Concern among the public and policymakers regarding current [
1] and future major HRH shortages, predicted to reach 12,9 million professionals worldwide by 2035 [
2], is increasing. These worries are often associated with awareness of a growing demand for chronic care, on the one hand and a recent tendency toward burnout among health professionals [
3]. Appropriate management, development, and retention of health professionals are frequently mentioned as critical factors both in addressing this challenge, and also in facilitating effective management of health organizations, and improvement in the quality of patient care. Nevertheless, many health organizations persist in archaic HR practices and the role of HR technologies is conceived as being to support existing ways of doing things. Some of them even struggle to estimate timely and accurately the size of their HRH [
4]. HRIS [
5], proven in other industries to be effective in transforming selection, management, development and retention of employees, are often thought of as a potential panacea for weaknesses in HR systems and practices in health organizations. It is expected that HRIS can help to launch, manage, and provide actionable insights on a full employee life-cycle, starting from recruitment and selection, and continuing through payroll and benefits administration, performance management, career and succession planning [
6]. However, little of this work has focused on health organizations or published in health literature. In consequence, knowledge regarding the adoption and impacts of HR-related innovative technologies in health organizations is still scarce.
Moreover, the rapid developments in the field of technology over the last decades referred to by the World Economic Forum as the “fourth industrial revolution” - after steam, mass production, and electronics – have given rise to a wide variety of technologies and their possible applications in HR management or development. However, those few studies that discuss HR technologies in healthcare focus only on limited types of technologies such as, for example, Artificial Intelligence (AI) (e.g. [
3]). This paper contends that a wide range of HR technologies can, in principle, support and improve HR practices in healthcare and thus help to address the upcoming HRH crisis. In reviewing this the paper draws on the existing typology of innovative HR technology disruptions that could transform the way we work and manage organizations [
7] including: 1. The acceleration of HR Management Systems (i.e. HRIS) and cloud-based solutions; 2. A massive shift from “automation” to “productivity”; 3. The introduction of continuous performance management processes; 4. The rise of feedback, engagement, and analytics tools; 5. A reinvention of corporate learning; 6. Innovation in the recruitment market; 7. An explosion in the wellbeing market; 8. The maturation and growth of the “People Analytics” market; 9. The spread of intelligent self-service tools; and 10. Innovation within HR itself.
The examples used in this paper come mostly from the background reading of the author undertaken in the course of research on HRIS in health and “People Analytics”.
Debate
Different forms of administrative information systems including HRIS have been used in health organizations for the past five decades, although these often used to be de-prioritized in health organizations by comparison with clinical information systems. Rising concern regarding HRH shortages has increased interest in exploring the role of HR technologies in the management, development and drive for increased efficiency of HRH. However, many of the existing studies related to technology or its impacts on the future of work in healthcare have focused primarily on just a few specific technologies, especially AI [
3,
52]. This is despite the promise that a wider and ever-expanding range of technologies, or combinations of technologies, can help to address various aspects of this crisis. A particularly interesting newcomer is Blockchain, which promises not only to facilitate HR data collection and storage but also to ensure its security and confidentiality. This is especially timely in the wake of the noteworthy hacks of 21.5 M records in the US’s Office of Personnel Management and 1.7 M records in the UK’s Ministry of Finance, as well a recent case in which a man was found to have been masquerading as a doctor for a decade, after faking his medical qualifications [
53].
Many of the existing studies related to technology and its impacts on the future of work in healthcare also focus primarily on automation of work. Thus, for example, we know that the work of technicians, transcribers, secretaries, clinical coders and information technologists are likely to be computerized first [
52]. Moreover, we can also deduce that it is likely that healthcare will have a mixture of automated, semi-automated, augmented and purely human roles. However, most of these studies often pay little or no attention to the fact that HR technologies are also likely to change how HRH are managed in health organizations.
The examples discussed in this paper illustrate how different HR technologies are helping or could help health organizations in improving their HR practices, and thus contribute to efforts to address the upcoming HRH crisis. However, while there is an evidence-base for the benefits and unintended consequences of operational and some strategic HRIS used in health organizations [
9], there has been relatively little information and discussion regarding most of the disruptive HR technologies discussed above. The exceptions tend to derive from high-income contexts or private health organizations, making it difficult to assess whether and how the adoption or impact of these technologies really varies between geographies, cultures and other salient factors. However, it is promising that there are now some attempts to gather evidence regarding how these technologies or their applications can contribute to HRH productivity, especially from an international point of view. One significant example is the book “Human: Solving the Global Workforce Crisis in Healthcare,” written by the Global Chairman and Senior Partner for Healthcare, Government and Infrastructure at KPMG professional service company [
13].
Most of the HR technology disruptions that have been discussed are still to find their place within health organizations’ routine HR practices. For example, none of the successful case studies featured on the website of LinkedIn Talent Solutions [
54] comes from a health organization. This may be explained by the absence of an evidence-base that could be used to justify investments in HRIS, the focus of health organizations on adopting clinical IT or perhaps by some notable challenges HRIS developments and implementations face internationally, in a sector where a “mistake” can cost lives. The most notorious HRIS project ended up being described as “The largest admitted IT project failure in the Southern Hemisphere,” costing the Queensland (Australia) health system $1.25 billion AUD [
55]. In the light of these considerations we need the collaboration of the academics and practitioners in developing new “programs of interdisciplinary research, encompassing economic evaluations, sociotechnical analyses, studies of information flows, and systematic assessments of the impacts of better workforce information on health care efficiency, quality, safety, and patient care, as well as new exploratory research to understand the value of information for driving analytics in support of sustainable and effective health systems” [
9]. In the meantime, HRIS projects in healthcare should carefully pilot and evaluate incorporation of these technologies into complex health work practices in a way which take into consideration the readiness and maturity of individual organizations, [
56] to including context-specific environmental, organizational and individual factors [
48]. Moreover, the decision to adopt any particular type of HRIS should be considered with a clear eye on the specific organizational objective, whether this be an aspiration to collect accurate data on HRH (thus implying the adoption of core HRIS), or a desire either to introduce or to further transform strategic HR practices (demanding the adoption of performance management and recruitment HR modules, or even some disruptive HR technologies).
Finally, considering growing public awareness and concern about legal, compliance and ethical issues of data security and privacy, the success of projects related to HRIS or the use of their data may directly depend also on the responsible use of these innovations [
40]. Some contexts have comprehensive regulations governing this, such as the European General Data Protection Directive. Others, waiting for their regulations to catch up, aim to fill this gap with ethical frameworks/policies. Diverse interdisciplinary scholars and practitioners are already actively working on addressing some of the ethical/legal issues related to adoption of HR and HRIS innovations [
40]. However, practical ethical frameworks are still not available for all HR practices such as, for example, People Analytics, or if they exist they are not specifically tailored to health organizations. Overall, this is a big challenge, especially for developing countries where these technologies are often open-source and their adoption is funded by international sponsors.