William Hersh: HIT education has undergone a 'huge change'

While William Hersh, professor and chair of the department of medical informatics and clinical epidemiology at Oregon Health & Science University in Portland, believes that technology is crucial to health IT education, he doesn't think it's necessarily the most important aspect of the industry for students to master.

"Informatics is not just about the technology, it's understanding how IT is used in healthcare," Hersh (pictured), tells FierceHealthIT. "Our curriculum does not just have courses on technology. No matter what field you're in these days, you don't learn everything you use at your job in your education; the education hopefully gives you a foundation. As you finish your formal studies, hopefully you're still always learning."

In an exclusive interview, Hersh touches on the evolution of health IT education over the better part of three decades, as well as how he thinks recent federal legislation impacts his efforts.

FierceHealthIT: How has your job changed since you first started teaching?

Hersh: There's been a huge change. Obviously the HITECH Act had an impact on things, but even before that, change was taking place. I've been in the field since the late 1980s, and back then, most of the electronic health records systems were home grown, locally developed. The commercial marketplace didn't start to take off until the mid- to late-1990s. Then of course, things really took off with the HITECH Act, where all of a sudden you get Meaningful Use dollars. The large majority of the healthcare systems uses EHRs now.

Many hospitals now have clinical informatics departments--people whose focus is on the clinical use of the IT system. Many of our graduates pursue jobs like that.

FHIT: What do you think will happen when the HITECH money runs out? How will that impact education efforts?

Hersh: Certainly the HITECH money is a lot of money, but also, HITECH was never designed to completely subsidize the IT operations of healthcare. With HITECH, you can argue whether Meaningful Use was the best way to do it, etc., but one clear outcome is that it has spurred the adoption of health IT and EHRs. Now people have these systems.

As the reimbursement models change to more value over volume, accountable care, better data use will become important. The field is clearly evolving. What it will do to the total numbers regarding education is hard to predict. It's clear that even with the HITECH money tapering off that healthcare organizations are still going to need to manage their data, use it to get reimbursed, to deliver the kind of quality care that they need to. I think there will still be plenty of educational opportunities.

FHIT: Where do you stand on ICD-10?

Hersh: I'm of mixed mind about ICD-10. In this day and age where we have not only electronic data, but systems that can process the data and search it, how important is it to code data?

One reason why it's important is because the people who pay the bills want to see a code there. There's a big debate in the informatics community about what should be done about ICD-10. Many organizations, such as the clinical side of my university, put a lot of money and effort into the process and were way ahead of schedule; they were ready to flip the switch on ICD-10 in July.

But ICD-10 is definitely a burden. You have to upgrade your software, upgrade your coding expertise. You have to get your clinicians to use it. On one hand, is that what we really need to do in this day and age? On the other hand, organizations have put so much time and effort into it, that to say that we're just going to abandon it means that all that money was spent for naught.

It's definitely going to be expensive and is going to reprioritize what people do with their systems.

FHIT: Do singular large breaches, like the Community Health Systems breach, impact your efforts?

Hersh: Patient security is always a focus. We have courses that detail privacy and security and we touch on it from the get-go. If you're going to make use of data, you also need to know how to protect it and keep it safe and what all the laws and regulations are.

I think in general, there are a lot of career opportunities for people who want to take their interest and enjoyment of technology and put it to good use as far as people's health. When that happens, however, people need to put the health in front of the technology. 

Editor's Note: This interview has been condensed for content and clarity.

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