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Q&A: How Boston Medical Center Stays on Top of New Healthcare Regulations

This is part two of a two-part Q&A featuring Arthur Harvey, M.S., chief information officer at Boston Medical Center. Part one can be viewed here.

Health IT isn’t the most sought-after career for the younger generation. But that does not stop cyberattackers from targeting the healthcare sector more than any other.

With that said, it is important for health systems to be able to recruit top talent to protect personal health information and keep patients’ trust.

In part two of my interview, Arthur Harvey, M.S., chief information officer at Boston Medical Center, discussed health IT pain points, recruiting talent and staying on top of new healthcare regulations.

Editor’s note: This interview has been lightly edited for length, style and clarity.

S.R.: Some people might say that IT is not a very appealing job. What should health systems be doing to recruit top talent and how do you make sure that the younger generation can be interested in the field? 

Arthur Harvey, M.S.: I attended Brandeis University and I taught the next generation who were seeking master’s degrees in this field. I agree with your premise that the next generation isn’t really excited about IT jobs. However, I’m not sure the next generation, in my observation, is excited about any jobs. They want an intrinsic change in the way work is done to more of a gig economy with more flexibility and more of a feeling of self- satisfaction. They’re looking for something that makes them overall happier. And that’s not wrong. I get it. I’m older and I’m from a generation where you went to work, you shut up and you would do as you were told. You worked at it and if you were good at it, you would manage — at least that was the hope. That doesn’t mean I didn’t work at a bunch of startups and get to do creative things. But at the end of the day, jobs in health IT are hard to fill both because generally there are less people with the skills needed who are interested in doing the work. And in my opinion, a lot of that’s around the fact that the work is technically demanding. It’s hard and requires an ability to understand things like math and statistics, in many cases, which people don’t seem to want to learn. So, that’s all part of the challenge: How do you get people basic skills? How do you convince people that working in IT is a good thing to do? This isn’t even just for health IT, its more general than that.

The good news from the health IT perspective is that I have two advantages that my colleagues in banking don’t have. The first advantage is that I work at a safety net hospital and I chose to work at this particular place and I really like it because at the end of the day, we do work that makes people who need our help have better lives. We do the work that makes the world a better place. It’s a really good recruiting tool because people say, “Boy, there’s a mission there.”

A second thing is that I generally don’t go out and hire people with these skills, I train them. We tend to hire younger people and train them and yes, that means I suffer high turnover. Many of the hospitals in Boston are full of people who have cut their teeth at my shop, and that’s okay. We do that.

We also look for clinicians who are interested in doing IT. I have a lot of people who used to be various types of clinicians who decided that they’d like to do IT. That has been
a good way for me to expand.

All of that being said, there is a humongous shortage of people who can actually do some of the more technically skilled jobs and to be quite honest, most of what you’re seeing is a lot of those jobs getting outsourced.

So yes, I do have trouble filling roles like network engineers and data architects. The analytics and technical roles I can usually just grow somebody into it.

S.R.: Would you say recruiting is your biggest pain point right now?

Arthur Harvey, M.S.: No, because frankly, we do pretty well. I’m a big believer in promoting from within. We do give people opportunities where appropriate, so I tend to have a loyal staff who seem to like working there.

I would argue my biggest pain point is the changing business models and the changing regulations in healthcare. Every time a government organization like ONC comes out with a new set of rules, it’s a humongous impact for IT. You have to do redesigns; you have to potentially put in tons of upgrades. We write reports and do a ton of stuff and the timeline available to do it all is often inadequate.

In Massachusetts, for Medicaid, we went to an ACO model for a lot of patients, which required all kinds of new technology and new work and we did not have adequate time to get that done. The reality is that we did the best we could, and we’ve been pretty successful, but it’s the biggest challenge. It’s the external shocks to the system.

My colleagues want me to give a five-year plan, but I can’t. I have no idea what the world’s going to look like in five years. Let’s talk about a three-year plan that we’re going to write in pencil because I don’t know what’s going to happen next year. ONC could completely change the rules on data blocking and data sharing next week. Then I have to throw away everything I planned for all and start over. So that’s really my biggest challenge. I’m not griping about it; we need these things need to happen. It’s just I don’t think the impact on IT is often understood when policy makers make perfectly reasonable policies to try and accomplish what they’re trying to accomplish. The actual implementations get tricky.

S.R.: How do you stay on top of all the new regulations?

Arthur Harvey, M.S.: I have a team that does that. When we talk about where you spend money in healthcare IT, if you’re a place that’s my size, it’s pretty typical that I have a manager and a team of a two or three analysts that really all they do is follow these regulations and chase them around and look to see what it impacts and things of that nature. That’s a big part of what we do. If I’m putting three FTEs on that, that’s three FTEs that aren’t doing something that some doctor wants done, right?

It’s the right thing to do because we need to be compliant. We also have a good legal department and a government affairs department that stays aware of the conversations going on about what might come in the future. But that’s just something you’ve got to do if you’re a smaller shop than I am, you tend to rely on an outside entity to keep track of this stuff for you. The reality is that it’s a full-time job for small group of people.

S.R.: What is an executive pearl of wisdom you would like to share with your peers?

Arthur Harvey, M.S.: I would say the most important thing for any executive is to be part of the team. We’re at our best at BMC when the executive team is communicating effectively and well, and we’re pulling in the same direction. It’s important to have a shared goal and work as a team and communicate about it.

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