Developments within and beyond healthcare have created a need for workers with upgraded skillsets. For cardiology (as well as other disciplines within and beyond medicine), upskilling—the process of teaching employees new skills or enhancing their knowledge to continue in the same profession or field—may help to fulfill this need.
Upskilling now ranks among the six most significant healthcare industry trends identified by PwC Health Research Institute (HRI), a unit of the U.K-based professional service firm PricewaterhouseCoopers (see page 38 for the list of all six). “For all healthcare [entities] … 2019 will be a time to invest in increasing their workforce’s efficiency and productivity to ensure that they can compete at the top of their abilities and licenses,” PwC HRI authors wrote in Top Health Industry Issues of 2019. Providers and companies that don’t make such investments, won’t be able to compete effectively in a changing market and will encounter major obstacles to growth, PwC predicts.
Travis Singleton, executive vice president at Merritt Hawkins, a national physician search firm in Dallas, agrees. “Healthcare is in the midst of a profound transformation, both in terms of how services are paid for and how they are delivered,” he tells CVB. “The emphasis will be on reducing costs while maintaining quality and enhancing consumer convenience. This will require a different mindset than has been the case in the past and a workforce with a new suite of skills.”
Catalysts & benefits
Multiple catalysts are driving the need for an upskilled healthcare workforce. Benjamin Isgur, PwC HRI leader, points to the greater emphasis that both providers and payers are putting on increasing efficiencies and decreasing costs, and their strategy of leveraging automation as a linchpin between the two priorities. He also cites the advent of artificial intelligence (AI) and the burgeoning number of applications that fall under the AI umbrella, such as using algorithms to better interpret images and enhance care pathways for both populations and individual patients.
Also fueling the demand for upskilled staff is the rapid pace of increasingly sophisticated medical technology, including, for example, telemedicine solutions and structural heart therapies. “Upskilling will remain necessary in order to remain current as technology evolves,” says Andrew Hajde, CMPE, senior industry advisor at the Medical Group Management Association (MGMA). He believes developments in, and increasing reliance on, data analytics as well as competition among providers are boosting the need for workers with expertise in benchmarking, efficiency and process improvement. Such demand, he predicts, will become the status quo in medicine as facilities move forward with initiatives designed to “eliminate waste … and work smarter, and not just harder.”
While upskilling has the potential to bolster healthcare providers’ bottom lines and sharpen their competitive edge by enabling employees to harness technology to improve operations and patient care alike, there is more to the equation. Employees crave opportunities to expand their skillsets, and investing in a more educated workforce packs significant potential to curtail employee attrition. A survey fielded by PwC HRI in September 2018 revealed that 75 percent of U.S. workers were willing to learn new skills or completely retrain to remain employable (“Workforce of the Future: The Competing Forces Shaping 2030”).
On the healthcare front, 34 percent of healthcare employees who participated in the PwC HRI survey said it was very important to find an employer that would help them and their colleagues prepare to meet future demands, and 41 percent said it was somewhat important to do so. Of the queried healthcare professionals, 34 percent said they would be very likely to remain with an employer that offered training to help them meet future work demands; 40 percent said they would be somewhat likely to do so.
Healthcare’s tight labor market is another driver. Isgur says healthcare providers should expect to encounter fierce competition for workers with specialized training—unless they deliver it themselves. “That, too, makes upskilling and reskilling a smart, nimble, sustainable strategy,” Isgur claims.
Meanwhile, competition for patients is increasing significantly, and telemedicine—which necessitates maintaining a pool of employees whose skillset supports its use—has become ammunition against such competition. “More and more, patients want convenience,” says Wayne Hartley, MHA, growth and service line development officer and vice president of consulting services at AMGA Consulting, a unit of the AMGA (formerly the American Medical Group Association) in Alexandria, Va. Telemedicine can provide the convenience that patients want, but Hartley and other sources say healthcare employers may need to help their staff learn the skills to use and interpret patient data gleaned from telemedicine solutions.
Lots of lift
The wide breadth of technology developments applicable to cardiology means there are potential benefits to upskilling both clinical and nonclinical staff. “In cardiology, training and upskilling will occur in the areas of scheduling, registration, care coordination, remote patient monitoring and, eventually, AI-assisted clinical decision-making, amongst many other areas,” Hajde says. Education pertaining to the use of new front- and back-office hardware and software applications, diagnostic and imaging equipment will be part of the picture as well.
Andrew M. Freeman, MD, director of clinical cardiology at National Jewish Health in Denver and a member of the American College of Cardiology (ACC) Innovation Steering Committee, says upskilling should be offered to cardiologists as well as other staff. “Cardiologists need, for example, the know-how to query enormous databases, even national databases, to come up with conclusions to improve patient care,” he explains.
Given the challenges and, in some cases, the financial investment entailed in upskilling staff, some might ask whether bringing talent to the cardiology table could better accomplished through outsourcing.
Citing World Economic Forum data, PwC HRI says such a strategy “presents significant challenges” in part because a hefty portion of the skills healthcare workers will need could change as soon as next year and because the list of required skills will continue to expand.
Another reason to invest in upskilling (vs. outsourcing), says Joel R. Sauer, MBA, executive vice president of MedAxiom Consulting, is to leverage staff’s existing knowledge. “Experts from outside the organization will obviously be well-versed in the technology being implemented by a cardiology practice or department, but they won’t be up to speed on internal processes and systems that touch the technology,” Sauer explains. While the expenses aren’t easily quantified, the costs of time and effort needed for outside personnel to learn internal processes and systems will always exceed upskilling expenses, he notes.
Outsourcing can also cause discord among employees, who may assume that outside help has been engaged because their superiors don’t trust or value them enough to invest in helping the current team expand its skills. This, sources say, has strong potential to spark attrition, in turn leaving practices and departments in the lurch.
Whom to upskill & how To realize the full advantages of upskilling and maximize return on investment (ROI), it’s necessary to proceed carefully, ensuring that your upskilling program is effective, Hajde recommends. Calculate a training program’s ROI “as net benefits divided by program costs, multiplied by 100,” he says.
Begin with a needs analysis to identify which employees should be upskilled first, sources suggest. It’s important to make these decisions in the context of the technologies already in place and when others are scheduled to be implemented as well as clinical needs and other factors. “Remember, not everyone who is learning in a particular area will need the same level of skills,” Hartley says. “For instance, you can have an entire group being trained on the basics of machine learning and delve deeper with some whose responsibilities may [necessitate] going deeper.”
Practice leaders also should work with each employee to create a personal development plan that includes clearly defined performance metrics and goals. Singleton and Isgur advocate empowering employees to choose their own skills development paths and, when possible, accommodating different learning styles. Some staff will learn better from hands-on training while others might expand their skills by attending classes, reading written material and/or watching videos.
It’s often necessary to tap into outside resources, such as technology consulting organizations, for training. Cardiology leaders can be on the lookout for relevant CME courses, and those with academic affiliations might be able to leverage university courses. Smaller practices might consider a “train the trainer” approach, wherein key employees undergo formal skills training and, in turn, provide the same training to their colleagues.
Invest now, or fall behind
As reimbursement becomes more intertwined with value in healthcare, the financial benefits of upskilling will become more apparent across the medical landscape, Singleton says. Cardiology will be no exception, with patients awarding higher patient satisfaction scores to providers that ensure top-caliber care. Leveraging upskilled personnel to optimize use of data, analytics and technology is a strategy not just for preventing disease and reducing hospital admissions and lengths of stay, he explains, but also for prospering under “global payment models” and delivering quality care over the long term.
“Upskilling requires an ongoing investment, but there is little choice in the matter,” Singleton concludes, echoing the sentiment of other sources. “Healthcare organizations that don’t embrace the model will be left behind.”