The Government Accountability Office’s (GAO) decision to not select a single female on the Health Information Technology Advisory Committee (HITAC) in December was just one of many indignities women in health IT have faced over the years while trying to rise up through the ranks in a male-dominated field.
After GAO selected seven men for a new term within the 25-person HITAC, HHS Secretary Xavier Becerra ended up selecting a female candidate, Medell Briggs-Malonson, MD, Chief of Health Equity, Diversity and Inclusion for the UCLA Hospital and Clinic System, for the eighth spot. In total, the committee has eight female representatives who serve for terms that last nearly three years.
While Briggs-Malonson’s selection attempted to right this particular wrong, the initial snub brought backlash and bad vibes from health IT stakeholders and served as a reminder that the industry’s gender gap is still as wide as ever despite recent efforts to change the disparities. Deven McGraw, who applied for a spot on the HITAC, says that a field like health IT tends to bring a lot of dismissive attitudes towards women.
“I think there’s a sense that women lack the necessary technical expertise, they’ll bring the softer sort of policy, ethics and maybe some operational experience within health care, but I think those get perceived as not technical and therefore not enough expertise to serve on a committee whose role is at least in part to recommend standards,” says McGraw, who was the co-founder and the chief regulatory officer for Ciitizen, a consumer-health technology start-up. Ciitizen was recently acquired by Invitae.
“If you look at engineering and technical fields generally, there tend to be fewer women in those fields. It’s getting better because of the focus on STEM education and promotion of women in technical fields, but it has a long way to go. It’s not like women don’t like tech. They do. But it can be very daunting when you’re the only women in your class or on the committee,” McGraw adds.
Jan Oldenburg, a veteran executive in patient engagement technology development and implementation, said that there is institutional bias in health IT against women. She says women sometimes come to health IT through less traditional paths, such as nursing, and that can create biases against their credentials. However, Oldenburg says those non-traditional paths are necessary to think outside the box. She also says some women are brought into health IT companies as changemakers, willing to call things out, and that people have a hard time accepting that.
“This is not just about health IT, but my experience, and I think many women’s experiences, is full of situations where you are speaking what you view as the truth and it’s not accepted by the organization until a man says it, often after claiming credit for it. It’s that whole thing that what I say is not heard in the same way. You’re talked over. You’re interrupted,” says Oldenburg.
“Personally, I have the benefit of being somewhat brash, so I just keep raising those issues and not fitting the expectation of what you should be doing in your role or how you should be behaving. I have heard that I was too outspoken, not deferential enough to people above me and I should be more diplomatic when I raise issues.”
In this day and age, there’s increasing recognition for the need for diversity, both with regards to gender and race, and yet the same thing keeps happening.
Deven McGraw, Invitae
A survey from the Stanford Byers Center for Biodesign examined how professionals working at medical device, device-based diagnostic, digital health and health information technology companies view the industry’s gender gap. Two stats were particularly revealing in proving McGraw and Oldenburg’s points about gender perception being a problem in health IT.
More than 60 percent of male respondents said the major barrier is a woman’s desire to balance work and family responsibilities, while 70 percent of female respondents said the biggest obstacle was exclusion from networks of communication and influence. Nearly 80 percent of male respondents said promotion criteria are equitable and that the workplace empowers women to reach their full potential; but just over a third of the women respondents agreed.
Goes beyond health IT
When it comes to the gender gap problem, health IT is no different than the larger health care world. In fact, it may be even more egregious because the broader industry employs more females yet there are few women in leadership roles at health systems and health plans. One study published in JAMA found that women held only approximately 15 percent of the CEO positions in health care organizations.
For most C-Suite roles in health care, women only held about 20-30 percent of the positions. The only exceptions were human resources officer and head of marketing/communications.
“It’s the typical glass ceiling where women can only get so far,” says McGraw. In fact, it took a female government official to nominate her for privacy and security policy work on the HITECH Health IT Policy Committee. She said was appointed to the role by then HHS Secretary Kathleen Sebelius. But for the HITAC, she has been rejected twice when she applied. “In this day and age, there’s increasing recognition for the need for diversity, both with regards to gender and race, and yet the same thing keeps happening.”
The right kind of mentorship and coaching programs can go a long way in helping women get heard, says Oldenburg. She credits former Kaiser Permanente CEO George Halvorson as someone who had a multidimensional senior leadership team and showed respect in how he doled out responsibilities when they worked together both at KP and HealthPartners.
Beth McCombs, the CTO at BD, a $17 billion medtech company, also advocates for mentorship and representation. She says that early on in her career she had a lot of amazing male mentors who helped her, but it wasn’t until she saw a female director of research and development that she was inspired to move up. She has since paid it forward.
“Having diverse backgrounds at the leadership level, and all levels, is important to make sure we’re making good decisions and bringing different perspectives into the company. I make the time to mentor any woman who reaches out who I can support because I see the importance paying it forward. I’ve had a lot of amazing support throughout my career,” McCombs says.