Curbside Consult with Dr. Jayne 6/14/21

Today’s post is an interview with Laura Miller, founder and CEO of TempDev of Miami, FL.

Tell me about yourself and the company.

I started TempDev back in 2000. We are primarily a NextGen Healthcare consulting firm, working in practice management and EHR. We tend to be technology driven. I have my degree in computer engineering, we have quite a few engineers on staff, and we have quite a few female engineers. We have development solutions and we also focus on implementation and training as well as project management.

You started as a NextGen application specialist at a physician organization. What gave you the confidence to go out on your own?

I had a good mentor, and a lot of women have that story. I had somebody who encouraged me to do this and also helped me establish myself and my career, who taught me a little bit about consulting. It was a time where I don’t think there were that many people with engineering backgrounds doing development for NextGen clients, and so I think the market was primed for it. As I started exploring, I realized that there was a lot of business opportunity.

I was lucky that on a personal level, I didn’t have a ton of financial obligations. My husband works at Microsoft and we had full benefits. It wasn’t the riskiest of moves, but when I try to tell people that, everyone says, “It still was.” I ended up leaving my full-time job and starting TempDev, and here we are 14 years later.

As an entrepreneur responsible for the livelihoods of others, what kind of thoughts were running through your head as the world began to shut down due to COVID-19?

That was the scariest time I’ve ever had in my career. We have always grown as a company. We had never had to have those difficult thoughts and conversations. We have been incredibly fortunate in our trajectory to never had that enter the picture for us at that level.

As COVID started to happen, at first it was a slam of work. Everybody was implementing telehealth and they didn’t know how to see patients or how to bill it. All these organizations we were working with didn’t even know how they were going to keep their lights on, much less that they were going to spend their money on consultants to try to deliver telehealth, and then let us go.

We were fortunate that there were a couple of companies that kept a lot of our consultants working. It was the first time we had ever had a bench in our entire 14 years. We took the time to say, let’s invest in us. It was the first time we had taken a step back and said, let’s build some things for TempDev. We have some people who aren’t busy. Let’s build some products so that when things come back, and they will come back, we will be ready for them. 

We did. We invested heavily in a couple of products. We invested in COVID testing templates, COVID vaccine templates, and credit balance tools. As things started to come back, it took off and we are busier than ever now.

For the COVID-19 vaccine templates, have you seen a lot of ambulatory practices that have had access to the vaccine or being able to distribute it to their patients?

I’ve actually been pleasantly surprised at who I’ve seen get access to vaccines. It has not been my private practices, the big groups that typically are engaged with consultants. It has been our smaller community health groups and tribal groups. It has been the groups that, as you talk equitable vaccines and you have those conversations, it’s who you want to have these vaccines. It’s who you want to be out there giving them to the community. That was who had the vaccine and who we were talking to in December about vaccinations. A lot of our private clinics didn’t get them until more recently.

Are ambulatory medical practices  starting to rebound?

Most of our clients have rebounded. The investment in FQHC, we’ve definitely been seeing a pickup in that market. They are starting to feel some of the investment that came earlier this year in them and are starting to be able to make improvements they have been wanting to make for a long time. I would say that for most of our groups, their volume is back.

As they are getting back up to speed, what kind of trends are you seeing as they reprioritize their technology goals?

Telehealth is here to stay. Everybody is asking, in what capacity? How are we going to get reimbursed? What does that look like in the future?

As both a patient and a consultant, I love telehealth. I think it’s so wonderful, especially since many of us waste so much time getting to a doctor and sitting in waiting rooms for a five-minute appointment, a checkup, or a talk about a result. It’s so great to be able to have a quick conversation. That needed to happen and a physician can get reimbursed for it, so I think telehealth is here to stay.

TempDev has always been a remote company, so as the pandemic started to unfold, we were well positioned because everybody already worked from home. But for most of our clients, a lot of people aren’t going back to work. Some of the smaller groups tend to be where we see the IT people going back. But a lot of the groups we work with, they’re scaling down on their real estate. If they are talking about maybe getting people back, it is certainly in a much more limited capacity, because I think people got accustomed to working from home and they think it works for a lot of people.

Patients having direct access to their visit notes is a hot topic. Have you seen an increase in requests for help meeting those requirements?

People are still confused by information blocking, especially with the fact that that rule happened during the pandemic. It caught a lot of people off guard. I don’t think they entirely know what it means. I know there were countless webinars. I know people were telling them about it. But I don’t think everybody has grasped what is going to happen there because we don’t get a ton of questions about it other than “Hey, how do I meet this requirement?” which we will walk through with them. We don’t get a lot of questions around, what’s the downstream impact, what if my patient reads this, and should I put this in a note? These are things that you have to think about now that you’ve opened the gate to all of that information. I don’t think people have gotten there yet.

As the only woman in your computer engineering degree classes, what advice do you have for women who are pursuing the STEM fields?

Stay in it.So often we get intimidated, or we often feel like it’s not our place and we don’t belong. I personally never felt like I fit into that culture. It’s not who I am. I love technology, but I do not like a geek culture. I don’t have anything against it. That doesn’t mean that I wasn’t good at math and science or that I couldn’t code, but I didn’t always fit in, and that was OK. I think I brought diversity to something that maybe wasn’t diverse.

Also, a lot of us women just are not showboats. It’s not who we are naturally. That doesn’t mean that we don’t know the information. You also don’t have to have a 4.0 GPA to do well in businesses and to do well in engineering. You can get a B in a class or you can struggle through some engineering classes and that doesn’t mean you’re not cut out for it, it just means that sometimes you might have to work a little harder.

So many cultural things are set up to make us believe that it’s not a place where we belong. I so often just want to tell girls, hey, you belong here. That’s one of the reasons we tend to have a lot of women here, especially for being a tech company. People ask, how did you get all these female engineers and how is your tech team led by all women? It’s because it’s a place where women want to be, because culturally, we fit in here. We didn’t define the culture that a lot of other tech companies have out there. That made something special and something different where people wanted to be and where people wanted to stay, because it is tough.

It’s not the easiest field to be in. In college, they used to tell us things like, you’re going to be up until 3 a.m. in a lab before you’re going to launch a product, and that’s the way life is. I thought, I want a family. I don’t want to be in a lab at 3 a.m. before a product launch, I want to be home in my bed sleeping, and I want to have a life, and I want to have balance. I’m here to tell you that it’s totally fine, and you can have that. It’s not how life has to be. That isn’t necessarily what is presented to you early on in college and in your early career.

You have your children on your team. What advice do you have for young entrepreneurs who are building a company to make sure they have time for family?

You have a limited time with your children because they go off to college. You get 18 years with them, hopefully. Or they’re at home and you don’t want to waste it. I have made it a rule to pretty much to stop work from 5:00 to 8:00 each evening. I have my phone on me, so if something blows up, I will get on it, but things can wait. You can’t work your entire life. Your children are good at making you understand what your priorities are and keeping them in check. From 5:00 to 8:00 every day is my kids’ time. Then I put them to bed and I will probably go back on my email and I will probably finish up my workday. But I make sure I always have time for them. I make sure they know that they are number one and everything else is number two.

That doesn’t mean I won’t go out of town or that I don’t sometimes treat work with a high priority that needs to be, but it can never be above my kids. That’s who I am and that drives me. I’ve never run into a problem with it. So many times we as women are set up to believe that there’s something wrong with that and there isn’t. Going back to work from home culture, I can run out and get my kid who is sick from school and bring them home. They can lay in their bed and be sick from school and nobody at work is judging me. They don’t even know I’m gone, and they don’t even know my kid’s home sick. That’s something so nice about being able to be a mom and being able to balance your work.

Do you have any final thoughts?

If you’re not working in a place that makes you happy, build a place that makes you happy. Try to do the right thing at that place and make whatever decisions are needed to build a place where people want to be, where women or employees feel valued and feel like they can put their families first, feel like they can take care of clients and still have time, and still have work-life balance. Build that as a company because you can’t run down your employees. Your employees are your number one asset. If you ever ask me the hardest part of my job, it’s recruiting and finding employees to fill the positions we have. Losing an employee is even harder for us. Make sure to respect that and build a place where employees want to be, and always have that as your guiding light.Make sure it’s a place where all employees want to be and not just a certain subset.