How to Hire an IT Director

The advent of mandatory EMR makes this position critical.

By Peter J. Polack, MD, FACS

About eight years ago or so, our practice decided to move from paper records to electronic records. The decision was helped along by the fact that we were literally running out of space for our paper charts. I had been looking at electronic medical records systems for years prior to this but could not justify the cost to my partners—apart from the “gee-whiz” factor—until we were up against the wall, so to speak. Our administrator had previously worked in a nonprofit, where he met an individual who was doing contract information technology (IT) work and recommended we hire him to help us achieve our goal of having a paperless practice.

Fast forward to today. We implemented EMR in our practice at the end of 2008 and performed a gradual rollout to minimize the impact on the clinics and thus the bottom line. We were able to start adding new patients with no significant effect on our efficiency and have subsequently added other patient types to the mix. Our IT Director, who spearheaded this project, commuted from almost an hour away the eight years that he was with us; alas, this eventually took its toll and he decided to leave us and take a position closer to home.

The Search Begins

Since we are approaching the deadline for so-called “meaningful use” of EMR, we felt this was a critical position to fill—and soon. In a practice our size, the IT Director is the next most important person after the administrator and the chief operating officer or assistant administrator. And since we were already running on EMR, though not yet at 100%, time was of the essence. Fortunately, we had two other IT employees who could keep things running during our search.

As physicians and medical practice administrators, we feel pretty comfortable with the thought of having to recruit, interview and hire a new medical associate. There are professional headhunter firms that can throw resumes your way and even help vet potential candidates. We know what questions to ask, what skills are important, and we know how to tell whether or not an applicant is the real deal. The problem with trying to hire an IT director is that we don't know what questions to ask, what skills are important, and we probably can't easily identify someone passing himself or herself off as an expert when he or she is not.

Our next step was to consult with our extended family of experts: my brother, who oversaw an IT department, and the spouse of one of our partners, who works for a major software company. Together, we decided that any potential IT candidates would need to be vetted by someone who was in the IT industry, even before our experienced management team performed any interviews. It is difficult to verify the credentials of people in this field—the alphabet soup of credentials includes MNS, ACE, ACTP, CCNA, CCNP, MCP, CNX, LPIC, LCSE, OCP, WAN-ACE, CSTE, to name but a very few—much less their skill sets. After our conference call, we had our plan of action:

■ Create a job description. Do you already have a good idea what this person will do for you? Great. If you don't, get some assistance. You can either ask the Director of IT for a practice in your area or the local hospital to help you come up with a very specific job description. This should include the certifications required for the job and the expected hours as well as duties. For some people, squeezing through crawl-spaces to run network wire is a deal-breaker. You'll also want to ask your consultant what the expected range of salaries would be in your particular market, given your specified skill sets. Even in this economy, people in the IT industry with experience can command decent pay.

■ Post the ad. Do you practice in a small town? Then you might want to think locally. It might be difficult to recruit someone away from a major metropolitan area and your salary offer might be less than the pay package they are accustomed to receiving. Apart from placing the ad in your local newspaper, you should post it on a major job-listing site like Monster.com. One advantage of using a site like that is that the resumes are stored in an electronic format that makes going through the information much easier. It also makes it easier for potential candidates to search for the appropriate job.

■ Start vetting the candidates. Rather than using a headhunter (more on this later), we opted to go with a consultant, Mike Sellers of CVPSite.com, a credential-verification company. They offer a free service to employers that verifies the credentials claimed on the resume of a potential IT candidate (they charge the applicants a fee for going through their certification process, thereby giving them their seal of approval and making them more attractive prospects). Based on our job description and some other specific criteria, Mike ran the resumes through their proprietary system to rate the candidates. He then took the top 16 of these and interviewed them by phone in order to ascertain whether their listed credentials were genuine—he could usually tell after just a few questions (in one instance, the candidate gave up early and readily admitted that his qualifications were bogus). When the process was complete, we were handed a spreadsheet with all of the applicants and their ratings on a multitude of specific criteria, ranked top to bottom, with the finalists clearly identified.

■ Consider using predictive testing. Recent research is showing that personality or IQ tests are less predictive of an employee's success in a particular job than what is known as conative testing. This describes a person's modus operandi (or MO)—how they are likely to act in a particular situation. The one that we have used is called Kolbe Testing www.kolbe.com. The practice administrator and/or direct supervisor of the applicant takes one test to determine their own Kolbe ‘profile,' then takes another test to determine the profile of the ideal employee. Last, the job applicants take another Kolbe test to see if they would be a good ‘fit' for the practice. Obviously, this should be just part of your overall assessment (we have just started using this tool, so the jury is still out). Another type of assessment tool to consider is Predictive Index testing from PI Worldwide at www.piworldwide.com.

■ Final interviews. After going through the process above, you should have four to six finalists for your face-to-face interviews. Since your expert has already vetted their credentials and assessed their technical skill sets, your finalists are all on a level playing field. Now all you have to do is subject them to the same rigorous evaluation process as you do for any other highly compensated employees and make sure that you feel that person is a good fit for your practice. You know they are highly skilled, but you'll also want someone with good people skills as well as a lot of patience in dealing with less technically gifted employees. It is critical for the person in this position to act as a liaison between the technical world and the real world.

You might also want to consider involving a subordinate in the evaluation process—a person who works in the same technical field can have valuable input. Last, your future IT director will soon become your expert on electronic medical records and so will need to get up to speed on such things as the meaningful use provisions.

Why We Went With an IT Expert

Why didn't we just hire a headhunter, as we do when hiring a medical associate? Like a listing agent in real estate, the headhunter doesn't necessarily represent the buyer—in this case, our practice. Their main job is to place their clients, the job applicant, i.e., the ‘seller.' Sure, their reputation is at stake and they want to make sure you are satisfied so they can count on you for more business. But they will make their fee, regardless of who is placed in your practice. And although most reputable headhunter firms provide some sort of guarantee if the prospect doesn't work out, this is not something we wanted to waste a lot of time on. Unlike a potential physician candidate, with an IT position there are many more prospects to have to go through and, as physicians and medical practice administrators, we are a bit out of our element. For this reason, and for reasons I listed above, we decided to go with a ‘broker,” an expert who performs a formal candidate analysis. OM

Peter J. Polack, MD, FACS, is co-managing partner for Ocala Eye, PA, and a specialist in cornea, external disease and refractive surgery. Ocala Eye is a seven-partner, multisubspecialty practice located in Ocala, Fla. The practice has five locations, including an ASC and laser center. Dr. Polack can be reached by e-mail at ppolack@ocalaeye.com.