This document contains survey results from 35 health information organizations (HIOs) about their staffing, skills needs, and challenges. Key findings include: - Most HIOs have 6-50 employees, with technology and operations making up over half of current staffing. - Top skills needed are in technology (45%), operations (20%), and participant coordination (14%). In-demand technical skills are security, data integration, and project management. - HIOs face difficulties filling positions due to lack of available candidates and high salary requirements, especially for technical roles like security and data integration. - Recruitment challenges will likely continue as most HIOs plan long-term financial sustainability through

9. 0
2
4
6
4% 4% 4% 4% 4% 4%
11%
7% 7%
11%
22%
11%
What was the date of the first data exchange?
Yes
80%
No
20%
Is your HIO currently
operational?
Fig. C
Fig. B
N=27
N=35
Fig. A: CMS Regions

10. 0
10
20
0-5 6-10 11-15 16-20 21-50 > 50
32% 38%
9% 12%
6% 3%
# employees
What is the total number of employees in your HIO?
N=34Fig. D

11. 0
5
10
15
0 - 50 51 -
100
101 -
200
201 -
300
301 -
400
401 -
500
501 -
600
601 -
700
701 -
800
801 -
900
901 -
1,000
>
1,000
48%
13% 13% 10% 7% 3% 3% 3%
# participants
What is the total number of hospitals, physician practices and
other organizations participating in your HIO?
0
5
10
15
20
25 57%
51%
63%
34% 31%
49%
31%
46%
29% 26%
14%
Please indicate the types of transactions your HIO processes.
N=35Fig. F
Fig. E N=31

12. 11%
3%
69%
17%
What is the governance
structure of your HIO?
State Agency or
Other Gov Org
For-Profit
Not-for-Profit
501(c)(3)
Other Not-for-
Profit
State-
designated
54%
Regional
46%
Is yours a state-designated or a
regional HIO?
0
5
10
15
Other Opt-In Opt-Out -
Affirmative
Docs
Opt-Out - No
Affirmative
Docs
(No Response)
6%
23%
29%
20%
3%
What method of consent do you use for participation?
Operational
Not Operational
N=35Fig. I
Fig. G Fig. HN=35 N=35

13. 0
5
10
15
20
25
30
29%
49%
23% 26%
80%
29% 29%
9%
43%
How does your HIO plan to be financially sustainable?
State Agency or Other
Gov Org
Other Not-for-Profit
Not-for-Profit 501(c)(3)
For-Profit
Fig. J N=35

14. 0
5
10
15
20
25 57%
26%
37%
26%
40%
63%
54%
9%
3%
17%
What are your HIO funding sources?
State Agency or Other
Gov Org
Other Not-for-Profit
Not-for-Profit 501(c)(3)
For-Profit
Yes
49%
No
51%
Are you partnering with one of
the HITECH Workforce
Development Consortiums?
N=35
N=35Fig. L1
Fig. K

15. Yes
23%
No
77%
Have you used/are you currently
using HITECH Workforce
Development interns?
Yes
12%
No
88%
Have you hired any of the
HITECH Workforce Development
graduates?
N=35Fig. L2 Fig. L3 N=35

16. 0
10
20
30
40
50
60
70
80
Total # employees
How many positions are currently held as full-time,
part-time, job-share, on-site contract or outsource?
Outsourced
On-Site
Contractor
Job Sharing
Part-Time
Full-Time
0
5
10
2-5
positions
6-10
positions
11-15
positions
16-25
positions
26-50
positions
51+
positions
23% 23%
17%
23%
6%
9%
HIO Size (# currently held positions)
N=35
N=35
Fig. M
Fig. N

17. Technology
41%
Operations
34%
Participant
Coordination
15%
Other
10%
Current Organization Staffing
0
10
20
30
40
50
60
Date of first data exchange
Current Staffing by Age of Organization
Technology
Executive
Management
Participant
Coordination
Other
Fig. O N=35
Fig. P N=34

18. 0
2
4
6
8
10
12
Existing Organization - Current Staffing
Technology
Outsourced
Job Share
On-Site
PT
FT
Fig. Q N=35

19. 0
2
4
6
8
10
12
Existing Organization - Current Staffing
Operations
Outsourced
Job Share
On-Site
PT
FT
Fig. R N=35

20. 0
2
4
6
8
10
12
Existing Organization - Current Staffing
Participant Coordination
Outsourced
Job Share
On-Site
PT
FT
0
2
4
6
8
10
12
Privacy / Security HIM Skills Business Development
/ Sales
Other
Existing Organization - Current Staffing
Other
Outsourced
Job Share
On-Site
PT
FT
Fig. S N=35
Fig. T N=35

21. 0
2
4
6
8
10
12
Technology Operations Participant
Coordination
Other
Existing Organization - Current Staffing
Outsource
Job Share
On-Site
PT
FT
Yes
77%
No
23%
Do you currently use any
specific vendor product
support or development?
Yes
40%
No
60%
Are you currently seeking any
specific vendor product
support or development?
Fig. U N=35
Fig. V1 Fig. V2N=35 N=35

23. 0
5
10
15
Date of first data exchange
Staffing Needs by Age of HIE Organization
Technology
Operations
Participant
Coordination
Other
Technology
45%
Operations
20%
Participant
Coordination
14%
Other
21%
Skills and Qualifications
Currently Being Sought
Fig. W N=35
Fig. X N=35

24. Region 4
15%
Region 1
9%
Region 5
22%
Region 6
5%
Region 7, 8
0%
Region 2
33%
Region 3
5%
Region 9
0%
Region 10
11%
Staffing Needs by CMS Region
Fig. Y N=35
Fig. A: CMS Regions

25. 0 1 2 3 4 5 6 7
Security
Data Integration
Data Integrity
Connectivity
Data Quality / Compliance
Payment Processing
Technical Project Mgmt
Software Support
Business Intelligence / Reporting
Spec / Design / Coding / Testing
Help Desk / Support
Other
# HIE organizations seeking skill set
Skills and Qualifications Currently Being Sought
Technology
Fig. Z N=35

26. 0 1 2 3 4 5 6 7
Executive Mgmt
Product / Services Mgmt
Marketing / Sales / PR
Finance
Human Resources
Legal
Master Patient / Client Index
Documentation
Adult Education
Other
# HIE organizations seeking skill set
Skills and Qualifications Currently Being Sought
Operations
0 1 2 3 4 5 6 7
Fundraising / Capital / Sustainability
Participant Account Mgmt
Data Governance
Operations Governance
Government Regulations
Industry-Specific SMEs
Patient/Member Advocates
Other
# HIE organizations seeking skill set
Skills and Qualifications Currently Being Sought
Participant Coordination
Fig. AA N=35
Fig. AB N=35

27. 0 1 2 3 4 5 6 7
Privacy / Security
HIM Skills
Business Dev and/or Sales
Other
# HIE organizations seeking skill set
Skills and Qualifications Currently Being Sought
Other
Bachelor's Degree
58%
Master's Degree
19%
PhD
0%
MD
3%
JD
13%
Other
7%
Please identify the degrees your organization is
currently seeking.
Fig. AC N=35
Fig. AD N=35

28. CPHIMS
15%
PMP
22%
CISSP
7%RHIA
11%
CHPS
7%
RHIT
7%
Health Informatics
15%
Medical Informatics
0%
Nursing Informatics
4%
Microsoft
4%
Oracle
0%
Cisco
4%
Other Vendor
4%
Please identify the certifications your organization is
currently seeking.
Fig. AE N=35

29. 0
5
10
15
20
25
< $75,000 $75,000 -
$89,999
$90,000 -
$119,999
$120,000 -
$149,999
$150,000+
Please indicate the salary ranges for positions your HIE
organization is currently seeking.
Other
Participant
Coordination
Operations
Technology
Fig. AF N=35

30. 0 2 4 6 8 10 12 14
Security
Data Integration
Data Integrity
Connectivity
Data Quality / Compliance
Payment Processing
Technical Project Mgmt
Software Support
Business Intelligence / Reporting
Spec / Design / Coding / Testing
Help Desk / Support
Other
# respondents reporting difficulty
Difficult to Fill Positions
Technology
HIE
Recruiter
Fig. AG
N=47
(35 HIO / 12 Recruiter)

32. 0 2 4 6 8 10 12 14
Executive Mgmt
Product / Services Mgmt
Marketing / Sales / PR
Finance
Human Resources
Legal
Master Patient / Client Index
Documentation
Adult Education
Other
# respondents reporting difficulty
Difficult to Fill Positions
Operations
HIE
Recruiter
N=47
(35 HIO / 12 Recruiter)Fig. AH

33. 0 2 4 6 8 10 12
Fundraising / Capital / Sustainability
Participant Account Mgmt
Data Governance
Operations Governance
Government Regulations
Industry-Specific SMEs
Patient/Member Advocates
Other
# respondents reporting difficulty
Difficult to Fill Positions
Participant Coordination
HIE
Recruiter
0 2 4 6 8 10 12
Privacy / Security
HIM Skills
Business Dev and/or Sales
Other
# respondents reporting difficulty
Difficult to Fill Positions
Other
HIE
Recruiter
Fig. AI
N=47
(35 HIO / 12 Recruiter)
N=47
(35 HIO / 12 Recruiter)Fig. AJ

34. Lack of available
candidates
30%
Local competition for
same talents
17%
Salary requirements
too high
24%
Narrow skillset / career
focus of the candidates
7%
Losing good
employees/contractors
to other opportunities
9%
No healthcare
experience
13%
Have you faced any of the following staffing challenges within
the past 6 months?
Recruiting Firms
13%
Job Boards
19%
Referrals
27%
Professional Orgs
16%
Alumni Programs
12%
Conferences / Events
7%
Other
6%
How do you find candidates for open positions?
Fig. AK N=35
Fig. AL N=35

37. o
o
o
o
o
o
o

38. o
o
o
o

39. o
o
o
o
o
o
o
o

40. o
o