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Readers Write: Remote Control: Why Remote Consulting Works for HIT

March 1, 2013 Readers Write 8 Comments

Remote Control: Why Remote Consulting Works for HIT
By Casey Liakos

3-1-2013 8-20-06 PM

With the recent proclamation by Yahoo’s CEO Marissa Mayer that all company employees must work in a Yahoo office, the business world and Internet have been abuzz with arguments for or against this decision. Remote work is something that is on our minds often since it is a service our consulting firm offers in the EHR/Epic space. We haven’t seen anybody join the debate with a specific focus on EHR or Epic consulting, so we thought we’d chime in.

What Yahoo is requiring is really an apples-to-oranges comparison to the onsite/remote debate in EHR consulting. These are two different industries with two different sets of circumstances, and Yahoo’s decision clearly has no direct bearing on the HIT world. But there are corollaries between the two, and we think this is a good time to spur some discussion.

It should be pointed out that we are big fans of Mayer. She’s an inspirational figure in many ways, and above all, she’s from Wisconsin. So we have her back.

Time will tell whether this decision will benefit Yahoo, and there’s no shortage of people who feel strongly about it one way or another. But when we look at remote vs. onsite strictly through the lens of EHR/Epic consulting, we think that the logic Yahoo used in this decision is all wrong.

Why EHR projects are a natural fit for remote consulting

We are not advocating for all HIT consulting to be handled remotely. But we strongly believe that there are certain project phases and key areas where it just makes sense.

By now there have been countless philosophical points made on both sides of the Yahoo debate. But to our company, there are two factors that need to be considered, and these are the only two that truly matter when it comes to assessing value of a consulting purchase: productivity and cost.


The remote services model that we offer to our clients has several key advantages when it comes to productivity. First, it puts resources on your team for the entire week. Traditional consulting practices have resources working Monday through Thursday – but of course your business doesn’t stop on Friday. Remote consultants can work a schedule to match your team’s hours, which brings an instant productivity boost.

Another factor that people may forget is that the technology available to us today makes remote work nearly seamless. I don’t need to go into detail — we all know many technologies that can put someone “in the room” when needed. With widespread remote system-access tools and file collaboration products already implemented in your organization, the remote consultants don’t miss a beat.

In fact, there are strong arguments to be made that communication can actually improve with a remote services model. A recent Harvard Business Review blog entry about working remotely makes some nice points:

  • Proximity breeds complacency. I’ve worked with leaders who sit in the same office with those they manage but go for weeks without having any substantive face time with them. In fact, they may use e-mail as their primary source of communication when they sit less than 50 feet away. It’s even worse if they sit in different parts of a building or all the way on another floor. This is not to say that these leaders are in any way lazy, just that because the possibility of communicating is so easy it is so often taken for granted.
  • Absence makes people try harder to connect. When I managed a team of professionals in nine locations, I made a point of deliberately reaching out to each of them by phone at least once a week and frequently more often. I’m not an anomaly here. Most leaders I work with make an extra effort to stay connected to those they don’t ordinarily run into. They can see that taking even a few minutes to talk about what’s happening in their respective worlds before addressing the tasks at hand makes a difference in maintaining the connection with a colleague. What’s more, because they have to make an effort to make contact, these leaders can be much more concentrated in their attention to each person and tend to be more conscious of the way they express their authority.

Note: we’re not necessarily advocating working from home, which can potentially present its own set of distractions. Our remote teams work together in client teams, primarily from our company offices. This minimizes distractions, encourages collaboration, and helps solve customer issues quickly.


The most obvious cost savings with remote consulting is the rate. When priced correctly, this model can save your organization a boatload of money over the course of the engagement.

The other key savings with remote work come with eliminating travel expenses. Flights, hotels, rental cars, meals… these are very real and often prohibitive factors when your project requires outside help. With tasks like build, testing, and system bug/incident resolution, the work can almost always be done remotely if managed well. Why pay a huge premium to stick the resource in a cube down the hall all day?

The cost savings of using remote consultants go much deeper than just hard dollars saved on rate and expenses. Easy administration indirectly saves you money. Managing office space, computers, telephones, security badges, etc., all carry a cost that you can eliminate. With remote consultants working from their firm’s offices, these costs are incurred by the firm, not the client.

There’s inherent stability associated with remote consultants as well. Turnover is much less of an issue when you have happy team members sleeping in their own beds every night. The cultural and organizational learning curves associated with consultant turnover carry a large cost that can be eased greatly with a remote model.

Most importantly, we feel remote consulting is the most cost-effective way to find and hire the best consultants for the job. Think about it in the context of Epic. Many of the very best Epic minds and most experienced resources are former Epic employees. A great number of these folks no longer work there because of the travel burden associated with being at customer sites every week.

Epic is a great place to work for a million reasons, but it should be no surprise that the #1 reason cited for leaving Epic is the heavy travel. Hiring remote consultants is the best way to gain access to these resources. They still want to work on Epic projects, they just don’t want to travel or can’t due to family obligations.

Tips for making remote engagements successful

Even if the consultants work remotely, you are still the manager. Speak with consultants or get a status report at least weekly. Any resource that is ignored, whether onsite or remote, has the potential to be working on the wrong things at the wrong time.

You and your team should be responsible for funneling work to consultants. This is the #1 hurdle we’ve seen: getting hyper-productive consultants enough work to stay busy. When all else fails, give them a brand new project to plan and execute from the ground up and watch what they can accomplish with a little support from your team and SMEs.

Make remote workers part of your team. Make sure they’re involved in all team meetings, e-mail lists, and communications.

You are not Yahoo

Many have attributed Marissa Mayer’s decision to the need to foster more innovation within Yahoo. Time will tell whether this move helps achieve that goal. HIT projects require organizations not only to be innovative, but to move quickly and get things done in a cost effective way. For this, a remote consulting solution can be an excellent option.

Casey Liakos is client relations director of Vonlay LLC.

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Currently there are "8 comments" on this Article:

  1. Great article Casey. I can’t emphasize enough about your point on giving consultants enough work – I’m staffed at a customer that assigned me a project that was supposed to take me 3 months – I finished it in 3 weeks. I now spend time looking for ways to improve their current processes as well as teaching myself other Epic applications since they don’t have things for me to work on.

  2. I agree with your points Casey, especially in relation to providing a competitive advantage to sites that want former epic people. Remote work isn’t for everyone but certainly appeals to a large number of talented former epic employees that no longer want to travel, me included. Thanks for articulating this point of view so well.

  3. Let’s be clear your not talking about “Consulting” what your talking about and spinning is staff augmentation which I agree in curtain arena’s lends itself well to remote work as during the “Build”, Validate” and “Testing” phases of the implementation you simply cranking out data it, but your not consulting on anything, instead your heads down performing repetitive tasks either building order, order sets or validating and testing processes. While I give you kudo’s for spinning a service line your firm has banked on to promote its advantages you didn’t also list its disadvantages which to be fair should be listed.

    As I first stated what your advocating is remote staff augmentation and not consulting as they genuine consulting requires you to put yourself in the clients setting and determine the best approach – path forward to solve both the business issue and the guide the patient care process. That requires you to be on-site walking the nursing units and ED’s to learn what is done well and what needs tweaked.

    So lets be clear your a Staff Augmentation Firm and not a Consulting Firm.

  4. Interesting, “So Let’s Be Clear” you don’t have any argument with my points that I bring to light related to the shortcomings of the Readers Writes article, just my grammar and punctuation. Wow I’m disappointed but I’m assuming my points hit the bulls-eye. And, no I’m not an Anthony Scalia with terrible grammar, but rather a seasoned Healthcare IT executive with close to 30 years of experience and has sat on both sides of the table and have seen firms that paint themselves as “Consulting Firms” disappoint myself and my clients in their ability to the leadership to be called a Consulting Firm. I’d much rather firms such as these present themselves for what they are “Staff Augmentation” Firms.

    Don’t get me wrong, I’m familiar with the authors firm and what his firm can bring to the table and in certain situations I might use them to complement or augment my staff but not to provide consulting services when I want a consultant I want someone who possess expertise and a longevity in the area I need help with and has seen other systems implemented and optimized to look at best practices from all converging points. I believe you’ve drunk the Epic Kool-Aid and believe that by knowing Epic that makes you a Healthcare IT expert or “Rock Star. Sorry that doesn’t cut it, go and put in another decade in the healthcare IT vertical space and implement a few other vendors systems and spend some real time at a hospital or ambulatory mulch-specialty site and then you can call yourself a “Consultant” until then you’re not a consultant your what my peers and I call “Application Implementation Specialists.”

    So Let’s Be Clear I don’t have any issues with Epic, I applaud Epic and respect the vendor, its leadership, employees and clients, just firms or vendors trying to pass themselves off as something they’re not.

  5. Wow, seems a little snarky to me…. I completely disagree with the distinction between ‘staff augmentation’ and consulting. When I arrive at a client site they are paying me for ALL of my knowledge and experience. Yes in some stages of an implementation the work can be tedious and hardly creative. BUT, there are tons of time when the opportunity presents to bring value to the effort. The single largest challenge of being a traveling consultant (Epic implementations in my case) is knowing when to speak up and when to just be quiet. There are layers of nuance that come into play, but the real value we provide the client isn’t just mastery of a particular area of Epic (or some other solution) – it’s the accumulated awareness that comes from multiple sites and all of the variety that is involved.

    Year ago (before the age of PCs) I worked for several years as a welder – I draw on those experiences in every engagement just as much as a recent implementation.

    Implementing a large complex solution in dynamic settings where change is the order of the day requires skills that are completely unrelated to specific application knowledge. That is where the ‘consultant’ portion kicks in. We know how to communicate, we understand group dynamics, we have highly elevated problem solving skills. And, perhaps most importantly, we have the ability to visualize what the downstream impacts are of one approach versus another. Our clients pay us to bring all of these skills to an engagement. It isn’t all sitting in a conference room crafting ‘big’ decisions, sometimes it it one on one mentoring of FTEs. And yes, sometimes it is helping the client understand that the ‘kids’ from Epic may not understand everything they are saying.

    Sometimes the opportunity to work remotely allows us to actually THINK about possible solutions away from the hassle of cubicle land. And, at least for me, I find that I am MUCH more productive in remote work than when on site. The perfect engagement is one where you can work periodically remotely. And yes, having work to do is a real need and something that we have to help our clients understand.

    In my experience well managed implementations will have confidence in their plan and be adept at managing remote workers. There is an element of trust involved, but in a well managed project there are built in methods for evaluating the work of the consultant team.

  6. “when I want a consultant I want someone who possess expertise and a longevity in the area I need help with and has seen other systems implemented and optimized to look at best practices from all converging points”

    If that is your working definition of a consultant, then why doesn’t a Vonlay consultant fill that definition?

    All consulting firms are staff augmentation resources. You’re just serving different areas of expertise. I’m not clear still on what exactly it is you do, but given the animosity towards these types of firms, my guess would be that you’re in the “real” consulting business and have lost business to these “inferior” firms. If client’s can’t tell the difference, it’s probably not just because the client is stupid.

    I don’t disagree that there are benefits to spending time onsite, my guess is Vonlay doesn’t either. The ultimate reason consulting firms want to be onsite is to create relationships to in turn generate more $$$$.

    Finally, you may think that a few grammar mistakes are not important, but yours is simply atrocious, to the point where some of your sentences are barely readable. If I was a prospective client, there’s not a chance I would hire you based on what I just read.

  7. To those that have hired or contracted any sort of remote resources, in what areas of responsibility have you seen the most success? Any successes outside of straightforward build work?

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