Hiring an IT Specialist

The latest information technology solutions carry the promise of helping you keep your business flourishing while maintaining high patient satisfaction. The most innovative products can help you improve collaboration with patients, customers, and other practices, all of which is best for patients and your practice. In reality, this means higher quality of care, greater process efficiency, increased customer satisfaction, and better regulatory compliance.

But to make sure you're getting the right products for your office -- and that you're maximizing their utility -- it often helps to have an IT staff in place.

But that raises a separate question: Where can you find qualified IT specialists to hire?

For medical practices, hiring the right technical help is a special and important challenge. Do you suspect that there is more you can do with technology to support your clinical operations, but aren't sure exactly how? Are you finding that your network and e-mail systems are in need of attention that is beyond your limited time and expertise? If it's time for your practice to hire an in-house technology specialist to troubleshoot your network, fix the printer, add the new scanning functionality, and handle pretty much anything in between, do you know how to begin?

Hiring a jack-of-all-trades technology professional -- a systems administrator -- can be more challenging for medical practices than other types of businesses.

You need to find someone who will function like others in your practice and take on whatever there is to do. Interpersonal skills are as important as the technical qualifications that look like gibberish to those of us without technical backgrounds. The antisocial geek who likes to be alone in a dark room with a monitor is not likely to be very helpful to the nurse who is tentative about using a mouse. An IT snob will not help your staff take advantage of the opportunities to bring technology into the practice and gain efficiency in clinical operations.

Reviewing resumes

As you review resumes, look for candidates who have experience applying their skills in practical ways, rather than simply academic accolades. A computer science degree from a four-year school is often slanted toward programming, which is not the jack-of-all-trades IT guru your practice needs. Your dream candidate is more likely to have an associate's degree from a local technical school and/or certification degrees. "Sysadmins," as systems administrators are sometimes called, may have credentials from companies such as Microsoft, Cisco Systems, and IBM, which guarantee a certain level of competence. 

Your systems administrator should have familiarity with network design, load balancing (making sure a single server doesn't get overwhelmed with requests), and security.  Network design means he should be able to figure out which hardware you need and how to make a network run smoothly (it stays "up" and available to staff with a responsiveness that is transparent to the end-users). Of course, he should also know the protocols for data flow --  enough knowledge to troubleshoot and converse with your vendors --  but he does not need to be a world-class programmer.

It would be the icing on the cake if your sysadmin came into the practice understanding the workflow of a medical practice, from patient telephone call processing to ordering tests and tracking results. With knowledge of medical office functions and responsibilities, an IT specialist will recommend technology solutions to apply to the daily processes that can improve operational efficiencies. If you're thinking it's not reasonable to expect one person to know all this cold while also performing the occasional manual hardware repair, you're right.

What is vital, therefore, is hiring someone who knows how to get the answers he needs. Your candidate should belong to technical societies and online chat groups to establish a similar kind of support network that you maintain with your peers. Does your candidate have budgeting and disaster-planning expertise? These would also be nice, but not required. As your practice continues to become more sophisticated in its use of technology, your jack-of-all-trades can develop these skills.

Interviewing a techie

If you don't have much knowledge about technology yourself, it may seem daunting to interview someone who does. How do you know what questions to ask? Start by inquiring about candidates' training and professional memberships. Then you might try these ideas:

Do some role-playing. Be prepared with a couple of scenarios, such as an irate and frustrated user, and watch their body language as they react to each situation. Determine if they can clearly articulate solutions and set expectations while maintaining a good "bedside manner." Describe a current technology problem in the practice and ask the candidates what steps they would take to resolve the issue. Listen for an organized attack plan and for solutions that you had not considered to evaluate each candidate's methodology and attention to detail, and to glean for innovative problem-solving skills.

Ask what forums, FAQ Web sites, and other online support sources the candidate uses, and check these online after the interview. The level of technical support (can you easily understand the discussions and issues?) they offer will guide you to the level of outside technical knowledge to which your candidate looks for assistance.

Ask about a recent problem that you experienced with technology and see how readily your candidates are able to diagnose and resolve your issue in comparison to the process you experienced. For example, if you've recently upgraded to the Microsoft Windows XP Service Pack 2 (SP2), ask your candidates about their SP2 upgrade experience and compare that with what you learned going through it yourself.

Ask about experience with firewalls and network security. The Internet is not some monolithic entity; instead, it is comprised of innumerable individual information services. You are probably familiar with many of these services: Web, FTP, chat, instant messaging, newsgroups, e-mail, telnet, and streaming audio and video. Firewalls can be employed to individually grant or restrict traffic based on each of these services, and your candidate should address the individuality of these as she inquires about your network security policy. (If you don't have a network security policy and the candidate asks about it, fess up and ask the candidate to tell you how she would work with you to develop a policy and what experience she has in that area.)

The candidate may inquire about which Internet resources your users need to do their jobs (such as access to e-mail or basic Web pages) as opposed to those resources they might like to have (such as access to streaming audio and video). This level of discussion provides insight to an aspect of the candidate's abilities that may be an asset as your practice extends its use of technology.

For example, if your candidate ventures into the area of patient educational material in streaming audio and video format, you have uncovered a techie with healthcare knowledge that may seem too good to be true. It will be too good if your practice is not ready to take some risks in the area of technology. This candidate is an innovator and may become bored with the daily network management functions, so be sure you hire for your objectives.

Ask about the candidates' experience with e-mail filters, virus-scanning, and handling e-mail attachments, including outgoing attachments. For example, if your candidate suggests that sensitive patient information may not be appropriate for e-mail, you can probe more deeply on his knowledge of medical privacy issues and find out what he knows about HIPAA. Moreover, if you plan to move into the EMR world, a candidate with knowledge of, and interest in, the subject may help position your practice for that investment.

Ask candidates if they have a Web page, even a family Web site for sharing vacation photos. Get the Web site address from the candidate and take time to look at it. The Web site will provide additional insight on the candidate. Look for any blatant errors in spelling and grammar. Look for design style and aesthetics. Consider the appropriateness of the content given the intended audience. Check on the Web site immediately, so the candidate won't have time to perform any clean-up.

Background checks

Of course, you should ask for and check references, but garnering useful information this way is often difficult. So also ask for any contacts for which the candidate may have provided services on a contract or freelance basis. Before hiring a new systems administrator, insist on a criminal background check. Your sysadmin will be the gatekeeper for your entire business system --  the last thing you want is for your gatekeeper to be a crook.

Well-developed technology management can be a springboard for the introduction of new systems and technologies, particularly those that affect the care process. Hiring someone with the right mix of technical, management, and interpersonal skills will provide your practice with an invaluable resource.

Rosemarie Nelson, MS, has experience as
a medical office manager, in information
technology, and as a consultant to physicians and practice professionals. Currently a senior consultant for the Medical Group Management Association, she was manager of the multi-manufacturer Office of the Future project and serves on the board of the American Heart Association North East Affiliate. She can be reached at rosemarienelson@alum.syracuse.edu or at editor@physicianspractice.com.

This article originally appeared in the January 2005 issue of Physicians Practice.