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Healthcare Technology Creates New Nursing Jobs

Rise in 21st-century innovations improves industry-wide employment.

A customary view of how healthcare technology creates new jobs often focuses on new devices that require trained healthcare professionals for their use. For example, the first commercial diagnostic ultrasound scanner was launched in the 1960s, then developed expansively in the following decades. Today, there are tens of thousands of diagnostic medical sonographer jobs, growing by a projected 26% by 2024, according to the U.S. Bureau of Labor Statistics (BLS).

But the devices sector of the healthcare industry is just part of the full picture of how technology affects healthcare jobs. The expansion of health information technology has an even broader impact, because it doesn't just affect the people directly working with the technology itself but the entire healthcare workforce. The application of health IT plays a major role in improving the quality of healthcare, expanding the reach of healthcare, integrating the delivery of healthcare and evolving the business of healthcare. All of these advancements are being carried out by healthcare workers. In addition to expanding existing jobs, each new technological trend in the healthcare industry is often associated with new and emerging healthcare jobs.

Initiatives in Healthcare Technology 
The expansion of healthcare technology was brought on not only by the push to improve patient care quality and to compete in the healthcare marketplace but also because of regulatory mandates. Very important in this regard were the Health Information Technology for Economic and Clinical Health Act, also known as the HITECH ACT of 2009, which authorized billions of dollars in incentives for healthcare enterprises to adopt and implement electronic health records. This has led to new health IT jobs throughout the healthcare industry, as hospitals, health systems and other healthcare facilities adopted and launched complex electronic health records systems; trained physicians, nurses and allied professionals in their use; and complied with the "meaningful use" regulations, which mandated that healthcare enterprises must use electronic health records to measurably improve quality, safety and efficiency.

All of this expansion and advancement of electronic health records was carried out by the healthcare workforce, including a relatively new and rapidly expanding sector of health IT workers. In addition, demand has grown for clinicians who are trained in the use of electronic health records systems, and for services to help healthcare organizations implement these systems.

Another initiative that impacted the healthcare workforce has been the rule from the Center for Medicare & Medicaid Services mandating the implementation of ICD-10 for medical coding. This expansion from 13,000 diagnosis code sets in ICD-9 to 68,000 in ICD-10 required digital re-coding of systems at each healthcare enterprise. Again, this transformation was carried out by the healthcare workforce, requiring coders and information managers trained in the new coding, and also the training of both clinical and nonclinical staffs in the new coding. Deadlines for the new coding have been set and changed several times in this decade, with final implementation mandated by October 2015. But compliance and management issues related to ICD-10 continue at most healthcare enterprises.

These two major initiatives have been ongoing during this decade, and have resulted in major expansion of the healthcare workforce directly involved in their implementation. According to the BLS, the number of job openings due to growth and replacements for medical records and health information technicians is expected to grow from 189,000 in 2014 to 218,000 by 2024, a 15% growth rate.

In addition, these technology initiatives also directly impact the jobs of medical and health services managers, a broad category of nonclinical administrative workers. They numbered about 333,000 jobs in 2014, with a projected growth of 17% by 2024, according to the BLS. Other technological expansions, such as improvements in telemedicine, also have driven expansion in the healthcare workforce. In fact, the general advancement of integrated technology has impacted nearly all roles in the healthcare workforce and expanded the types and number of jobs.

Quality, Costs and Jobs
The impact of technology on healthcare has been shown to lower patient deaths and complications while also lowering costs. The achievement of this outcome has been accomplished through the healthcare workforce that is utilizing the technology. Physicians, nurses and allied professionals with access to accurate and easily accessible digital records for their patients are able to provide integrated treatment from diagnosis through treatment and after-care. This, in part, has also facilitated the rise in advanced practice clinician jobs, such as nurse practitioners and physician assistants, who can carry out many of the duties of physicians because they have much more complete diagnostic and treatment information through digital records. The number of physician assistant jobs is expected to grow by 30% from 2014-2024, according to the BLS, while the number of nurse practitioner jobs is expected to grow by 35%.

Digital records also are critical to the performance of home healthcare -- the fastest-growing industry in the nation. Because of easily accessible patient records, clinical workers can now provide effective diagnosis and treatment in the home and other outpatient settings, rather than admitting a patient to the hospital. Employment in the home healthcare industry is expected to grow by 60% between 2014-2024, according to the BLS, while outpatient care centers are projected to grow at 49%, other ambulatory heath care services at 40%, and medical and diagnostic laboratories at 32%. The rise in these industries is linked to the health IT movement. For example, medical tests at diagnostic laboratories can now be sent to primary care physicians or directly to patients with a few keystrokes, which wasn't possible a decade ago. These industries employ a wide range of workers in clinical and nonclinical positions from nurses and allied practitioners to chief executives and marketing and sales managers and many types of social service occupations.

On the business and revenue side, technology has had an immense impact on the healthcare industry. The transition to ICD-10 facilitates much more exact coding for improved reimbursements. The expansion of the reach of healthcare through health information technology also expands the demand for services and the payment and reimbursement for those services. The adoption of electronic health records has been heavily incentivized by government. So has value-based medicine, which includes the reduction of readmissions, improvement in patient satisfaction and other enhancements of accountable care, all of which are linked to improved health IT and performance metrics. All of this is important to job creation. Value-based care has created new and emerging roles in the healthcare workforce, such as care coordinator and chief experience officer, while the reimbursement incentives lead to higher revenues for the healthcare enterprise. Since more than half of healthcare organization budgets pay for labor costs, these revenues directly support the hiring of more staff.

Telemedicine, also called telehealth, is another area where technology is expanding care quality and jobs. Physicians, nurse practitioners, physician assistants and others can now assess, diagnose and treat patients across distances, which expands the reach and therefore the demand for services of patient care. The main limiting factors for telemedicine have been regulatory, but these are changing as more states and government health agencies recognize the upside of telemedicine. Research on the market for telemedicine shows fast growth on a global level, with the largest market in North America. Demand for telemedicine trained physicians, nurses and other practitioners is expected to grow significantly in the next decade.

Leadership Roles
The rise in technology in healthcare not only improves the outlook for clinical and technology jobs but also for leadership roles. These roles are expanding in number and in scope of duties, directly and indirectly related to technology. For example, there are now openings for director of telehealth, director of telemedicine programs and chief telehealth officer. Chief information officers and chief technology officers have been rising in importance and in numbers over the past decade. With health information technology expanding the reach, quality and business of healthcare, many new leadership roles have emerged in part due to the rise of technology. For example, a chief population health officer presides over services that are due to the technological expansion of healthcare's reach. A chief experience officer is supported by digital capabilities to facilitate and measure patient experience. A chief strategy officer's success is likewise dependent on digital capacity to measure success, along with strategic planning predicated on future revenues, which are enabled by medical coding-guided reimbursements. And for every hospital CEO, the outlay for and management of information technology are major areas of responsibility.

The impact of healthcare technology on jobs extends far beyond the actual operation of devices and systems. Technology is thoroughly integrated into all facets of healthcare today. Improvements in technology in healthcare industries have led to more jobs, better jobs, and new and emerging jobs. With the demand for healthcare rising at the same time that healthcare information technology continues to evolve, technology-related employment in healthcare will continue to expand in the future.

Susan Salka is President and CEO, AMN Healthcare

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