When I interview chief information officers and other health IT professionals, I sometimes find myself inadvertently using a military metaphor to describe their daily work: "You're the people in the trenches every day," I say.
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It can certainly seem like a daily battle out there, with CIOs and their staffs constantly having to keep up with an onslaught of new regulations, an ever-shifting landscape of care coordination and new payment strategies. Their tight-knit teams make use of new tools and technologies, keeping constant vigilance against security threats while working together to protect patients and safeguard the health of populations.
Perhaps the military and health information technology have more in common than some realize?
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The unemployment rate for veterans who've served in the U.S. Armed Forces since September 2001 ticked down a bit in 2013, according to the Bureau of Labor Statistics, but it's still high: 9 percent, compared to a 6.7 percent national average. Some 722,000 former service members were unemployed in 2013.
A 2012 study from the Center for a New American Security found that a chief reason is that many veterans have a hard time translating the skills they learned in the service to private sector work.
"Civilian employers do not always realize that military-specific jobs – such as machine gunner, tank driver or helicopter crew chief – have some components that are directly comparable to civilian environments," the report read.
Many returning vets have skills and leadership qualities that most job applicants could only dream of. Still, the unemployment numbers speak for themselves. As Secretary of Veterans Affairs Eric Shinseki told the New York Times, "Unless we can translate that into understandable business language, it's hard for the employer to get a full appreciation for the skills and knowledge the veteran will bring."
Meanwhile, healthcare is having an opposite problem: Jobs are going unfilled. There's a much-ballyhooed physician shortage looming. There's a nursing shortage, too. And there's an ongoing staffing problem affecting many hospital IT teams.
"Organizations are, to some extent, having to pick and choose what they're doing," she says. "We for years thought the top barrier to IT implementation was financial considerations. Two years ago, for the first time, I saw IT staffing edging out financial considerations – the fact that folks couldn't get enough IT staff."
Added HIMSS Vice President, Professional Development, JoAnn Klinedinst, "You have hospital boards applying pressure to CIOs to transform care, and yet the CIO doesn't have the talent to do it," she says. "So then what do you do? Spend lots and lots of money bringing the consulting firms in and hope that the expertise and knowledge gets transitioned to the existing staff. Or you delay. Or you move ahead with substandard staff that don't have the skills and/or the resources to do a proper job."
Securing a good future
But what if these were two problems that could help solve each other?
That's the idea behind projects such as the HIMSS Veterans Career Services Initiative, a collaboration with the U.S. Department of Labor's Education and Training Administration and Bellevue College in Bellevue, Wash. The program seems to offer returning service members education and resources related to the burgeoning health IT industry.
The initiative's "vMentors" are veterans with years of experience in IT who can help guide fellow vets by offering insight into their experiences in the field. They represent a "unique mentorship opportunity for our transitioning military and veteran community," said Amy Justice, Veterans Career Services program manager, in a HIMSS press statement. "Participants will be able to ask questions related to career development, military transition and lessons learned from health IT industry leaders who have 'been there/done that.'"
Mac McMillan, chief executive officer of healthcare security firm CynergisTek, is another person who thinks health IT should be availing itself of the unique skill sets of returning service members. Perhaps he's a bit biased, but McMillan says privacy and security is a prime area for many jobseekers to look.
With wars in Iraq and Afghanistan winding down, "There are a lot of vets that are getting out of the service now with tremendous training in either information security or cyber security that are going to be looking for jobs," he says.
"If I were a health system, and I were looking for a good quality ISO with a lot to give, and a lot of discipline and a lot of motivation and know-how, I'd be hiring a vet."
McMillan speaks from experience. He spent his formative years in the United States Marine Corps, serving as a lieutenant colonel and intelligence officer.
"In the Marine Corps, especially in smaller units, the intelligence officer is also the security officer," he says. "So the guy that handles the intelligence and the sensitive material is also responsible for protecting that stuff.
"As I came up through my career and became more operational, where security became important was understanding the threat," McMillan added. "I think a lot of people in the private sector don't really learn an appreciation for threat."
In the military, on the other hand, "they constantly think about threat," he says.
"The military deals with threat in a very real way, every day. With respect to their communications, with respect to their operations, with respect to their own personal and unit safety, etc. Anything can happen. Systems can malfunction, people can do bad things, and you always have to be on guard."
Heather Roszkowski, chief information security officer at Burlington, Vt.-based Fletcher Allen, says her years in the Army similarly taught her the "value of protecting information.
In a war zone, "you don't want people to know where the soldiers are on the battlefield or what equipment they have, because bad things can happen," she says. "That translates over to healthcare. We don't want people to know about that patient unless they're caring for that patient."
And healthcare security can often feel like a war zone.
"With technology changing as quickly as it does, it's a constant battle to keep up with it," says Roszkowski. "New viruses come out every day, and you need to be able to respond to them."
That's why she's thankful for another lesson from her time in the service: an appreciation for structure and team-building that has served her well on the front lines of healthcare.
"There's a very regimented process and structure in the military," she says. "There are regulations we have to follow. We have a very organized chart as far as who reports to whom. And I take all those lessons learned from my time in the service, and I look to apply them to what I do every day. I've created a team with a structure that I feel best fits how we're dealing with our information security."
"In the military it's a life or death situation," says McMillan. "You protect the information or people get hurt. In healthcare, it's also a life or death situation: You protect the information in the systems or people could potentially get hurt.
"Where it differs is in the military it's a very structured environment, we have very rigorous frameworks and controls and methodologies and requirements we have to meet, " he adds. "There's a lot more rigor and discipline – which is a thing, quite frankly, that healthcare could benefit from: a little starch in the diet."
'They get it'
None of which is to say, of course, that privacy and security is the only area of health IT ripe for contributions from former members of the Marines. Or the Army, Navy, Air Force or Coast Guard, for that matter.
Indeed, McMillan says any healthcare CIO would be wise to at least take a closer look at job candidates from any branch of the armed forces.
"There's some great folks out there," he says. "If you look at the communications and computer networks that the DoD has today, the guys and gals who are managing those systems are working with state of the art technology in very complex environments where they're moving data all over the world and to many different environments."