Do you see informatics growing or shrinking in the next 5 years?

[stephenfnielsen]

My coworkers banter back and forth about this, but what do you all think?

I was at Epics user group meeting a few months ago and was floor by some of the technology that they have coming out in the next few years. But in my opinion, all signs point to more, more, more demand for healthcare resources and less, less, less resources. I don't care if you are a Republican, Democrat or any other party inside or outside the US, everyone agree that too much is being spent on healthcare.

My prediction: Big time healthcare IT bubble over the next 5-10 years in the US. We'll see more integrated systems, a cloud based repository of health information, greater use of tele medicine both for inpatient and outpatient medicine. Then BOOM a huge pop! Whether true or not, IT will be seen as revenue negative and scarce funding will be funneled to patient care activities and out of IT.

Anyone see it differently? Can we possibly continue the exponential growth in the industry?

[WagnerRN]

I see both growing and shrinking... I think it is important for anyone going into informatics to do a lot of research. It seems many do not and will get burned for it or take longer to get a job (as you can see often in this nursing informatics forum). I think EPIC might be a bubble because once all the hospitals are completely implemented, I see layoffs and a lot of hospitals are using temporary contractors. Major organizations more likely will retain an informatics staff but smaller local organizations will wind down after a successful go live.

Overall I do not see nursing informatics as a bubble because electronics will be the way to go regardless of economy.. It is how you re-invent yourself (going into telemedicine, research & development, RFID's and IT software like EPIC will require upgrades periodically) and what skills do you have under your belt (look at the interview questions in the forum).

The reason why I say RFID's, hospitals are losing millions of dollars in lost or stolen equipment.. It's hard enough to track down a doppler or bladder scanner in your own unit sometimes.. Look for the microsoft future vision: health video in youtube or this forum I posted a few days ago and you will see an example of a physician using a tablet to find an equipment.

Also even in Europe, certain nations are using "smart" insurance cards that wherever you go within the Euro zone you can transfer and store new information with you wherever yo go.. France for example: The French health insurance card, a smart card named "Carte Vitale 2", includes a digital photograph and other personal medical information in addition to identity elements. We need a system like that because currently at doctor's offices we often have to pay a fee to have files copied or faxed to another office so I can see a similar system coming our way in the future.

So again, I personally believe in almost any careers especially nursing, we have to keep re-inventing, keeping up with skills and updated software, new nursing knowledge, and how we make ourselves marketable.

[stephenfnielsen]

It will be interesting to see. Like you pointed out, technology is not going away, and there will always be jobs in the caring and feeding of EHRs. I think part of it will be how well CIOs can convince the CEOs and CFOs that IT will help the bottom line and improve patient outcomes. The 'keeping up with the Jones' mentality will definitely secure short and medium term growth (hey, such and such hospital let's me see my lab results and shares that information with the hospital that I visit when I go on vacation... why don't you?). I'm interested to see if we will be able to implement all the wonderful tech available, or if the financial fortitude will fizzle out.

[AprettynewRN]

It will shrink for many people having a field day with their 'epic implementation consulting', etc.

First, meaningful use rush will calm down. it does not take nearly so many persons to maintain or upgrade a system as to implement it for the first time. Second India is gearing to take over much of that support and software development along with the next rush to analytics, much as they took over the rest of the IT industry. Healthcare was really the last national domain and already many of the vendors are in the process of moving their operations there. More importantly "cloud"( a fancy name for web-based remote software and data offshoring) based open modular software is quicly emerging and being hailed as the next best thing and whyreally should providers have to shell out the kind of money that EPIC charges. it's crazy.

Already is and people who went to the HIMSS conference last year might remember emr's and modular open web-based components being a big focus... There will be some demand as telemedicine emerges but again, won't take near so many bodies to implement and as for rfid, streams, mobile, interface engines, frankly most clinicans simply do not have or will not invest in the technical skills required to be competent in these areas. (Ironically non-technical clinicians they're usually the loudest shouters about how IT persons supposedly just don't "understand" their workflow and left to their own accord would design a crappy system, all as they feel entitled to be in a technological field without knowing even the basics of the industry.

I say if you're not technical enough to understand what AGILE development, java J2EE or OLAP and datamining are, aren't deeply versed in clinical languages (like SNOMED CT, ICD10, LOINC, etc) so you can work on common data dictionary projects AND you aren't very well connected politically in your organization, you probably want to be thinking about doing something else in around 4-7 years. If not sooner..

Sorry to be a raincloud but that's how I see it. The days of people who really have no other IT education other than being familiar with a proprietary EMR making a mint aren't going to last forever.

[AprettynewRN]

I see both growing and shrinking... I think it is important for anyone going into informatics to do a lot of research. It seems many do not and will get burned for it or take longer to get a job (as you can see often in this nursing informatics forum). I think EPIC might be a bubble because once all the hospitals are completely implemented, I see layoffs and a lot of hospitals are using temporary contractors. Major organizations more likely will retain an informatics staff but smaller local organizations will wind down after a successful go live.

Overall I do not see nursing informatics as a bubble because electronics will be the way to go regardless of economy.. It is how you re-invent yourself (going into telemedicine, research & development, RFID's and IT software like EPIC will require upgrades periodically) and what skills do you have under your belt (look at the interview questions in the forum).

The reason why I say RFID's, hospitals are losing millions of dollars in lost or stolen equipment.. It's hard enough to track down a doppler or bladder scanner in your own unit sometimes.. Look for the microsoft future vision: health video in youtube or this forum I posted a few days ago and you will see an example of a physician using a tablet to find an equipment.

Also even in Europe, certain nations are using "smart" insurance cards that wherever you go within the Euro zone you can transfer and store new information with you wherever yo go.. France for example: The French health insurance card, a smart card named "Carte Vitale 2", includes a digital photograph and other personal medical information in addition to identity elements. We need a system like that because currently at doctor's offices we often have to pay a fee to have files copied or faxed to another office so I can see a similar system coming our way in the future.

So again, I personally believe in almost any careers especially nursing, we have to keep re-inventing, keeping up with skills and updated software, new nursing knowledge, and how we make ourselves marketable.

Well said. Should note that smart cards are emerging here too. What they're really useful for, rather than storing records (though obviously there is a mandate for providers to give pt their encounter record in an e-format), the patients private certificate from a public encyrption keypair - in otherwords an absolute secure mans of identifying the patient and establishing a secure channel of communication. The federated/repository/centeralized models , that of having banks of health data records duplicated all over from providers to EMRs are quickly being replaced iwth lean, far less expensive distributed models which save money AND reduce liability.

[gensheak]

I am 23 years old and I feel like I have grown up with technology. I have a hard time seeing it slowing down just in the next 5 years because it has come so far. I also see people trying to push limits on technology and making things more complicated before it would slow down. I think like anything it would hit a breaking point before it slows down. I think it has a lot of benefits that people would have a hard time giving up.

[stephenfnielsen]

Just this week there was a spread in the local paper about how the hospital I work for is 30 million under budgeted revenue right now, lots of belt tightening going on... but no plans to shrink the size of the IT department. There is definitely a huge focus on expanding that area right now.