When it comes to selecting who’s going to implement your healthcare organization’s new solution, there are many choices available. We’ll review why selecting a vendor-agnostic consulting firm provides the highest value for ROI.
Healthcare’s Past – A Vendor Heyday
Specific solutions for each specific need
It has been common place in the last decade for a health system’s IT department to support as many as 150 or more different systems from more than two dozen vendors. This situation is caused by the presence of so many specialized needs in different clinical departments and settings. For example, OB is certainly going to document differently then radiology or cardiology, and all will need different sets of data. Health systems benefited by having specific solutions to specific needs, but it also created substantial confusion and the need for management of all the different relationships.
The rise of Epic, Meditech, Cerner and Siemens
Several years ago IT departments began to consolidate to much smaller numbers of different applications. This primarily occurred when large scalable EMR vendors like Epic, Meditech, Cerner and Siemens became popular in the EMR ramp-up and with the advent of Meaningful Use (MU). The move from best-of-breed solutions to single vendor solutions solved some problems such as:
- No more need to manage a large number of vendor relationships,
- Any issues could be held to a level of accountability with one, or at least a small number of vendors, preventing finger pointing when things went wrong.
While this vendor consolidation solved some challenges, it created others at the same time:
- Putting all your trust in a single IT vendor meant that the vendor had to be a jack-of-all-trades and capable in almost all the different clinical environments. Ineffective result – forcing clinical users to either work with systems that don’t do everything they want or limiting usefulness while waiting on new implementations pending software development.
- Increasing the risk taken on by providers with the MU push to single vendor solutions merely to meet the requirements to provide health information exchange (HIE). With a sole vendor approach, the integration is much easier with less customization required. While the outcomes may be less than desired by the healthcare organization, it is unlikely that a move away from single vendor will happen any time soon due to to this complexity.
We have an additional issue with changing risk models requiring more data then ever and more specific integration of data to new tool sets like analytics, Business Intelligence and population health management. Meaningful Use criteria also contributes to the need for HIE, which adds another layer of complexity in integrating outpatient IT systems; from physician offices to labs to imaging departments and even clinics in places like Walmart. Keeping balance between managing relationships with vendors and getting cost effective solutions has never seemed more difficult. Many healthcare organization today are analyzing the scenario of, “Best-of-breed can give better pricing but more complex relationship management while single vendor costs more in purchase price and performance over best-of-breed.”
Enter the Consulting Firms
The rise of the consulting firms over the past two decades has mirrored the rise in complexity stated above. You can find specialized firms who focus on Meditech Implementation, Epic Implementation, Siemens Implementation, or even any of the HIE vendors. You can also hire someone who specializes just in outcomes for a particular department. Revenue cycle management, for example, where the consulting firm not only knows all of the technology solutions but is an expert in process change and workflow to maximize use of the tools. In some ways it is analogous to managing a large department store. You have people who specialize in electronics, home and furniture, clothing, grocery and so on.
Who’s the best resource for an Epic Implementation?
One of the questions asked on a regular basis is “Do I hire the people I need for an Epic Implementation OR do I outsource from Epic OR do I use a third party consulting firm?” The answer is usually dependent on:
- Knowing about the systems in place, and
- What the goals are for the implementation.
We’d suggest the answer is to select a vendor-agnostic consulting firm rather than:
- hiring new IT people in-house, or
- hiring Epic or Meditech to do the Implementation of your EMR, or
- hiring InterSystems, Orion, or Medicity to implement your Interface engine or HIE.
Vendor-Specific or Vendor-Agnostic?
The benefits of a vendor-agnostic consulting firm
There are many benefits to hiring a vendor-agnostic firm to do the implementation. We’ll focus on three:
Experience – Most healthcare IT consulting firms typically hire experienced people from vendors to work for them across the country, on multiple sites, which gives them the ability to see more implementations and how they work and when they don’t. The reality here is that healthcare administration would like to have seen better outcomes from their investments in IT and that includes meeting timelines and expectations for their users and the financial results they want for their boards. A vendor-agnostic firm is far more likely to be transparent on how long something will take than a vendor who wants to sell more products or solution upgrades along the way. The vendor-agnostic firm may provide a timeline reality an organization doesn’t want to hear but setting that expectations correctly in the first place rather than failing on go-live dates is preferable to most!
Speed – Another advantage of the vendor-agnostic firm, many times being able to complete an implementation faster than with in-house people or with the vendor’s team. Why? Consulting firms usually hire very high quality people who come with a high pricetag to get them on their team versus staying with McKesson, Meditech, Epic or Medicity. As a result, these experienced people are much more effective in getting the job done and eliminating unnecessary steps in the process.
Two examples from Orchestrate Healthcare consultants:
- Consultant 6504 works on HIEs given that he has 20 plus years of experience in both HIE products and in healthcare IT in general.
- Consultant 9873 is in an expert in interface engine technology having worked for years on the Orion team but now also knows InterSystems, Mirth, and Corepoint in depth due to exposures during consulting.
Having consultants on-board like this not only helps in the implementation timeline but when there is an additional challenge to overcome they have probably seen it before and can save time on the problem-solving. When a vendor proposes a new solution these types of consultants can tell you what is a good idea and what may be redundant or unnecessary.
Focus – Beyond getting providing the most appropriate timelines, setting expectations, and reducing the cost of an Epic Implementation through speedy implementation, vendor-agnostic firms are also typically more focused on what needs to be done than the vendor themselves. Where we could never make the case that in-house people would be less focused than a third party firm, there is a value in reducing the responsibility for the training of in-house team members to be state-of-the-art in implementation skills and rather utilizing their skills in maintenance.
A vendor-agnostic firm can focus on the implementation work only, leaving your in-house department accessible for day-to-day activities. The continuity of focus is key to the speed of deployment and meeting the expectations of go-live timelines.
Is there a down side to hiring a vendor-agnostic consulting firm to do a Meditech or Medicity implementation? Yes, and it is typically cost. The hourly rate of consulting firms can be as much as double the rate an organization may pay their own IT team. Third party firms are relatively competitive with vendor staff in costs but won’t cap their costs the way a vendor does. However, hourly rate isn’t the entire cost that should be considered.
Hiring people requires a benefit cost as well and in most cases that runs to as much as 35% of the hourly rate as an addition. Also, in-house staff need to stay educated on the vendor solution, and when the project is complete organizations then have to deal with reduction in the implementation team, which is a whole different cost problem. Is there an absolute formula that CFOs could follow to weigh the implementation options? We’ve examined many of the advantages of working with a vendor-agnostic firm, and ultimately there is no way to really measure the ROI of having the deep experience of a vendor-agnostic consulting firm like Orchestrate Healthcare, but when jobs are done and users are happy the ROI is obvious.
It’s A Wrap – Selecting A Vendor Agnostic Firm
Which firm do I hire?
Generally, potential health system clients want to find a consultant who will fit on their team as the consultant will need to integrate with existing staff, and that staff will sometimes see the consultant as a threat. Solution? Interview consultants to learn about depth of experience, number of clients served successfully and gain references.
KLAS rating is another important factor because having a third party rating service monitor the performance of firms in the market gives an independent look at how the firms do versus them simply providing their best reference clients while avoiding sharing the ones less satisfied with their work.
Vendor-agnostic firms aren’t for everyone – but they are worth a look in all implementation cases. Finding out what is really going in the market and where the success and failure points are is important and interviewing firms can help you with that. At Orchestrate Healthcare, we specialize in supporting Epic Implementations, Meditech Implementations, Cerner Implementations, Medicity, Orion, InterSystems, and more and we do it while maintaining a commitment to quality reflected by our top KLAS score ratings year after year.
If you are ready for a healthcare IT consulting company that exceeds your implementation expectations rather than just talking about it, give us a call today at 877-303-3377. We invite you to learn more about our services, or to schedule an interview with one of our Best-In-KLAS consultants.