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News 2/12/14

February 11, 2014 News 12 Comments

Top News

2-8-2014 3-16-29 PM

I’ve confirmed with several sources that Epic will soon offer consulting services beyond implementation work, very much as described in the original rumor report from EpicConsulting. Epic employees with at least four years’ experience will be allowed to live somewhere other than Verona to take on more post-live consulting work. My sources say the consultants will offer work that isn’t strictly even in the systems domain, such as implementing clinical programs and doing Lean Six Sigma work for clients. Many questions remain: (a) how will this decision affect Epic’s relationships with consulting companies?; (b) how will Epic price its services?; (c) will skilled Epic people really want to stay with Epic, or just leave as they’ve been doing to take higher-paying jobs with consulting companies?; (d) is Epic going this route because customers want it, to try to reduce project cost by offering lower-priced consulting, to avoid losing experienced employees, or because they know implementation work will eventually dry up and the market will move toward other services?


Reader Comments

2-11-2014 5-02-30 PM

From Anonymous Health System CIO: “Re: HIStalk RFI Blaster. I recently used your RFI Blaster to solicit consulting company proposals. I have found your sponsors who responded to be capable and professional. Compliments to these companies that have good skills and follow-through: Aspen Advisors, Encore Health Resources, Impact Advisors, Leidos, Lucca Consulting, and Santa Rosa Consulting.” I created the RFI Blaster as suggested by a CIO who wanted an easy way to give HIStalk Platinum Sponsors a chance to earn his business. Filling out the short online form blasts your request out to companies of your choosing, and I specifically didn’t make “contact telephone” required since not everybody wants to be called about their request. I appreciate the report and the shout-out to the sponsors who were good to deal with.

From Jay: “Re: Melanie Pita, chief product officer and general counsel of Prognosis Innovation Healthcare. Has left the company.” Unverified, but her bio has been removed from the company’s executive page.


HIStalk Announcements and Requests

2-11-2014 1-45-27 PM

inga_small We’ve posted our annual guide to HIMSS meet-ups, which includes details on how to connect with HIStalk sponsors that are not exhibiting but are available for one-on-one meetings. We will publish our full HIMSS14 guide this weekend, which includes details on over 100 vendors (all which happen to be sponsors). Look for our guide to exhibitor giveaways next week so you’ll know where in the exhibit hall to find the best free coffee, fun trinkets, and cookies during the day and of course cocktails before heading out on the town.

inga_small Speaking of HIMSS, I’ll be participating in Medicomp’s Quipstar HIT Quiz show Tuesday, February 25 at 3:00 p.m. and looking forward to having a big crowd in the live studio audience. Even though I came in last when I played a couple of years ago, I agreed to give the game another go because Medicomp is making a generous donation to my favorite charity.

2-11-2014 4-27-51 PM

Fans of the Smokin’ Doc now have another reason to drop by HIStalk’s HIMSS Booth 1995 and say hello to Lorre, who will selectively dole out these potentially collectible (probably not) HIStalk pins from her treasure trove of cool things that were in our price range.

2-11-2014 4-50-33 PM
2-11-2014 4-41-31 PM
2-11-2014 4-43-04 PM
2-11-2014 4-44-16 PM

I mentioned that I agreed to run a new short-term ad at the top of the HIStalk page only so I could donate most of the proceeds to the DonorsChoose charity that helps financially strapped classrooms (to which I’ve donated personally for years.) I fully funded the following projects totaling $2,870 on behalf of all HIStalk readers this week, all projects submitted by Teach for America teachers because I respect that organization’s work just as much as I do that of DonorsChoose. I’ll be funding more projects shortly thanks to the sponsors who have booked the ad space: VMware, InterSystems, GetWellNetwork, Aspen Advisors, IngeniousMed, Billians HealthDATA, and Greenway. Above are excerpts from some of the notes the teachers sent in response to the help we as readers provided to their students. We funded:

  • $604 for a New York City eighth grade teacher for a podium and certificates to create a National Junior Honor Society ceremony for her students in the poorest Congressional district in the US
  • $506 for a Glendale, AZ teacher to provide interactive math stations for her sixth graders
  • $255 for a La Place, LA teacher, whose second grade class is meeting in a trailer after their school flooded last year, to expand their Listening Learning Center of read-along books
  • $234 for a Baltimore teacher who needs a Chromebook to access learning websites that offer classroom practice
  • $226 for a Chicago teacher whose elementary school students need non-fiction books that the school can’t afford
  • $201 for a North Charleston, SC classroom whose high-poverty, at-risk students need white boards and supplies for interactive activities
  • $185 for a Jackson, MS elementary school class for write-and-wipe markers and erasers
  • $187 for a Rosedale, MS high school for toner and a file cabinet for printing college applications and practice standardized exams
  • $167 for notebooks and pencils for a Chicago teacher’s 35 freshman girls to create College Bound Journals
  • $185 for a Memphis teacher’s need for pencils for her third graders
  • $249 for a Salt Lake City, UT teacher’s need for fourth-grade books

2-11-2014 4-49-29 PM

A reader notified a friend who happens to be a DonorsChoose executive team member that I was donating on behalf of HIStalk readers. That DonorsChoose executive donated to a project of her own choosing in honor of HIStalk’s readers, which is pretty cool.

2-11-2014 5-53-49 PM

Welcome to new HIStalk Platinum Sponsor PDS. The Madison, WI-based company, founded in 1986, offers an ITIL-compliant, 24x7x365 Patient Portal Support Service Desk to assist patients with Epic MyChart, Medseek, and other patient portal systems. PDS offers HIPAA-trained analysts, transparent service, and a first-call resolution rate above 90 percent. Check out their site to see a list of health systems PDS supports across the country and to read a success story from Bon Secours Health System. Thanks to PDS for supporting HIStalk.


HIMSS Conference Social Events

Send us your event details if it’s a good one (i.e., free food and drinks at minimum) and you promise that all HIStalk readers are welcome to attend, even if they work for your most hated competitor as a given reader might well do.

Physician Technology Partners is hosting a dinner Tuesday, February 25 at Roy’s Fusion Cuisine to introduce a new Epic MyChart implementation and help desk solution. RSVP online or by email.

2-11-2014 5-06-04 PM

Perceptive Software will host an event at Jimmy Buffet’s Margaritaville at Universal CityWalk on Monday, February 25 from 8:00 to 11:00, with shuttle service provided to and from the major hotels. They will have food, drinks, and a live Caribbean band. RSVP here.


Upcoming Webinars

February 12 (Wednesday) 1:00 p.m. ET. Healthcare CO-OPs and Their Potential to Reduce Costs. Sponsored by Health Catalyst. Presenters: David Napoli, director of performance improvement and strategic analytics, Colorado HealthOP and Richard Schultz, VP of clinical care integration, Kentucky Health Cooperative. Consumer Operated and Oriented Plans (CO-OPs) were established by the Affordable Care Act as nonprofit health insurance companies designed to compete in the individual and small group markets. Their intended impact was to provide more insurance options for consumers to pay for healthcare.

February 13 (Thursday), 12 noon ET. Advancement in Clinician Efficiency Through Aware Computing. Sponsored by Aventura. In an age of information overload, a computing system that is aware of the user’s needs becomes increasingly critical. Instant-on roaming for virtual and mobile applications powered by awareness provides practical ways to unleash value from current HIT investments, advancing efforts to demonstrate meaningful use of EHRs and improve clinical efficiencies. The presenters will review implementation of Aventura’s solution at Orange Coast Memorial Medical Center.

February 18 (Tuesday), 1:00 p.m. ET. Epic 2012 Training and Support: Building Your Team. Sponsored by MBA HealthGroup. The webinar will present a case study of creative staffing solutions for an Epic 2012 upgrade at an academic medical center, describing the institution’s challenge, its out-of-the-box solution, and the results it obtained working with a consulting firm.

February 19 (Wednesday), 1:00 p.m. ET. What is the Best Healthcare Data Warehouse Model for Your Organization? Choosing the right data model for your healthcare enterprise data warehouse (EDW) can be one of the most significant decisions you make in establishing your data warehousing and foundational analytics strategy for the future. The strengths and weaknesses of three primary data models will be discussed: enterprise data model, independent data marts, and late-binding solutions.


Acquisitions, Funding, Business, and Stock

2-11-2014 3-41-59 PM

Nuance Communications reports Q1 results: revenue flat, adjusted EPS $0.24 vs. $0.35, beating estimates.

2-11-2014 3-44-45 PM

Employee health management site Castlight Health, co-founded by US CTO and athenahealth co-founder Todd Park, files for a $100 million IPO that values the company at $2 billion. Castlight reported a net loss of $62.2 million last year on revenues of $13 million.

2-11-2014 3-45-20 PM

The Advisory Board Company announces Q3 results: revenue up 13 percent, adjusted EPS $0.26 vs. $0.28, missing estimates.

Virtualization technology vendor Sphere 3D will acquire V3 Systems, which offers desktop cloud management solutions.

2-11-2014 5-51-53 PM

I wondered why Meditech was so late in posting its Q3 SEC report since I’ve been watching for it for months and now I know: the company reports that it improperly recognized revenue and is figuring out how to keep its auditors and the SEC happy. In the mean time, the company can’t issue new stock or complete its filings. Meditech isn’t publicly traded, but still has to comply with SEC rules. The issue sounds relatively minor and accidental – revenue was recognized in cases where the company’s implementation employees didn’t complete all the contractually required visits. Customers paid and the work got done, but 100 percent of visits must be completed to book the revenue. The company refreshingly concludes:

We are less embarrassed than you might think. There is no question of fraud or malfeasance here. We acknowledge we should have been following the revenue recognition rules as specified by our own policy, but one of the reasons we have auditors is to find issues like this promptly. They didn’t do it. However, because of the urgency of resuming our SEC filings, we’ve decided to put our unhappiness with them into abeyance at this point, and deal with that later. From an operational point of view, there should be absolutely no effect on the company, other than the additional expenses we are incurring with the auditors and the outside analysis firm to fix the problem (not to mention the huge amount of extra work our accounting and implementation staff are undergoing to provide the required information). The cash is still in the bank, free to be used – the only question is how the revenue was supposed to be reported on our filings. Customers should not be affected in any way. Our plans for the future remain the same.


Sales

Christus Health selects Wellcentive’s population health management platform.

2-11-2014 3-49-36 PM

MaineHealth chooses MediQuant’s DataArk active archiving system.

Privia Medical Group (VA) will implement athenahealth’s PM, EHR, patient communication, and care coordination services for its 154 providers and affiliated ACO.

2-11-2014 3-48-15 PM

Blanchard Valley Health System (OH) will deploy Merge Healthcare’s VNA interoperability and cardiology solutions.

Humana will implement CoverMyMeds to allow physicians to submit drug prior authorizations directly to Humana via an online portal.

Georgia Physicians for Accountable Care selects eClinicalWorks Care Coordination Medical Record.

Dean Health Plan (WI) chooses Health Language for terminology management.


People

2-11-2014 10-58-17 AM 2-11-2014 10-59-01 AM

AtHoc names Mary-Lou Smulders (Oracle) VP of marketing and Matthew Gloss (Mellanox Technologies) general counsel.

2-11-2014 3-51-52 PM

Healthfinch hires Sanaz Cordes, MD (Cogent Healthcare) as COO.

2-11-2014 6-22-22 PM

Kevin Fickenscher, MD, formerly of Dell and AMIA, is named president of health services for remote patient monitoring company AMC Health.

2-11-2014 7-25-50 PM

LDM Group names Paul Hooper (Emdeon) as VP of retail innovations and product commercialization.


Announcements and Implementations

Ontario’s Hôpital Montfort uses Summit Healthcare’s InSync and SST for dictionary migration to Meditech 6.0.

Healthcare Access San Antonio, Holon Solutions, and the Texas Organization of Rural and Community Hospitals will connect area hospitals, clinics, physician offices, and other providers to a regional HIE across 22 South Texas counties.

Memorial Health (CO) launches its $30 million Epic implementation.

Athenahealth announces that it has integrated drug monographs from its Epocrates acquisition into athenaClinicals.


Government and Politics

2-11-2014 6-40-49 AM

CMS and ONC introduce Randomizer, a tool that allows providers to exchange data with a test EHR in order to meet measure #3 of the Stage 2 transitions of care requirement.

2-11-2014 7-00-50 PM

ONC launches a challenge to develop a Javascript/HTML-based, easily understood Notice of Privacy Practices that can be incorporated into websites. Submissions are due by April 7 and the winner gets $15,000.

2-11-2014 7-38-53 PM

CMS announces that Healthcare.gov won’t accept new insurance enrollments this weekend because the Social Security computer system has a planned 62-hour maintenance downtime starting Saturday, which is also the deadline for applying for coverage that will become effective March 1.


Innovation and Research

A screening program for abdominal aortic aneurysms integrated into an EHR reduced the number of unscreened at-risk men by more than 50 percent within 15 months, according to a Kaiser Permanente study.

Penn Medicine (PA) announces that it will work with analytics vendor Teqqa, LLC to provide real-time antibiotic sensitivity information to physicians via a mobile app as part of its antimicrobial stewardship program. Penn received equity in Teqqa as part of the agreement.


Technology

2-11-2014 6-06-51 PM

I may have missed this article from a week or so ago even though I see Inga picked it up on HIStalk Practice. Walgreens clinics will use ePASS software from Inovalon (formerly MedAssurant) that prompts its clinicians to ask patient-specific questions based on data from 100 million patient visits and records of the patient’s own behavior. The software will suggest problems that the patient might have, walk the clinician through asking questions, and then create a SOAP note that goes back to the EHR. The same software is integrated with Greenway, NextGen, and Allscripts.


Other

The local paper highlights the struggles of United Hospital District (MN) in implementing Meditech. Administrators blame internal workflow problems for registration-related pains and interface issues for difficulties exchanging data between Meditech and the hospital’s NextGen system.

2-11-2014 4-10-45 PM

A TV station in Hawaii reviews the cost of implementing Siemens Soarian at taxpayer-supported Hawaii Health Systems Corporation (HHSC), originally budgeted at $50 million but now estimated at $109 million. The health system’s regional CEO says IT and support staffing estimates were so far off that headcount had to be doubled. The hospital workers’ union expressed concern that a Siemens employee serves as HHSC’s CIO, saying, “It’s like the wolves watching the henhouse,” but the health system responded that it hired another consulting firm “to oversee Siemens.” Siemens responded that the scope of the work of the original $29 million contract hasn’t changed, but HHSC keeps asking for more modules, services, and staffing that weren’t in the contract.

2-11-2014 7-12-55 PM

A survey of 1,000 physicians finds that 70 percent don’t think the HITECH program was worth its cost, 45 percent say EHRs have made patient care worse, and 43 percent say EHRs caused them to lose money. A third say they doubt their current EHR will even be around in five years. A key fact was omitted in the press release – what was the survey’s methodology? In other words, how were respondents selected; how were the questions presented; what was the demographic, specialty profile, and practice type of respondents, etc.? The findings are pretty big news if the survey’s methods were sound.

John Lynn hosted a Google+ video hangout on cloud technology and data centers that can be streamed from his site.

OCR files a HIPAA complaint against a Las Vegas hospital and Dignity Health, claiming the hospital used its medical records to contact former patients to get them to switch to the health plans the hospital accepts. The hospital denies the charge, saying its contacts were intended to be “informative.”

2-11-2014 7-29-24 PM

OK, who proofed this press release’s headline?


Sponsor Updates

  • HealthLogix from Certify Data Systems passes numerous Integrating the Healthcare Enterprise profile tests at the 2014 IHE North America Connectathon.
  • TeraMedica will debut its zero-footprint universal viewer for its Evercore vendor-neutral archive at the HIMSS conference.
  • ICSA Labs issues Passport’s CareCertainty service 2014 inpatient module ONC Health IT Certification.
  • Arcadia Healthcare CEO Sean Carroll discusses the struggles facing hospitals in a Boston Business Journal article.
  • MedAptus releases a risk severity toolkit to help provider groups with coding of patients covered under risk-based contracts.
  • Memorial Healthcare (MI) uses Iatric Systems Meaningful Use Manager to access data for a Meaningful Use audit.
  • An API Healthcare-commissioned survey reveals that the majority of Americans age 30 and older are concerned with the impact of healthcare reform on the quality of patient care and staffing at hospitals.
  • Providers have collected more than $10 million in CMS reimbursements over the last five years using the Covisint PQRS submission process.
  • Richard W. Zollinger, II, MD shares how Capario has helped his practice to accelerate cash flow, improve profitability, and remain independent.
  • Sandlot Solutions launches a channel partner program for healthcare consultants, software vendors, and payers.
  • iHT2 announces the details of its San Francisco summit on population health management and analytics.
  • FeedHenry and AirWatch partner to offer a joint solution that enables enterprises to quickly and securely create and manage multiple apps and devices.

REST and FHIR
By Bryan Weiss
CDA PRO

2-11-2014 6-42-42 PM

REST is a techie thing. It’s another way for computers to talk to each other. Another flavor of API (application programming interface.)

What matters in this context is not how it works or why it’s better or worse than anything else, just that it’s a very well established and widely deployed standard that software developers are using today (and have for the past few years) to develop applications that work over the Internet, like smartphone applications that reflect data from Web servers in the cloud or Web servers that talk to each other.

FHIR uses REST as its technical underpinnings to do the same kinds of things that HL7 has always done — enable the exchange of healthcare information (patient clinical summaries, lab orders end results, etc.) between systems.

When most people say, "We’re using HL7," they usually mean HL7 version 2 messaging, which defines a format for one system to send healthcare information to another over a network. It’s a point-to-point communication (think email) between two systems, though often there is a specialized message router that sits in between to help translate the variations in the message format that each side understands.

The Meaningful Use (MU) regulations have ushered in broad use in the US of a newer generation of HL7 standards focused on something called CDA — clinical document architecture. In CDA, what gets transferred between systems is a document (think word processor file) that contains the same kind of information as HL7 v2 messaging, but using XML format. XML is a document format that is used a lot on the Internet when data is exchanged in document format. The HTML exchange between browsers and web servers today is a form of XML.

CDA is part of version 3 of HL7, which is a very broad framework that describes the underlying theoretical model for how data should be represented and encoded, regardless of whether it’s communicated via messages like HL7 version 2 or CDA documents (version 3) or other formats. There is thus a version 3 messaging protocol that replaces the version 2 messages, but it hasn’t caught on much, especially in the US. So as a practical matter, HL7 version 2 usually means point-to-point messages and HL7 version 3 usually means CDA documents.

HL7 data interchange today for most people is either version 2 messaging or version 3 CDA documents. The specific flavor of CDA called out in Meaningful Use Stage 2 today is termed C-CDA, which stands for consolidated CDA, so named because it "consolidated" various CDA-derived standards that came before it.

Though I speak on behalf of nobody other than myself and am not taking sides, there is a oft-cited position that HL7 standards historically have been a bit too formal and academic and also too open to varying interpretation. Even if both sides of an exchange are using HL7 v2 messaging or HL7 v3 CDA documents, there’s still a lot of work to do (one integration at a time) to ensure that what the receiver understand is what the sender intended.

FHIR is also part of HL7 v3, only instead of using XML documents like CDA does, it uses REST interfaces.

FHIR looks like it has passed the "shiny new object to get excited about" phase and is being worked on actively by many vendors and other clinical data interoperability stakeholders. Relative to the early stage of its lifecycle that it is currently in, FHIR has significantly more momentum than any previous HL7 standard. In addition to using REST (which makes it a great way to exchange healthcare data for things like mobile applications), the folks working on FHIR are doing their best to learn the right lessons (good and bad) from past generations of HL7 standards.

It will be a while before we can know for sure if FHIR delivers on its promise and even longer before we know for sure what it means for the evolution from the entrenched HL7 v2 messages or the currently MU-mandated CDA documents. Some of that probably depends on if, when, and how future editions of MU mandate the use of FHIR, but also how quickly it achieves critical mass of application developers.

I think for most HIStalk readers who work at healthcare providers and non-vendor stakeholders, FHIR is more something to be aware of than something that requires action right now. In the software development side of vendors and consultants (and IT groups within other healthcare interoperability stakeholder organizations,) more concrete action is required to learn FHIR, work on prototypes, and participate in some of the connectathon testing between servers and applications that are taking place.


Contacts

Mr. H, Inga, Dr. Jayne, Dr. Gregg, Lt. Dan, Dr. Travis, Lorre.

More news: HIStalk Practice, HIStalk Connect.

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12 Responses to “News 2/12/14”

  1. 1
    flpoggio Says:

    Re: Meditech revenue recognition
    Now here in black and white is one very BIG difference between private companies (a la Epic, Meditech, etc) versus publicly traded companies. When similar issues came up at QuadraMed in 2002 it basically started a sales/financial slide and just about killed the company. When the SEC audits were done they said there was no malfeasance, just lousy bookkeeping. No matter stockholders had left them high and dry. The same thing happened with McK/HBOC in 1999…although that one was illegal and people went to jail for it.

    Now with MT since all the stockholders are private and can’t sell their stock on the open market, there is no dumping, no Wall street expose, etc. Just clean up the books and keep on trucking.
    Chalk another one up for staying private.

  2. 2
    Lazlo Hollyfeld Says:

    It is the safe play to stay with Epic if you an employee given that they are here to stay in one capacity or another despite what will be a slow-moving mammoth shakeout in Health IT vendors and US hospitals by the end of the decade.

    Deloitte, pWC, and Accenture will be here in one capacity or another too and I expect they will respond in kind to Judy. They aren’t going to stand around like pikers and let her eat their high-margin lunch.

    Bigger issue is what happens to the mid-tier consulting firms who aren’t highly specialized in a niche and have a track record of doing a lot of work where Epic has a heavy install base including AMCs and increasingly Children’s Hospitals. Big fish will mostly survive with maybe 1-2 exceptions that choose to exi and the small highly specialized ones will too. It is the middle guys who are going to get squeezed and get squeezed hard by this.

  3. 3
    Fourth Hanson Brother Says:

    Well that would explain the lowballed support FTE numbers that Epic’s been putting out lately….

  4. 4
    Redacted Says:

    a) Numerous people have told me that they are calling this the ‘consulting killer’ in internal meetings. There shouldn’t be any ambiguity surrounding their intentions. Epic consulting firms help the customer, but they cost Epic employees. Pretty easy to see where they are siding on this one.

    b) Someone said 75$ in the thread below, but that seems ridiculous because then you’d have 2 month tenured IS doing validation and billing at a higher rate.

    c) I haven’t heard anything about a pay increase for these folks, so at this point it’s taking a bucket of people who are already dedicated enough to stay at Epic for 4+ years, and then giving them the benefit to work remote? If that’s the case, then the only people this should really persuade are those who were going to leave due to having to stay in Madison.

    d) To avoid losing employees and because they know implementations will dry up.

    I still think one of the biggest problems with their plan is they are pretending that they have this enormous reservoir of 4+ year employees to draw from. Now take that bucket, and pull out all of the employees who have roles that are critical to Epic/customer success. I think they’re getting ahead of themselves with the consulting killer talk.

  5. 5
    John_Chilmark Says:

    Heading down the consulting path for Epic is certainly in response to a market that is beginning to plateau. Problem is, software vendors who move in this direction are rarely, if ever successful as consulting is quite a different model from software development and sales.

    Could this be the beginning of a downward slide for Epic?

  6. 6
    former Epic Says:

    one could argue though that Epic is already losing those people who are 4+ years and critical to customer success. Might as well try to hold onto 1 in 5 by giving them a new opportunity. A lot of the burnout at Epic for those who stay is not just the travel but the repetition of install after install. Also, the $75 per hour seems absurd. The billable rate for implementation is at least in the 100′s – I forget the exact amount.

    I agree with John_Chilmark though – the devil’s in the details with this…it’s just a matter of doing it and suddenly being successful. Unlike software, you’re not stuck with massive switching costs for consultants.

  7. 7
    Former Epic Says:

    Considering there are very, very few Epic implementation staff that have been there 4+ years, I don’t know how they are going to be a “consultant killer”. Especially if they charge $75, how are they going to pay their consultants a competitive rate without taking a large financial hit? If you were an IS with 4 years experience, you could make literally $100+ an hour consulting (more if willing to travel).

  8. 8
    Lazlo Hollyfeld Says:

    Epic is going to have deep consulting bench strength in a host of unique or high-specialized fields especially in revenue cycle management with people who have just been implementing and doing account handling for Epic only 4-6 years out of school?

    This is just about grabbing a bigger slice of implementation services pie on facilities that are migrating over to Epic from a competing vendor and going after what a company like xG Health Solutions is trying to do which is sell consulting services to large Epic clients that will utilize Geisinger’s ‘secret sauce’ on optimizing system/workflow experience using Epic on the inpatient/outpatient side for a host of area including population health, patient engagement, etc. Sure it drives Judy crazy that a company like xG Health Solutions is out there in the first place and largely taking what she views as should be Epic $$$.

  9. 9
    Realist Says:

    Having done Epic installs for many years, I can tell you this: there are some good consultants out there, but also some mediocre and really bad ones.

    There are many consultants right now making a lot of money simply because they ended up at the right place at the right time. In any other market, many of the current Epic consultants would be making 2-3 times less than what they make now. With Epic entering the consultant arena, the weaker consultants will be pushed out pretty quickly. I am sure that the demand for top-level consultants will remain, but the demand for mediocre consultants will decrease, and so will their paychecks.

    Bottom line: if you are a top-performing consultant, I don’t think you have much to worry about. If you are a mediocre consultant, the celebration is over.

  10. 10
    Jim Says:

    Madison is a nice city, but it is silly to think that every smart person embarking on a HIT career wants to live there. I would think this will help slow the attrition of folks who were going to go and start their own Epic consulting firm.

    The broader issue is that consulting is a fundamentally different business than software. To think that Epic’s move will be a graceful entry into a new realm is naive. There are different competitors in consulting – competitors who have been refining the discipline for 10-15-20 or more years. Getting market share will not be easy. In fact, I would guess that the other consulting firms will immediately begin using the “if you aren’t happy with something, doesn’t it make sense to get a fresh set of eyes” angle.

    I think Epic thinks consulting equals amplified support. They couldn’t be more wrong. Them assuming they can do consulting is no different than Accenture thinking they can build an HIS product.

  11. 11
    Fourth Hanson Brother Says:

    Epic has been stretched beyond thin in certain areas already, especially revenue cycle implementations. A theoretical Epic consulting firm, however, doesn’t have to be just implementers. The problem is that Epic has been pretty thin otherwise- Tech Support has been running up to five customers per TS instead of the old 3, development is always an issue.

    The customers have been eagerly buying up the “consulting killer” theme however- its been disruptive not only to consultants, but I’ve heard some scary stories recently about customers holding out for either permanent employees of Epic’s promised consultants, and getting neither- and end users are suffering greatly.

  12. 12
    InsideEHR Says:

    I think the term “consulting” here is being used a bit loosely. The Epic Consulting team will essentially be staff augmentation services for those folks wanting to leave Madison. The upside is that these folks keep access to their benefits and maintain direct contact to Epic’s internal resources, including development & documentation, which is the biggest differentiation from the competition. Business-wise, they can probably run this division at a loss if they want for awhile ,but that isn’t typically the strategy at Epic.

    As others have said, those firms that have strong process improvement programs, provide more strategic/management services or have developed their own IP aren’t the competition. It’s the firms that simply staff go lives, upgrade assistance, and augment customer analysts as part of an implementation that are the competition for Epic in this space, at least initially. It should either force some nice innovation in those spaces or trim the fat. Either way, the industry will benefit from a cost standpoint.

    Long-term, I think Epic’s leadership would love to see the software become dynamic to the point that configuration and setup aren’t the focus. That is still a generation or two away from being realistic, but the implementation services division as a whole should transition from being builders to being more process & patient population focused, which will realistically cut the required amount of staff considerably as you don’t take people straight out of college and plug them into those roles. IS over time should shrink as a piece of the overall pie.

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  • Lindy: @Chester of Malvern. Just save your energy and buy into the "flawless" world of Epic. Though you might want to stop b...
  • Not Tired of Suzy, RN: @Karen_DeSalvo I am not aware of any evidence that EHRs have improved outcomes or reduced costs. And that does not inclu...
  • AC: "I challenge readers thusly: what core set of published standards or capabilities must a given EHR support to be conside...
  • HIS Junkie: Re: Openness... What about this question - Who or what organization should demand that all vendor systems be open (defi...
  • TheMDofTruth: Where can I find a MedBox? I'm in need of some all natural medication....

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