Health care shortages and federal rulings for HITECH and the like-
what do they have in common? Money and human capital. The US
healthcare system is facing a shortage of nurses and physicians. In
the US, physicians shortages are estimated to reach 54,000-139,000
doctors by 2033 (Rich, 2021). The shortage of nurses is as profound
as physicians. In order for medical facilities, primarily hospitals, to
staff their facilities they are having to pay more for nurses.
According to a recent survey, the hourly rate for travel nurses can
be as high as $150/ hr (Avant, 2021). When hospitals are short
staffed they must defer elective procedures that typically reimburse
with higher margins. So, hospitals have a higher cost structure and a
lower revenue stream.
HITECH and other federal mandates carry a significant price tag to
implement. For example, HITECH called for the creation of an
electronic health record system with the goal of " increasing
efficiency, reducing costs, and improving the quality of care."
(HealthAffairs, 2015). Implementation and upgrade of these systems
is costly in terms of dollars and also carries a high human capital cost.
In the same Health Affairs article, they noted "After spending $28
Billion so far of the $35 billion total taxpayer investment, significant
progress toward interoperability has been elusive." Implementation
of these systems requires a significant investment in planning and
training. This can be impossible with inadequate staff to care for
patients or temporary staff working that may not be there to work
with the final system. The systems once in place are also an ongoing
drain on the human capital and it was noted that electronic health
records (EHRs) are a leading cause of anxiety for physicians and
nurses across the country (HelathAfffairs, 2015).
There are only so many dollars in the system and so many hours. If
dollars are being used to pay increased wages for staff then dollars
aren't available for other things like EHR systems. If staff is spending
time caring for patients, then there isn't time to spend on training for
new federal mandate implementation. Conflicting priorities without a
good solution.
Thune, J., & Alexander, L. (2015). Where is HITECH's $35B investment
going? Health Affairs: Leading Publication Of Health Policy Research
& Insight. Retrieved February 21, 2022,
