Article Archive
March/April 2024

March/April 2024 Issue

Technology: Using Technology to Address Staffing Shortages
By Sue Coyle, MSW
Today’s Geriatric Medicine
Vol. 17 No. 2 P. 8

As the health care staffing shortage grows, practices and providers are looking to technology for a solution.

The health care staffing shortage is no secret. Exacerbated by the COVID-19 pandemic, the shortage spans the entirety of the industry and is expected to continue growing at alarming rates. Some studies predict, for example, a shortage of between 200,000 and 450,000 registered nurses by 2025. At the same time, the need for health care and, thus, trained health care staff is increasing as the population ages—a fact that’s also affecting the workforce.

“When we think about workforce, it’s really a mathematical equation, and we just start with looking at various demographics,” says Mark Smith, group vice president of insights, optimization, and staffing at Providence, a comprehensive health care organization with employees throughout five western states. “First, every day in this country, we have 10,000 people turning 65, so we know that people are retirement eligible. We know by 2030, the baby boomers will be predominantly out of the workforce. We know that other generations have not grown at the same rate as the baby boomers.” This leaves more people leaving than entering.

But the retirement of a generation is not the only cause for staffing shortages. Health care workers of all ages are choosing or have no choice but to leave their profession due to a variety of reasons including burnout, working conditions, and the shortage itself. When a practice or facility is understaffed, the individuals who remain are likely to experience increased stress and dissatisfaction. As a result, there are more openings than there are potential employees in health care. According to Smith, “We have at least two openings for every health care worker today.”

Overcoming the staffing shortage requires many different tactics, but one thing is clear—the solution cannot rely solely on bringing in more professionals. After all, even if there were enough people interested in entering the field, acquiring the proper education, whether a degree or certification, takes time.

As a result, health care providers are looking to technology for ways to address the staffing shortage, finding new means of supporting administrators, caregivers, and, ultimately, the patients.

Administrative Burden
Technology can be implemented throughout many of the administrative duties that, while necessary, are time consuming and, in the midst of a staffing shortage, often frustrating.

“One of the things that we talk about is identifying the workload. Over the past years, as we’ve all begun wearing many hats. The defining principles of what we are doing day to day have grown and changed. By finding areas to automate things that are very detail and labor intensive,” says Natalie Edgeworth, senior manager of workforce optimization at Providence, they can help alleviate some of the administrative burden.

“Specifically, scheduling is one that we’re focused on—how can we put the right amount of people or the right resources in the right places when we can reasonably say this is what the need is going to be,” she explains. Using automated staffing forecasting, which uses data to predict what the staffing needs might be at given times, facilities are able to schedule their staff in a less burdensome yet still effective and safe way.

“Underneath what we’re doing with staffing and scheduling is taking rich amounts of data from our electronic medical record system to understand trends and patterns. We’re using a really powerful volume forecaster that looks at many different scenarios to give leaders insights into what could be most possible,” Smith says.

“So now we can both create these automated processes to eliminate the administrative burden on a lot of our leaders but also ensure that we’re putting our staff in a safe place and our patients in a safe place with the outcomes,” Edgeworth adds.

Beyond scheduling, technology can be used administratively to recruit and onboard employees as well as connect practices and providers with the pool of professionals they require, not only for full- and part-time positions, but the more flexible gig or per diem shifts.

Working more flexibly has become appealing to a variety of professionals in the health care industry, including parents as well as those who may have retired early but would like to continue working on a freelance basis. “During the pandemic, we saw other industries being impacted by COVID-19 that have been slow to recover. One of those areas is childcare,” Smith says. “So in many of the states where we serve patients, we have very distinct what I would call childcare deserts where we haven’t seen the services recover, which means that there are people making decisions to have to stay home. With gig or on demand, and using technology to connect to make available open shifts through the platform, individuals who might have flexibility to work in a different way can now access shifts and come to work for a health care system.”

While the ability to better manage scheduling and staffing are vital in addressing the staffing shortage, they’re not the only ways technology can be used during this time. It can also be integrated into the ways in which patients receive care.

For example, several platforms and organizations allow for virtual care providers to offer patients services that don’t necessarily have to be rendered in-person. “A virtual care network offers a crucial solution to alleviate burdens on in-person health care staff, mitigating burnout during peak seasons,” says Lyle Berkowitz, MD, founder and CEO of KeyCare.

KeyCare provides health systems access to a group of virtual care providers who, through coordination, supplement the health system’s workforce. “We have started with virtual urgent care staffing, so that any patient who calls a health system with a routine urgent care need can have a same day virtual care appointment (usually within 30 minutes),” Berkowitz explains. Berkowitz says products like KeyCare allow patients to have convenient access to care while providers and health systems do not go beyond their capacity. “This strategic offloading enables in-person staff to concentrate on complex cases, like severe infections or major trauma, optimizing their expertise where it is most impactful.”

Providence has also introduced a virtual component to caregiving with the cocaring model. “The cocaring model is really using telehealth at the bedside,” Smith says. We have incredible technology at the bedside, great cameras, great sound systems, and it has allowed us to bring virtual nursing to the bedside to provide supplemental care. Patients who have a question in the moment can have that answered by the virtual nurse. We can help with discharge so the patient really understands clearly what should happen.

“It supplements the staff,” he explains, adding that the unit has also helped with staff retention, with a waiting list of individuals who want to work there.

These options for integrating more technology into a practice or health system to help with the staffing shortage are great on paper but really only offer assistance if leaders, patients, and caregivers are on board. So far, in Smith and Berkowitz’s experience, the feedback has been positive.

A part of the reason for that positive reception in regard to health care leaders specifically, Smith says, is that the tools are being developed, presented, and implemented as the supports they are intended to be. “At the end of the day, everything that we’re doing is to make sure leaders have the insights they need to make their best decisions. We don’t envision the technology making the decisions for leaders,” he explains. “I think it becomes a very critical part of how we’re beginning to introduce things like the predictive scheduler to make sure we look at things like automation almost like a virtual caregiver who is providing support to a leader or another caregiver to enable those leaders to make decisions and to make sure that it’s really going to serve a human need.”

Similarly, the patients have been open to the changes, particularly the virtual caregiving. Berkowitz says that most patients, including older individuals, are quite used to the technology. “Virtual care is actually not a new technology for them. Most older patients are very comfortable with phones and video calls these days since they need to use that technology to communicate with their children and grandchildren. And for those who are not, they often have a helper who can facilitate the visit.”

As for the caregivers—the nurses, certified nursing assistants (CNAs), and more who are experiencing the added technology in the ways they are scheduled for work, in the flexibility they have in shifts, and in the supplemental support of virtual caregivers—Smith believes the developments allow them to do what they truly love. “[It] allows our nurses and CNAs to focus on the human element of care, which is where they really want to be.”

— Sue Coyle, MSW, is a freelance writer in the Philadelphia suburbs.