Showing posts with label recruitment. Show all posts
Showing posts with label recruitment. Show all posts

Wednesday, June 06, 2012

Healthcare Talent Management: Seeking Unicorns Using Broken Software Not Very Good for Patients - or Stockholders

In the May 30, 2012 WSJ article "Software Raises Bar for Hiring" by David Wessel, the Wall Street Journal's economics editor (subtitled "Software Screening Rejects Job Seekers" in the web page header), and in a followup June 4, 2012 NPR piece "Employers: Qualified Workers Aren't in Jobs Pool" where Wessel is interviewed by Renee Montagne, an issue noted in past years here at HC Renewal is discussed.

The issue is poorly done and/or misapplied e-Recruiting software actually causing employers to be blinded to needed talent, and skilled members of the workforce laid off in the Great Recession to remain unemployed.

From the NPR interview (emphases mine):

... WESSEL: Well, there are basically two views about unemployment today. One is that the biggest problem is there just isn't enough demand out there, not enough spending so employers are reluctant to hire readily. And if that's right, then there are things the government might do to stimulate demand - either Congress, or the president or the Federal Reserve.

The other view is the biggest problem is, as you suggest, this mismatch between the skills that employers need and the ones that available workers have. And if this view is right, and the fiscal and monetary policy can't do much. So people on the second camp seize on these very loud complaints from employers that they just can't find the workers they need. And the real question is how can that be?

MONTAGNE: Well, offer us an answer or two.

WESSEL: Well, I talked to a business school professor at the University of Pennsylvania, Peter Cappelli, and he suggested a number of possibilities. One is that with so many unemployed workers, employers may simply be too picky. They're looking for the perfect worker. They won't settle for the merely capable. One person in the business calls this looking for a unicorn. A second possibility is they're just not willing to pay enough. A third is that they've lost interest in training and they're insisting on experienced workers, so they're turning away a whole lot of people who could do the job but just don't have experience. And then, in what I find most provocative possibility, they've become over reliant on the software that's used to screen applicants.

MONTAGNE: Now software, that's an interesting idea.

WESSEL: Right. A whole lot of people who have applied for jobs lately, know that the initial application often is done online. That's because software takes the employers criteria, which is often extraordinarily precise, and then screens the application. There's one company that Mr. Cappelli writes about in the new book that says he had 25,000 applicants for a standard engineering position, only the software in the HR department told him nobody was qualified.  [An absurdity on its face - ed.]

In another one, an HR executive, in an experiment, applied for a job in his own company and couldn't get through the software screening. And as you mentioned, I wrote a column about this and I got flooded with people with experiences like this who were just enormously frustrated with the software and how it was preventing them from getting to a human being to get an interview on a job that maybe they could do.


In other words, the combination of employers looking for the "perfect, prefab employee" - a unicorn - is complicated by the fact that employers, or more properly, Personnel Departments (now euphemistically referred to as "Human Resources" departments, a "resource" they cannot properly manage, it seems) are using broken software.  This creates the erroneous appearance of a talent vacuum.

I made quite similar observations at my blog posts of several years ago including at a post of Feb. 2008 "If pharma cannot get its basic IT right, what about the hard stuff?"  and a Sept. 2011 post "Merck to Cut Up to 13,000 (More) Jobs by 2015."  I had noted repeated, bizarre solicitations for positions that were way-off base (such as for "Application Services Associate" in the Feb. 2008 post, and for "SAP Security Analyst--Merck & Co.,Inc.-INF003774" as mentioned here) by the automated e-Recruiting systems of a number of pharmas and healthcare organizations to whom I had submitted an electronic CV.

At the latter post I observed:

... I thought the problems with bizarre eRecruiting solicitations that I wrote about in my Feb. 2008 post "If pharma cannot get its basic IT right, what about the hard stuff?" were over.

However, just yesterday I received an automated solicitation from this company regarding something related to import/export, an apparent profound mismatch to my background. It makes me wonder if the people with a sufficient understanding of computational linguistics who could fix the parser in the eRecruiting system were all laid off.

As I mentioned in the earlier post, mismatched outbounds probably correspond to internal blindness to inbounds (i.e., in properly parsing resumes). I wrote:
Could a poorly-tuned or malfunctioning eRecruiting parser, which probably works in both directions (i.e., alerts not just outside candidates but also people internal to Merck of incoming resumes it identifies as "interesting") adversely affect the "apparently available" talent pool across many disciplines?

I still get entirely inappropriate solicitations from time to time, such as for marketing or low-level IT support roles, from this company -- where I was once high-mid management and use their exact term for that role, "Director", terms such as "Medical Informatics", "Electronic Medical Records" and others directly in my CV -- and others.

e-Recruiting systems could function poorly for a number of reasons, including but not limited to:

  • Incompetence
  • Deliberate sabotage, making it seem talent is exceptionally hard to find, to increase the job security of HR personnel who are themselves being downsized due, in part, to automation;
  • Deliberate sabotage to facilitate more hiring of lower-paid employees such as non-citizens found through other means.
Any of these scenarios, of course, is not good for stockholders and the unemployed.

Finally, I actually tried to alert the head of HR of one company, Merck, to this problem.  In the aforementioned Feb. 2008 post I reproduced the email and further commented:

... I wrote to the VP of HR and an HR associate, both of whom I knew, in Dec 2006:

Sent: Monday, December 18, 2006 10:45 AM
To: Levine, Howard
Cc: Lewis, Drew B
Subject: Merck eRecruiting system malfunction

Dear Howard,

I maintain a resume on Merck's eRecruiting site. I rarely get alerts, but recently I received the automated alert below for " Multi-Channel Management Campaign Manager" as below.

It is a profound mismatch to any keyword or context in my background (I am an MD & information science specialist, formerly Director Published Information Resources & The Merck Index.)

The eRecruiting system is apparently broken. It is likely others are getting similarly mismatched results. Suggest repair.

I was thanked for my email, and instructions received on how to turn off auto-notification by their job site. This was something I already knew how to do, and obviously was not a helpful or meaningful suggestion vis-a-vis "doing business."

Nothing more was received, and considering I continue to get frivolous solicitations regularly, apparently nothing much was done.


I had also observed:

  • Is this how state-of-the-art biomedical companies might be expected to manage their recruitment?

A response telling me to de-activate automated alerts from a company's clearly broken e-Recruiting system was not exactly what I considered in the best interests of shareholders.

Finally, in an ironic twist, hunting for unicorns with broken e-Recruiting software might prevent companies from finding the computational linguistics and other talent needed to fix these very systems.

-- SS

Saturday, September 13, 2008

Correcting historical information from the recruiter component of the Health IT Ecosystem

In the seemingly unending quest to correct inaccuracies and misinformation regarding clinician leadership of health IT and medical informatics, I wrote the following letter.

It is in response to an article entitled "The Chief Medical Informatics Officer: Past, Present and Future" by two well-known healthcare IT recruiters (I know the latter from her time at Hersher Associates) in the Sept. 2008 edition of "Advance for Health Information Executives", a non-technical journal for those involved in management of HIT.

This question also comes to mind:
can you get the future right when you have the past wrong - and were wrong in the past?
On having the past wrong:

To: firving@advanceweb.com, rmitchell@advanceweb.com, dolsen@advanceweb.com, shatfield@advanceweb.com
Date: 09/13/2008 12:53PM
cc: lhodges@wittkieffer.com, aanschel@wittkieffer.com
Subject: Re: "The CMIO: Past, Present and Future", Sept. 2008
Dear Advance for Health Information Executives,

I enjoyed reading the article "The CMIO: Past, Present and Future" by Linda Hodges and Arlene Anschel (Advance for Health Information Executives, Sept. 2008, p. 45-46). It was reasonably well done.

The following paragraph, however, contains factual errors:

"Prior to 1997 no true CMIO roles existed . Physicians as executives were part of a broader set of roles such as CMO or CEO. The physicians dabbling in health care delivery information systems lacked C-suite awareness and sponsorship; beyond a defined initiative, they also lacked specific responsibilities, expectations and accountabilities. They worked on a limited part-time basis in IS, often uncompensated for systems endeavors."

In fact, such roles did exist. I held one at Medical Center of Delaware in 1996, later Christiana Care Health System, hired by the CEO and reporting to the CMO, after holding a managerial role in a major municipal quasi-governmental organization. My colleagues held similar CMIO roles in other healthcare systems, some as early as 1991 and before. We had quite well-defined and fully-developed job descriptions and accountabilities with clear expectations.

In fact, through "dabbling" (by utilizing significant computer expertise dating to the early 1970's combined with clinical expertise) we were able to reverse projects that had turned into organizational nightmares and/or were threatening patient well-being, the latter being due to the clinical IT inadequacies of the identified IS leadership (see example case studies on this issue here and here).

It was puzzling to us that IT leadership was generally opposed to clinician involvement at a leadership level. Just as psychiatry and neurosurgery are two different specialties dealing with the same organ (brain), clinical computing is a very different specialty than management information systems. Both involve IT, but the commonalities in development, implementation, lifecycle and management diverge widely after that point.

We were, in fact, CMIO pioneers. An early version of my current website "Common Examples of Health IT Difficulties" that I began in 1998 was entitled "Medical Informatics and Leadership of Clinical Computing" and called for an expansion of roles such as ours, and empowerment of the CMIO role as a strategic imperative. My 1998 web site (and now the current site as well), have been read by thousands of healthcare and IT professionals worldwide.

I believe it and other writing by myself and others in the role pre-1997 helped fuel a shift in thinking about the strategic nature of the CMIO (e.g., "Strategic value of Informaticists", Healthcare Informatics, Nov. 1997, and "Broken Chord", Healthcare Informatics, Feb 99 , and a section of "Medical Informatics: Friend or Foe", Advance for Health Information Executives, May 2002 as examples of my own writings). The "strategic value" essay had been noted by The Advisory Board Company at the time of its publication and led to a long discussion with them on an issue of which they had been unaware.

In fact, access patterns to my current web site on HIT difficulty, tracked via a public web logging facility at extremetracking.com, show many direct queries on "healthcare IT failure" or similar concepts (see my 2006 poster here). Worldwide interest in this topic, and the need for more effective clinical IT leadership, is accelerating.

Finally, I continue my informatics advocacy writing at the multi author blog "Healthcare Renewal ." A recent MHRA-sponsored research project (MHRA is the Medicines and Healthcare Products Regulatory Agency, the UK's FDA-like agency) shows the thought-leadership impact of healthcare blogs to be significant, and that of Heathcare Renewal itself to be higher than several mainstream medical media outlets. The MHRA report is at this link (PDF).

I shall continue to call for leadership roles for healthcare informatics professionals, especially those with rigorous graduate and post-doctoral credentials from accredited organizations of higher learning (as opposed to the pseudocredentials offered by organizations such as HIMSS and others, see my essay "Is the HIMSS CPHIMS stamp substantive, or just alphabet soup?" at the Healthcare Renewal blog site at this link).

Finally, considering how the healthcare system can ill afford healthcare IT misadventure which can actually waste funds needed to care for the underprivileged, I ask the healthcare system "what took so long?" to realize that it takes a doctor to properly lead the creation of virtual clinical instruments.

I would argue that "what took so long" was obstructionism to progress caused by the territorial conceits of the IT and other components of the health IT ecosystem, for reasons both psychological and pecuniary.

These battles were and are waged, of course, at patient expense.

I am also concerned about the use of the term "
dabbling" to describe the activities of the pioneering informatics physicians and nurses. That is a pejorative term indeed for the challenging and patient-centered efforts of many brilliant cross-disciplinary clinicians.

A more appropriate term that might indicate a more genuine "evolution" of views by the headhunters would have been "explorer", "pathfinder" or something similar.

If anyone was "dabbling" it was the
hospital IS directors and IS personnel, entirely devoid of clinical education, knowledge and experience, who were dabbling with clinical medicine. They were uncritically importing their card punch tabulator mentality from the early days of data processing (explanation here) under the ill-conceived and bizarre (and opposed by the "pathfinders") notion that that mentality was appropriate for clinical medicine.

In fact, that mentality and all that went with it, tactically, stategically and operationally, was quite harmful. In my own direct observations as a CMIO, I watched in horror as "IS dabblers"
put the sickest patients in an ICU at great risk of iatrogenic infection with airborne pathogens (link), and caused chaos in an invasive cardiology facility performing the majority of cardiac procedures in an entire state, Delaware (link). I should not fail to mention the waste of resources and money that also occurred. 

The people behind these atrociously mismanaged clinical projects, some the "darlings" of the aforementioned recruiting companies and of the glossy HIT journals of the time, were never held accountable and in fact moved on to other organizations.

This style of clinical IT mismanagement continues to this day, and is an international phenomenon, at both the local level and the national, e.g., UK (link) and Australia (link).

Finally, on HIT recruiters being
wrong in the past in addition to having the past wrong:

Here is what prominent HIT recruiters wrote approximately at the time I was a CMIO.
From an article "Who's Growing CIO's" in the journal “Healthcare Informatics”:

I don't think a degree gets you anything," says healthcare recruiter Lion Goodman, president of the Goodman Group in San Rafael, California about CIO's and other healthcare MIS staffers. Healthcare MIS recruiter Betsy Hersher of Hersher Associates, Northbrook, Illinois, agreed, stating "There's nothing like the school of hard knocks." In seeking out CIO talent, recruiter Lion Goodman "doesn't think clinical experience yields [hospital] IT people who have broad enough perspective. Physicians in particular make poor choices for CIOs. They don't think of the business issues at hand because they're consumed with patient care issues," according to Goodman.

These were not helpful attitudes towards clinical leadership of HIT. In fact, the HIT recruiters were effectively serving as
enablers of clinical IT failure and potential patient harm through such "degree doesn't get you anything" ideologies, stunningly alien to biomedicine.

One wonders just how many "
from the school of hard knocks" HIT leaders were pushed by these recruiters onto healthcare organizations, and the harm such leadership may have done to healthcare and to patients.

These attitudes are definitely "not where the money is" today in HIT recruiting, but one wonders if the biases linger.

Have the recruiters truly learned their lesson? Perhaps, but perhaps not. Having been sent by the second author of the ADVANCE article last year into this unpleasantness -- incidentally while discussing with her the need for an article about the changing roles of CMIO's and giving her ideas for same - and then being chastised by her as "unprofessional" for writing my interview experience up in an anonymized fashion so that others might learn from it, I can only wonder.
[Translation of unprofessional: "your writing this up could get back to the employer or other candidates and hurt my future recruiting business. Education, knowledge sharing, and ultimately patient care be damned." - ed.]

It seems medical professionals who dabble in patient-centered activism to bluntly point out deficiencies in the lively, profitable HIT industry are simply acting unprofessionally, according to these experts.

My attitude is somewhat different, along the lines of the wise words of my early medical mentor, cardiothoracic surgery pioneer Victor P. Satinsky, MD at Hahnemann Medical College. Dr. Satinsky's simple mantra was:

"Critical thinking always, or your patient's dead."
 


-- SS