Guerra On Healthcare: For Health IT Success, Look Inside

Since the American Recovery and Reinvestment Act made healthcare IT the employment juggernaut of the future, tens of thousands have been banging on the door. Many have started their investigations by reviewing available positions, then applying for the best of the bunch. Most have been frustrated by a perceived insularity that looks suspiciously on industry "outsiders."

I've written before on how this dynamic can be overcome with a long-term commitment to break in by gaining the trust of healthcare IT's gatekeepers, often by engaging them for months on social networks such as Twitter and Facebook. But another key to finding the right job comes from picking a different starting point for the search -- rather than looking at what's out there, reflect on what's inside.

I interviewed a CIO the other day who had just gone down the open source road. While this particular open source solution has a long history and is supported by a major vendor, it's still considered an unconventional choice for hospitals. For a CIO, open source means more responsibility on their IT staff than the traditional vendor relationship. On the upside, it can offer a lower price point than other options which can be -- and in this particular case were -- cost prohibitive. So this organization essentially needed an IT leader who was comfortable getting his "hands dirty" and, luckily, it had one.

But more likely than not, this wasn't luck. Organizations running tight margins know they need a spending hawk leading the IT shop, as lax oversight can lead to unsustainable long-term maintenance contracts. And to be a true spending hawk, sometimes risk must be transferred from the vendor to the hospital.

This CIO is also very strong on negotiating those contracts, in this case stipulating the vendor only gets paid if the hospital collects meaningful use payments. In most situations, CIOs have been able to extract promises of electronic health record (EHR) certification, not the additional concession of guaranteeing meaningful use cash.

You, too, can do better than leaving such things to luck. It's essential those entering the healthcare IT field and, in fact, all those in the industry, understand their strengths before hitting the job boards or changing organizations. If you're good at the nitty-gritty technology issues, you may be better suited for an organization that needs you to get creative and leverage those skills; while if you're gifted at the palm-pressing and PowerPoints of C-suite navigation and board interaction, a larger organization may be the right quarry.

Success and fulfillment both come from the same source -- being able to fully exercise your unique skill set. You'll never find the right place until you first inventory those skills. Once done, you may need to burnish them with further education and/or credentials, but don't move in the opposite direction, seeking government-created certifications simply because they exist. Executives who refuse to "settle" do both their employers and themselves a huge favor.

Anthony Guerra is the founder and editor of healthsystemCIO.com, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at [email protected].