Presentation to the ITCH conference, Victoria, Canada, 2019

1. Kathleen Gray, Cecily Gilbert, Simone Pritchard, University of Melbourne
Kerryn Butler-Henderson, University of Tasmania
Karen Day, University of Auckland
ITCH Conference, University of Victoria, 15 February 2019
Ghosts in the Machine:
Identifying the Digital
Health Information
Workforce
#HIW_Census

2. Background
• Digital health appears to have a life of its own,
with no human hand needed for it to
revolutionise and transform healthcare.
• Investments in health information technology
outstrip investments in the workforce
development needed to deliver the outcomes.
• A specialised health information workforce,
with a coherent professional identity,
a definitive body of knowledge,
and formal education and career paths
– how hard could it be?
https://live.ft.com/Events/2019/FT-Digital-Health-Summit

3. Aim
To make health information work
visible …
to strengthen a health information
workforce that has a greater role …
In translating digital health rhetoric
into health system performance
improvements.

4. Method
1. Scoping review
>Trace the emergence and evolution of health
information work as specialised work
> Analyse the ways that human roles in any kind
of health information work are described
2. Workforce survey
> Anyone who self-identifies as part of this
workforce
> Any role where the main function is related to
developing, maintaining, or governing systems
for managing health data, or health information,
or health knowledge

5. K. Gray and C. Gilbert, Health information work - a scoping review protocol,
PeerJ Preprints, 15 February 2019. https://peerj.com/preprints/27535
Items retrieved
253- 276 items
There is literature on this topic from 1973 onward.
The number of items expanded greatly after 1990.
Numbers since 2010 are more than double the 1990s.
Data extracted
• Position identity, title, or label
• Role, responsibilities, functions
• Knowledge, skills, attributes
Search terms
• (health OR healthcare) adjacent to (information OR
knowledge OR data)
AND
• informatics OR management OR technology OR library OR
systems OR digital
AND
• work* OR profession* OR role* OR staff* OR expert* OR
leader* OR champion* OR special*
Sources searched
• Ovid Medline (1946 to June 2017)
• CINAHL Full Text
• Embase
• Applied Social Sciences Index and Abstracts
• Library, Information Science and Technology Abstracts
• core.ac.uk
• Google Scholar

6. Key findings from the literature
Specialised health information worker titles
Health Informatician
30%
Medical-Nursing-Allied
Health
11%
Health IT
9%
Other
9%
Health information
manager
16%
Health Librarian
25%
1.
Identities come and go, e.g.:
‘health knowledge manager’ disappearing;
‘digital health advisor’ emerging.
2.
Proposals to widen or take over roles and
responsibilities are plentiful among HIMs, HLs,
HIs.
3.
Assimilating the work entirely into
clinical health professions’ scopes of practice
is a persistent idea.
4.
Competencies, education and career pathways,
and accreditation/certification practices, are
less orderly than many other health professions.

7. Health Information Workforce
Census
Inaugural Australian census - May 2018
1,597 participant responses analysed
(=~20% of the actual workforce)
Next Australian census in 2020
Going global: first New Zealand census – Nov-Dec 2018
Proportionally phenomenal response rate: 763
Now seeking EOIs from research partners interested
to conduct the census in other countries……….
http://www.utas.edu.au/business-and-economics/hiwcensus

8. Workforce demographics
21.6% 0.3% 78.1%
1.9%
ABORIGINAL
AUSTRALIAN
AND/OR TORRES
STRAIT ISLANDER
3.4%
DISABILITY OR HEALTH
CONDITION THAT
LIMITS PARTICIPATION
IN ACTIVITIES

9. Workforce geographics
74.5% born in Australia
93.4% Australian citizen
0.8% reside outside of Australia

10. 22.9%
ACT 3.4%
Place of
employment
1.0% of individuals work in multiple states
The majority (72.4%) work in publically owned
organisations

11. Employment
conditions
15.1% individuals actively
seeking work in health
information
32.6 hours Average weekly
paid hours working in current
primary health information
role
34.3 hours Average weekly
actual hours working in
current primary health
information role
82.1% permenant positions
WEEKLY REMUNERATION*
*Before tax
0.4%
0.8%
0.7%
2.8%
4.5%
4.5%
14.0%
13.1%
24.0%
17.2%
7.6%
3.7%
2.0%
2.3%
2.1%
$1-$199
$200-$299
$300-$399
$400-$599
$600-$799
$800-$999
$1,000-$1,249
$1,250-$1,499
$1,500-$1,999
$2,000-$2,499
$2,500-$2,999
$3,000-$3,499
$3,500-$3,999
$4,000-$4,999
$5,000 or more

12. Employment experience
7.2 years average number of
years working in current health
information role
14.6 years average number of
years working in the Australian
health information workforce
13.7% plan to leave the
workforce in the next 5 years
Nearly half (44.3%) plan to
remain in the workforce for
>15 years
TIME IN CURRENT ROLE

13. Employment roles
80.3% of respondents work only
in a health information role
12.5% of respondents work in
both a health information role
and another role
7.2% of respondents currently
are not working in the health
sector
Types of health information work>

14. Tertiary
education
6.8% of respondents have no tertiary qualification in the health information field
8.3%
5.5%
1.4%
40.3%
3.2%
15.3%
21.7%
4.3%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
CertificateI-IV
Diploma
Associatedegree
Bachelordegree
Bachelorhonoursdegree
Graduatecertificateor
Graduatediploma
Masters
Doctoral
Percentage

15. Credentials
100
80
45
34
9
9
9
6
5
3
3
2
1
1
Certified Health Information Manager (CHIM)
Certified Health Informatician Australasia (CHIA)
Australian Library and Information Association (CP) Health Librarian
Fellow Australasian College of Health Informatics (FACHI)
Certified Health Information Practitioner (CHIP)
Certified Professional (CP) Australian Computer Society
Fellow Health Information Management Asociation of Australia (FHIMAA)
Member Australasian College of Health Informatics (MACHI)
Australian Library and Information Association ALIATec (CP) Health
Certified Professional Healthcare Information and Management Systems Society (CPHIMS)
Fellow Australian Computer Society (FACS)
Australian Library and Information Association Allied Field (CP) Health
Certified Associate Healthcare Information and Management Systems Society (CAHIMS)
Certified Technologists (CT) Australian Computer Society
71.8%
HAVE NO
HEALTH
INFORMATION
INDUSTRY
CREDENTIAL

16. Continuing
professional
development
11.5% of respondents
did not undertake
any form of CPD
in the last 12 months
Work based
learning
40.3%
Professional
activity
24.1%
Self-directed
learning
25.7%
Formal
educational
9.9%
Forms of CPD undertaken >

17. Professional association membership
44.5%
DO NOT BELONG TO
ANY PROFESSIONAL
OR INDUSTRY
ASSOCIATION

18. Discussion
Rich descriptions of who does health information work,
how they do it, and what contribution they make to
health, are hard to find in the research literature
Although the literature about this work is increasing,
the real-world practice of health information work
is not highly skilled nor easily identifiable
Professionalisation of this work is not strong (markers:
license to practice, association membership, CPD)
The interest groups that want to, or are able to, reform
health information work are not obvious

19. Conclusion
Does the concept of “digital health” somehow have inherent power to inhabit the human beings in the health
workforce and redirect them into these new ways of providing healthcare?
OR
Who are the humans who are taking us there from here? How serious is their engagement with the roles and
responsibilities of specialised health information work?
OUR GOAL:
Global recognition and understanding of the variety and impact of the health information work behind digital health.

20. Ghosts in the Machine:
Identifying the Digital
Health Information
Workforce
#HIW_Census
Thank-you! Questions? Comments?
Links:
https://peerj.com/preprints/27535
http://www.utas.edu.au/business-and-economics/hiwcensus
Contacts:
Kathleen Gray, University of Melbourne
kgray@unimelb.edu.au
Kerryn Butler-Henderson, University of Tasmania
kerryn.butlerhenderson@utas.edu.au