With the number of providers working to achieve meaningful use growing, electronic health record (EHR) vendors are struggling to keep up with the increasing demand for their products and resources. As noted here and elsewhere, eligible professionals and hospitals are searching for resources capable of filling in the gaps. And not only are the demands growing, but the requirements from achieving meaningful use will continue to change as providers progress through the different stages of meaningful use. Programs are beginning to emerge that aim at addressing and capitalizing on this shortage of qualified health information technology professionals.
So what is the value of consultants during an EHR implementation? Are they truly worth the cost?
According to one top health IT executive, the importance of consultant cannot be overstated: “If I had to do it again, I would have fought for even more.” One of the perhaps unintended consequences the Centers for Medicare & Medicaid Services (CMS) EHR Incentive Programs is their effect of the health IT labor, which has forced vendors into a lucrative but grueling predicament:
With everyone doing this right now, the good people have left the vendors to go consult. Whereas in the past you may have been able to lean more heavily on your vendor to have the best person to design and tell you what the system can do, I have found that I have had to bring really expensive consultants in. For as small as we are, I’ve got six or seven strong consultants who are in here advising, working on the workflow, and anticipating how the system can do this and not be able to do that. And in some cases, my vendor has even been leaning on my people.
It would seem then the vendor’s loss is the consultant’s gain. Looking behind cost, a good consultant can give providers leverage in working with vendors, knowing what to expect and how to anticipate potential pitfalls early on. This is especially true in instances where providers are turning to new vendors and unfamiliar products:
The one guy we have has done nothing but put this product in for fifteen years. The vendors have newer people, and the one they had said, ‘We’ll have to look in to this,’ or, ‘We’ll have to look into that.’ My consultant stood up and said, ‘It’s never going to do that. I’m going to tell you right now, this is how we’ve got to solve this problem.’
Considering the importance of an EHR system not only to a provider’s ability to achieve meaningful use but also his ability to compete with other providers, investing more upfront could mean avoiding extra expenses down the road to fix it. “If I had to do it again, I would have fought for even more,” continues our insider, “I put some consulting dollars in, but I wish I would have put more.”
For opponents of meaningful use, the vendor problem should inspire little sympathy. To folks like Richard Armstrong, MD, it’s a touch of karma mixed with a little come-uppance: “The vendors that developed these things are in cahoots with the government financially. They sat down in all these offices across Congress and convinced these people that’s this is the best thing since slice bread.”
From the provider’s perspective, particularly small practices, paying the price for knowledgeable resource could lead to a more meaningful and less regrettable investment. For those who can’t afford some of the more costly consultants, the Office of the National Coordinator for Health Information Technology (ONC) has made such resources available through the Health Information Extension Program’s regional extension centers (RECs) at little to no cost.
• Summer of the Health Data Breach continues
• IHIE sticks with values while advancing technology
• CIO series: Cloud EHR, virtualization with ARcare’s Greg Wolverton
• DoD-VA yields new open-source EHR solutions, more delays
• Fitch raises long-term EHR meaningful use concerns