5 Healthcare Jobs Transformed by Reform

The focus in hospitals on outcomes and patient satisfaction and on the use of electronic health records systems is changing clinical duties and job descriptions.

If your HR department is like most, it is recruiting more nurses with advanced degrees, looking to hiring a team of care coordinators, and possibly seeking out tech-savvy docs.

These hiring trends are not occurring in a vacuum. Healthcare reform is transforming how all levels of hospital workers—from physicians and nurses, to social workers, IT professionals, and senior leaders—do their jobs.

"Over time, healthcare may be changed in a really positive way," says Bryan Bassett, managing director at Health eCareers, an online recruitment firm headquartered in Denver, CO. "We're now going to be much more focused on patient satisfaction, on treating the patient as a customer. The focus is now on outcomes, and not just any outcomes, but truly successful outcomes. There's much more of a 'lessons learned' mentality, which is a very positive thing, but it will take us time to get there," he says.

Here are a few healthcare jobs that have changed as a result of healthcare reform.

1. Nurse Navigators and Care Coordinators
As treatment plans grow in complexity and reimbursements have become tied to outcomes, it is necessary for some patients, especially the very ill or those who see multiple specialists, to have a navigator or coordinator to help them make sense of it all and ensure that everyone is onboard.

For example, some nurse navigators specialize in coordinating cancer treatment, ensuring that all clinicians and social workers engaged in treating a patient with cancer are aware of a patient's current treatment plan. Some nurse navigators specialize in elderly patients, patients with a serious diagnosis, or patients with multiple conditions.

The care coordinator role is similar, although as many candidates come from social work or other backgrounds as nursing and there's greater emphasis on keeping the patient out of the hospital after their release by taking steps like calling the patient at home to see how they're doing, scheduling appointments for them and making sure they take their medications, always with an eye on cutting down on readmissions.

"Nurse navigators focus on helping patients get the care they need when they need it," explains Jess Judy, senior vice president of provider relations at LifePoint Hospitals. This is especially important in coordinating care for patients in ACOs and other managed care environments.

2. Clinical Pharmacists and Advanced Practice Nurses
Clinical pharmacists and advanced practice nurses have always been important, but their professional scope and capacity are expanding, says Judy. "We're seeing a real expansion of the clinical pharmacist role. Patients are on multiple medications, and it’s the clinical pharmacist's job to ensure the meds they take cause no adverse reaction."

Judy predicts an uptick in hiring and increased responsibilities for this role over the next decade, as the aging population continues to receive more prescriptions.

Another job seeing its role expand is that of the advanced practice nurse. "We're seeing a whole lot more advanced practice nurses than we used to," Judy says. In many ways, this is prompted by the popularity of [changing] top of license policies, he says.

"Instead of a physician counseling a patient about their medication or the care of feet if they're a diabetic, someone else who has that training can do it. In short, we want to make sure everybody is practicing to the maximum level of their skill level."

3. Physicians and Anyone Who Interacts with EHRs
"The day-to-day jobs of almost all physicians have been transformed. It used to be that many physicians worked in private practice, but now, doctors know that they will go directly in to a health system or hospital when they complete their education and training," says Bassett.

"The demands of the [PPACA] in terms of legislation around ACOs and electronic health records means that you just can't survive as an independent physician in a small practice. This is a massive transition in the way that role does its job," he says.

But there are positives to this change, says Bassett—being an employed physician might mean greater work-life balance and the opportunity for more flexibility in a physician's career.

Another massive policy change related to the PPACA that has changed the physician role is payment models. "It used to be based on volume," says Bassett. "Now, everything is outcomes-oriented. This changes how a physician looks at [his or her] daily routine."

The implementation of electronic health records marks another big change for clinicians. "Anybody who interacts with EHRs or EMRs just has different job requirements than they used to. There's a new expectation of technical competence, and just a general pressure to beef up on tech savvy employees."

While some of these transformations have been sudden and even dizzying to the industry, they are all important steps to progressing toward the value-based care model, which Bassett is convinced will remain in place for years to come. "The train has left the station," he says.