 31% 1%
System Design and Implementation 25% 29% 4%
Help Desk 12% 28% 16%
Systems Integration 22% 23% 1%
Workforce Solution – HIMSS Resources
Observation: The HIMSS Annual Conference is the most recognizable
workforce/staffing resource offered by HIMSS; Of the
different Provider groups, LTPAC Providers are the least
aware of HIMSS’ varied resources.
Implication: The HIMSS Annual Conference presents an excellent
opportunity to introduce the health IT industry to the full
array of HIMSS’ workforce/staffing resources.
Implication: The LTPAC market could benefit from an increased awareness
of HIMSS’ workforce/staffing resources.
Finally, all survey participants were presented with a list of HIMSS resources designed to assist
health IT employers in addressing a variety of workforce challenges, and asked to indicate
whether or not they were aware of said resource. As reflected in Table 30, the HIMSS Annual
Conference is understandably the most recognizable health IT workforce/staffing resource, yet
market awareness varied by Provider group, most notably the LTPAC respondents (25 percent).
Hospitals
28 | P a g e
Table 30: Workforce Solution – HIMSS Resources
Annual Conference 79% 57% 72% 65% 25%
CPHIMS certification 59% 49% 62% 52% 21%
CAHIMS certification 58% 47% 60% 52% 21%
Learning Center 56% 41% 52% 45% 20%
HIT Career Compensation
Survey 51% 35% 46% 39% 13%
HIMSS Scholarships 41% 32% 43% 29% 13%
JobMine 46% 31% 44% 32% 7%
The TIGER Initiative 22% 28% 35% 29% 13%
eMentoring 23% 17% 18% 16% 13%
Healthcare Providers LTPAC Hospitals Ambulatory
Vendors/ Consultants
29 | P a g e
4. Conclusion
Findings from the 2017 HIMSS Leadership and Workforce Survey suggest both Providers
and Vendor/Consulting organizations share many of the same clinical IT priorities for this
coming year, most notably issues involving privacy, security and cybersecurity as well as care
coordination, culture of care, and population health. That said, there do appear to be some
remarkable disconnects between the two audiences worthy of attention, such as the priority
placed on the Electronic Health Record (EHR). The divergent priorities highlight a “healthy
tension” within the marketplace as Providers and Vendors/Consultants wrestle on ensuring each
is focused on the concerns they deem most relevant.
The findings also paint Vendors/Consultants as having a “good pulse” on the clinical IT priorities
of Hospital-associated Providers. Yet the same findings revealed some remarkable variances in
the assessment of clinical IT priorities between Vendors/Consultants and non-Hospital Providers
suggesting there are a number of exciting targeted interests the Vendor/Consultant community
may want to pursue in the non-Hospital Provider market this coming year.
Finally, the findings clearly reinforce the importance of health IT to the U.S. economy. Health IT
workers have been able to look to Provider and Vendor/Consulting organizations for gainful
employment this past year, especially true for those pursuing Supportive IT roles (e.g. field
support staff; Help Desk functions). Buoyed by expectations that IT budgets for both Provider
and Vendor/Consulting organizations will grow or at least remain the same this coming year,
health IT workers should be able to expect their services to continue to be in demand. A few
notable markers specific to the non-Hospital Provider community nevertheless counterbalance
these positive workforce metrics, suggesting potential challenges ahead in extending health IT’s
footprint beyond the hospital environment. These will be issues we will want to closely monitor
in the next HIMSS Leadership and Workforce Survey.
30 | P a g e
5. About HIMSS The Healthcare Information and Management Systems Society (HIMSS) is a global, cause-
based, not-for-profit organization focused on better health through information technology (IT).
In North America, HIMSS focuses on health IT thought leadership, education, events, market
research, and media services. Founded in 1961, HIMSS North America encompasses more than
64,000 individuals, of which more than two-thirds work in healthcare provider, governmental,
and not-for-profit organizations, plus over 640 corporations and 450 not-for-profit partner
organizations, that share this cause.
6. How to Cite This Study Individuals are encouraged to cite this report and any accompanying graphics in printed matter,
publications, or any other medium, as long as the information is attributed to the 2017 HIMSS
Leadership and Workforce Survey.
7. For More Information Joyce Lofstrom
Senior Director, Corporate Communications
HIMSS
33 W. Monroe, Suite 1700
Chicago, IL 60603
312-915-9237
31 | P a g e
APPENDIX A – Provider Survey
HIMSS 2017 Health IT Leadership and Workforce Survey Provider Version
1. Which of the below best describes the type of healthcare organization for which you work?
Hospital-Based Organization
О Stand Alone Hospital
О Hospital that Is Part of a Health Care Delivery System
О Entity that is Part of a Health Care Delivery System (e.g. Corporate Office; Ambulatory
Clinic)
Ambulatory Organization
О Physician Office
О Outpatient Clinic
Long Term/Post-Acute Care (LTPAC) Organization
О Home Health Care
О Skilled Nursing Facility/Senior Care Facility
О Behavioral Health
О Independent Rehabilitation Facility
Non-Provider Health IT Organization
О Health IT Vendor Organization If selected send to Vendor/Consultant survey
О Health IT Consulting Firm If selected send to Vendor/Consultant survey
Other
О Other (please specify) If selected send to Vendor/Consultant survey
2. Please indicate the tax-status of the healthcare organization for which you work.
О For-Profit
О Not-For-Profit
О Government
О Don’t Know
3. Which role below best describes the position you hold within your organization?
О Executive Management
О Non-Executive Management
О Non-Management
4. To what extent do you have oversight of IT at your healthcare organization?
О Primary oversight
О Some oversight
О No oversight but have some influence on the use of clinical IT in our organization
О No oversight/influence at all If “No oversight/influence at all” is selected END SURVEY
32 | P a g e
5. To what extent are the below issues a priority for your clinical IT efforts in the next 12 months?
a. Business of Healthcare and New Payment Models
b. Care Coordination, Culture of Care, and Population Health
c. Career/Workforce Development and Diversity
d. Clinical and Business Intelligence
e. Clinical Informatics and Clinician Engagement
f. Compliance, Risk Management and Program Integrity
g. Connected Health
h. Consumer and Patient Engagement
i. Electronic Health Records (EHRs)
j. Genomics/Precision Medicine
k. Health Information Exchange, Interoperability and Data Access
l. Human Factors, User Experience and Design
m. Innovation, Entrepreneurship and Venture Investment
n. IT Infrastructure, HIT Standards and Medical Device Integration
o. Leadership, Governance, Strategic Planning
p. Privacy, Security and Cybersecurity
q. Process Improvement, Workflow, Change Management
r. Quality and Patient Safety Outcomes
Not a priority Low priority
Somewhat of
a priority Neutral
Moderate
priority
High
priority
Essential
priority
О О О О О О О
6. To what extent do you agree with the below statements?
a. The medical staff has a favorable attitude towards the deployment of clinical IT in our
organization
b. The nursing staff has a favorable attitude towards the deployment of clinical IT in our
organization
Strongly
disagree Disagree
Somewhat
disagree
Neither agree
or disagree
Somewhat
agree Agree
Strongly
disagree
О О О О О О О
7. Which of the below IT executives does your organization employ? (select all that apply)
О Chief Information Officer
О A senior clinical IT leader (e.g. CMIO, CNIO)
О A senior information security leader (e.g. CISO)
О None of the above If selected skip to Q9
О Don't know If selected skip to Q9
8. To what extent do you agree with the below statements?
Only display if “Chief Information Officer” selected in Q7
a. Our CIO is considered to be part of the organization's executive team
b. Our CIO has primary responsibility for presenting IT issues to the Board of Directors
Only display if “A senior clinical IT leader” selected in Q7
c. Our senior clinical IT leader (e.g. CMIO, CNIO) is considered to be part of the
organization's executive team
Only display if “A senior Information security leader” selected in Q7
d. Our senior information security leader is considered to be part of the organization's
executive team
Strongly
disagree Disagree
Somewhat
disagree
Neither agree
or disagree
Somewhat
agree Agree
Strongly
disagree
О О О О О О О
33 | P a g e
9. Please select the statement which best describes the projected change, if any, to your
organization’s IT operating budget for the next fiscal year.
О It will definitely increase
О It will probably increase
О No change
О It will probably decrease
О It will definitely decrease
О Don't know
HEALTH IT WORKFORCE STUDY Questions
10. How many Full-Time-Equivalent (FTE) IT staff positions (filled and open) support your
organization.
О No one FTE staff position dedicated to supporting our organization’s IT needs
О 1 – 5 If selected skip to Q12
О 5 – 20 If selected skip to Q12
О More than 20 If selected skip to Q12
О Don’t Know If selected skip to Q12
11. Please describe how your organization’s IT needs are supported.
[OPEN TEXT]
12. How would you characterize your organization’s current IT staffing profile?
О We are fully staffed
О We have open positions to be filled
О Don’t Know
13. Compared to this time last year, has the total number of FTE IT staff positions (filled and open)
in your organization changed?
О Yes – it increased
О Yes – it decreased
О No
О Don’t know
14. Compared to this time next year, do you expect the total number of IT FTE staff positions
(filled and open) in your organization to change?
О Yes – the number of IT FTE positions should increase
О Yes – the number of IT FTE positions should decrease
О No
О Don’t know
15. During the past year, did your organization hire any IT FTEs?
О Yes
О No If selected skip to Q17
О Don’t know If selected skip to Q17
34 | P a g e
16. During the past year, in what areas did your organization hire IT FTE staff? (Please select all
that apply)
Management
О IT Management
О Project Management
Development
О Programming
Implementation
О Process/Workflow Design
О System Design and Implementation
О Systems Integration
Support
О Architect
О Clinical Application Support
О Clinical Informaticist/Clinical Champion
О Database Administration
О Financial Application Support
О Help Desk
О Infrastructure
О Internet/Intranet
О IT Security
О Manage Mobile Devices
О Regulatory, Reimbursement and Accreditation Issues (e.g. Meaningful Use)
О User Training
О Other (please specify)
О Don’t know
17. During the past year, did your organization outsource any of your IT services to a vendor or a
consultant?
О Yes
О No If selected skip to Q19
О Don’t know If selected skip to Q19
18. In what areas did you outsource your IT services to a vendor or a consultant? (Please select
all that apply)
Management
О IT Management
О Project Management
Development
О Programming
Implementation
О Process/Workflow Design
О System Design and Implementation
35 | P a g e
О Systems Integration
Support
О Architect
О Clinical Application Support
О Clinical Informaticist/Clinical Champion
О Database Administration
О Financial Application Support
О Help Desk
О Infrastructure
О Internet/Intranet
О IT Security
О Manage Mobile Devices
О Regulatory, Reimbursement and Accreditation Issues (e.g. Meaningful Use)
О User Training
О Other (please specify)
О Don’t know
19. To what extent do you agree that the following issues presented as a challenge to your
organization’s health IT staffing/workforce efforts during the past year?
20. Recruitment of qualified IT workers
21. Retention of qualified IT staff
22. Retirement of “baby boomer” IT staff
23. Managing the performance of current IT staff
24. Developing the skills of current IT staff
Strongly
disagree Disagree
Somewhat
disagree
Neither agree
or disagree
Somewhat
agree Agree
Strongly
disagree
О О О О О О О
20. Did you scale back any IT projects or IT initiatives this past year because of any health IT
staffing/workforce challenges faced by your organization?
О Yes
О No
О Don’t Know
21. Did you place on hold any IT projects or IT initiatives this past year because of any health IT
staffing/workforce challenges faced by your organization?
О Yes
О No
О Don’t Know
22. Did you use the services of a IT staffing/executive search firm this past year?
О Yes
О No
О Don’t Know
36 | P a g e
23. Are you aware of the following HIMSS resources to support an organization’s health IT
workforce/staffing efforts?
Yes No
JobMine О О
CAHIMS certification О О
CPHIMS certification О О
Learning Center О О
Annual Conference О О
eMentoring О О
HIT Career Compensation Survey О О
HIMSS Scholarships О О
The TIGER Initiative О О
37 | P a g e
APPENDIX B – Vendor/Consultant Survey
HIMSS 2017 Health IT Leadership and Workforce Survey Vendor Version
1. Which of the below best describes the type of healthcare organization for which you work?
Hospital-Based Organization
О Stand Alone Hospital If selected send to Provider survey
О Hospital that Is Part of a Health Care Delivery System If selected send to Provider survey
О Entity that is Part of a Health Care Delivery System (e.g. Corporate Office; Ambulatory
Clinic) If selected send to Provider survey
Ambulatory Organization
О Physician Office If selected send to Provider survey
О Outpatient Clinic If selected send to Provider survey
Long Term/Post-Acute Care (LTPAC) Organization
О Home Health Care If selected send to Provider survey
О Skilled Nursing Facility/Senior Care Facility If selected send to Provider survey
О Behavioral Health If selected send to Provider survey
О Independent Rehabilitation Facility If selected send to Provider survey
Non-Provider Health IT Organization
О Health IT Vendor Organization
О Health IT Consulting Firm
Other
О Other (please specify)
2. Which role below best describes the position you hold within your organization?
О Executive Management
О Non-Executive Management
О Non-Management
38 | P a g e
3. To what extent are the below issues projected to be a priority for your clinical IT clients in the
next 12 months?
s. Business of Healthcare and New Payment Models
t. Care Coordination, Culture of Care, and Population Health
u. Career/Workforce Development and Diversity
v. Clinical and Business Intelligence
w. Clinical Informatics and Clinician Engagement
x. Compliance, Risk Management and Program Integrity
y. Connected Health
z. Consumer and Patient Engagement
aa. Electronic Health Records (EHRs)
bb. Genomics/Precision Medicine
cc. Health Information Exchange, Interoperability and Data Access
dd. Human Factors, User Experience and Design
ee. Innovation, Entrepreneurship and Venture Investment
ff. IT Infrastructure, HIT Standards and Medical Device Integration
gg. Leadership, Governance, Strategic Planning
hh. Privacy, Security and Cybersecurity
ii. Process Improvement, Workflow, Change Management
jj. Quality and Patient Safety Outcomes
Not a priority Low priority
Somewhat of
a priority Neutral
Moderate
priority
High
priority
Essential
priority
О О О О О О О
4. Please select the statement which best describes the projected change, if any, to the
volume of clinical IT business your organization addresses during the next fiscal year.
О It will definitely increase
О It will probably increase
О No change
О It will probably decrease
О It will definitely decrease
О Don't know
HEALTH IT WORKFORCE STUDY Questions
5. How would you characterize your organization’s current staffing profile?
О We are fully staffed
О We have open positions to be filled
О Don’t Know
6. Compared to this time last year, has the total number of FTE staff positions (filled and open) in
your organization changed?
О Yes – it increased
О Yes – it decreased
О No
О Don’t know
39 | P a g e
7. Compared to this time next year, do you expect the total number of IT FTE staff positions
(filled and open) in your organization to change?
О Yes – the number of FTE positions should increase
О Yes – the number of FTE positions should decrease
О No
О Don’t know
8. During the past year, did your organization hire any FTEs?
О Yes
О No If selected skip to Q17
О Don’t know If selected skip to Q17
9. During the past year, in what areas did your organization hire FTE staff? (Please select all that
apply)
О Executive Team
О Sales/Marketing Team
О Field Support Staff (i.e. Systems Implementers)
О Support Staff (i.e. Human Resources professionals, Finance Team, Web Team)
О Other (please specify)
О Don’t know
10. Did you scale back any IT projects or IT initiatives this past year because of any health IT
staffing/workforce challenges faced by your organization?
О Yes
О No
О Don’t Know
11. Did you place on hold any IT projects or IT initiatives this past year because of any health IT
staffing/workforce challenges faced by your organization?
О Yes
О No
О Don’t Know
12. Did you use the services of a IT staffing/executive search firm this past year?
О Yes
О No
О Don’t Know
40 | P a g e
13. Are you aware of the following HIMSS resources to support an organization’s health IT
workforce/staffing efforts?
Yes No
JobMine О О
CAHIMS certification О О
CPHIMS certification О О
Learning Center О О
Annual Conference О О
eMentoring О О
HIT Career Compensation Survey О О
HIMSS Scholarships О О
The TIGER Initiative О О