I can’t remember exactly where I saw someone talk about the “WIIFM” (What’s in it for Me) principle, but it really is an important principle that when understood can have an amazing impact for good. This post isn’t about whether you should live a life asking WIIFM. I’ll leave that question to people much smarter than me. Instead, I want to look at how applying the WIIFM principle to others can help those working on a successful EHR implementation.

In most cases I’m talking about, the WIIFM should be changed to “What’s in it for Them?” Understanding the answer to this question can help you as an EMR consultant, an EMR vendor or even a practice manager or doctor that’s trying to work through an EMR implementation.

One of the first things I cover in my e-Book on EMR selection (It’s free, check it out) is the idea of getting buy in from those that will be affected by the EHR implementation (that’s usually everyone). One of the best ways to get EHR buy in from people is to understand the WIIFM. It’s not fool proof, but it’s one good strategy for getting people on the same bus, going the same direction.

Let me tell you that there’s always a way to find a WIIFM in an EHR implementation. This list of EMR and EHR benefits is a great place to start. However, many of those benefits can be extrapolated in ways that will show what’s in it for every person in the clinic.

Let’s say for example, that your goal for implementing an EHR is to increase clinic revenue by freeing up chart storage space so you have an extra exam room for another provider. You can then talk about what that new revenue can be used for to improve the clinic. Maybe it could include bonus checks or other incentives. These become tangible things that staff can use to better understand WIIFM in an EHR implementation.

I’m sure many of the nay sayers out there are thinking, but an EHR doesn’t provide those benefits. That’s why it’s so important that you define which benefits your clinic is striving to achieve before you select or implement an EHR. The list of benefits you use to show WIIFM ends up being your goals for your EHR implementation. They can be used to define your EHR selection process. They can be included in the EHR contract so you have some assurance or protection if the EHR vendor can’t deliver on their sales promises. Not to mention, after the EHR implementation you have a way to measure if it was a success or not based upon those goals.

Test the WIIFM principle. Not from an arrogant Me Me Me approach. Instead, step into the other people’s shoes and ask WIIFM. This approach can really help improve any EHR Implementation if applied correctly.

About a month ago, the market finally fell enough for my wife and I to buy our first house. It’s pretty exciting to finally be able to do it since we pretty much tried to buy a house every year since we moved to Las Vegas 6 years ago. Thankfully, we never did until now (although that’s another story).

After purchasing the home, I found myself spending a fair amount of time having to repair a number of things around the house. One day I pretty much spent all day being a plumber as I (and a nice friend) replaced the garbage disposal, fixed a leaking sink, replaced the mechanism (whatever it’s called) in the toilet. Turns out that none of these things are really all that difficult. Although, it definitely had the initial learning curve for me to realize that it’s pretty straightforward once I got into it.

After spending the day as a plumber on my new house, I couldn’t help but think, “I’m doing the job of a plumber and all I want to really do is blog.”

Many of you are probably wondering what any of this has to do with EMR and healthcare IT. Well, I am the EMR blogger who loves analogies (see marriage and divorce, pregnancy, marriage for money, weight loss, and Katherine posted a Lady or the Tiger one that I enjoyed).

The comparison seems obvious to me. There’s a whole lot of doctors out there that really don’t want to be IT project managers. They don’t want to be EMR implementation specialists. They don’t want to be EMR Contract negotiators. They don’t want to be software evaluation specialists. They want to practice medicine by providing care to patients.

Of course, many of you might easily suggest that I could have paid someone else to do the plumbing and I could stick to the EMR blogging like I want. This is absolutely true. I’m sure there were plenty of plumbers that would have been happy to take my money. Unfortunately, they charge an arm and a leg and I like my limbs. Plus, there’s something valuable about having the knowledge of how something that I’m going to use every day is done.

Extend that to doctors. They could certainly hire an EMR consultant to come and help them do their EMR implementation. In fact, my first job doing EMR was partially to solve this issue. They needed someone who could take care of the EMR implementation from top to bottom. If you find the right person, there’s no doubt that it can work very well. However, similar to the plumber, there’s a cost associated with doing that. Plus, if you use a consultant, you’re outsourcing some of the knowledge and expertise that you would gain if you and your staff put your nose to the grindstone and did it yourself.

Plus, while I can’t say that I particularly enjoy plumbing, I have to admit that there really was an amazing feeling of satisfaction knowing that I was able to accomplish a task which I’d never done before. I think many doctors and clinics have had that same sense of satisfaction after implementing an EMR in their office.

Today I have a special shirt made just for HIMSS, thanks to the great people at Enterprise Software Deployment.

If you see me at HIMSS, check out my shirt. It has the top 10 real reasons I’m at HIMSS listed on the back of the shirt. My favorite is #4 Booth babes. I’ll post the full top 10 later tonight.

Also, be sure to check out Enterprise Software Deployment at HIMSS if you need a great EMR consultant or if you’re looking for a position doing EMR consulting. You can find them at Booth #2777.

Here’s their HIMSS exhibitor description:
At ESD, our goal is to ensure successful implementation of a new EHR system or upgrade from start to finish in healthcare organizations around the globe. Our services include Clinical Transformation, Legacy System Support, Training, Supplemental Staff Augmentations, Clinical and System Transformation, as well as education and training in all aspects of Cerner®, Siemens®, Epic®, Eclipsys®, MEDITECH, and McKesson systems.

Thanks for ESD for sponsoring such a cool shirt for me.

I’ve been thinking about the EMR consulting business model for a long time (check out my first post on EMR consulting back on October 27, 2006). My personal career path has taken me a different direction. I do some occasional consulting for people, but it’s not really my core business. Unfortunately, I don’t scale very well.

With that said, I think there’s definitely a business model for a company that does EMR consulting. In fact, today I learned that one of my advertisers and also an EMR consulting company, Enterprise Software Deployment, was ranked #561 out of the 5000 fastest growing companies in America (see press release).

That’s right. I guess EMR consulting is a good enough business that they can use an EMR consulting business to become one of the fast growing American companies. Plus, I agree with the press release that this next year we’re likely to see EMR consulting grow even more.

While I ABHOR EMR sales people who like to call themselves EMR consultants, I think there’s definitely a place in the EMR industry for qualified EMR consultants. In fact, check out this series of EMR consultant posts where I talk about the possible advantages of using an EMR consultant:
Benefits of Using an EMR/EHR Consultant – Selection Process
Benefits of Using an EMR/EHR Consultant – EMR Training
Benefits of Using an EMR/EHR Consultant – Clinical Process Mapping
Benefits of Using an EMR/EHR Consultant – Comprehensive Technology Support
Benefits of Using an EMR/EHR Consultant – Improved Clinical Buy-in
NOTE: I wrote all these in early 2008. I don’t think too much has changed since then. Although, there are likely more EMR consultant opportunities.

Every couple months I get someone asking me if I could recommend any good EMR vendors. It makes complete sense why someone would ask this question. They want to try and narrow their search down from the 300+ EMR vendors that are out there. That’s an incredibly daunting number to consider and so everyone’s trying to narrow down their EMR vendor search (see also my previous top rated EMR companies post).

The problem with this question, is that the answer is different for every clinic. Why? Because every clinic has very different needs and every EMR vendor has very different capabilities. The key is to be able to match the capabilities of the EMR vendor with the needs and culture of the clinic.

EMR software is not like email. I can easily recommend that a business who wants an email system sign up for the free Google Apps email. That email (essentially gmail) blows every other email out of the water (especially with the free price tag). EMR software isn’t like that. There are a few dozen (at least) EMR vendors that have really amazing software depending on your clinics needs. For me to recommend an EMR vendor without knowing more about your clinic would be a tremendous disservice.

I would recommend those interested in selecting an EMR to purchase my EMR selection e-Book. It walks someone through the process of selecting an EMR based on their own clinical needs and business requirements. Plus, it educates the reader on the various EMR options so that they can assess which type of EMR software would be right for their clinic.

I guess this is why I get all worked up when RECs create a “preferred EMR vendor” list. It’s just ridiculous that they think they can do an RFP or some other EMR vendor evaluation that can somehow take into account the thousands of different clinical practices that exist in their area.

Of course, I haven’t resolved the need that people have to narrow down the list of 300+ EMR vendors. The full answer is in my EMR selection book I linked above. One part of that answer is to use an EMR selection website like Medical Software Advice or EMR Consultant.

Neither of those services are perfect at finding matches either, but it’s a decent place to start in narrowing down your EMR vendor list. At least they try to understand your clinic before making EMR recommendations. Plus, just because they provide you a list of 5 EMR vendors doesn’t mean that you can’t look beyond the list. Treat those lists as a good starting point for evaluating EMR vendors. Then, if there’s still not a good match you can keep looking.

The message of this post is to be wary of anyone that tries to recommend a specific EMR when they know nothing about your individual clinical needs.

Full Disclosure: Both Medical Software Advice or EMR Consultant advertise on this site, but they don’t know I wrote about them on this post. I just suggested them since I think they provide a good service.

When I wrote my previous post about EMR consultant challenges, I thought it might be valuable to create a list of possible ways to do EMR consulting. This list is just off the top of my head, so please feel free to add other EMR consulting opportunities that exist out there in the comments:

EMR Selection – Consult on selecting the right EMR.
EMR Implementation – Consult on the best way to implement the EMR. Map EMR workflows to their existing paper workflows.
Meaningful Use – Consult a practice on how they can achieve meaningful use and get the EMR stimulus money.
EMR Vendors – Consult EMR vendors on their software, their marketing, etc.
IT Consulting – Consult practices on the right IT infrastructure to support an EMR in their practice.
EMR Review – Review an already implemented EMR and suggest ways that the implementation could be improved.
EMR Training – Train end users on a particular EMR. This often is similar to or included in EMR implementation consulting.
EMR Certification – Consult EMR vendors on preparing for and getting EHR certified (some are even still looking for help with CCHIT Certification).

Ok, what other types of EMR consulting are out there?

Everyone has been touting all the tremendous opportunities that are out there for EMR consultants and healthcare IT people. No doubt, there’s a lot of action right now around EMR. However, I’ve started to see many EMR consultants starting to wonder where the fountain of youthwork is that they heard was coming for EMR consultants.

EMR consultants face a really interesting challenge. The small clinics usually can’t afford the services of a consultant (or feel that they can’t) and the large clinics have their own in house resources and so their reticent to pay an outside EMR consultant to come into their practice. Where does that leave the EMR consultants that heard there’s this amazing need for help with EMR selection and implementation?

Not an easy problem to solve. Plus, there’s an even larger group of providers that still haven’t made the decision and committed the resources needed to implement an EMR. This means that the EMR consultant ends up having to not only sale their EMR consulting services, but also have to sale doctors on EMR.

This doesn’t mean that there aren’t a number of opportunities for people wanting to consult on EMR selection and implementation. It just means that EMR consultants are going to have to be really creative in how they find new customers.

From my experience, it’s going to be all about the relationships and trust that these consultants create with the doctors. As in most business, but particularly in healthcare relationships matter a lot.

Anybody have advice they can give these EMR consultants? It always amazes me how every job is basically a sales job. It’s just what you’re trying to “sale” that changes.

Note: Let’s also not confuse true EMR consultants with EMR salespeople dressed in consultant clothing.

I read a number of online forums and blogs about EMR. Most of the time I’m amazed at all the smart people that are participating in the discussion of EMR. However, occasionally I come across comments that just make me cringe. Here’s one of those comments about the EMR selection process:

Key factors to consider are cost of licensing; maintenance and any other cost of ownership fees; types of service level agreements (SLAs); redundancy/mirror imaging (ability to minimize downtime or restore system in minimal time or an alternative process for business continuity); types of technical environment/architecture required; security and access points; implementation costs (avoid customization or keep them to a minimum whenever possible); maintenance costs for customizations, which vendors sometimes treat as a separate cost; cycle for upgrades/fixpacks/major version releases and support; training development and delivery; and optimization to ensure the system is being used as effectively, productively, and efficiently as possible throughout its life cycle. Hopefully, there will be some standardization of key features to ensure ease of usability in the near future.

Are those the key factors that should be considered in selecting an EMR in your book? Not that a number of the items aren’t important. However, most of that list doctors I know don’t care about and quite frankly they shouldn’t. I think most doctors look at the selection in this way: cost/ROI, usability, and let some tech person deal with all the technical details. I think that many have a challenge measuring these, but at the end of the day the ROI and usability of the software is all they really care about. Is that such a bad thing?

What’s interesting about the above statement is that the following statement preceded it:

I would recommend that physicians invest in a reputable and health care industry focused consultant or consulting firm to help in the vendor selection process to determine which system best fits their needs.

I can’t argue with this advice. However, the list of EMR selection “key factors” above makes me think that whoever made the list isn’t a “reputable” EMR selection consultant.

Some of you might remember that I relatively recently wrote an article about types of EHR consultants for MDNG magazine. It was a fun article to write. Considering my word limitations, I had to limit it to just a very specific topic. However, I still have a bunch of other commentary on EHR consultants that I plan on posting either on this blog or as an e-book eventually, but I digress.

What I thought was pretty cool about MDNG was that they took my article and not only published it online and as the cover story of the magazine, but they also did a podcast of a doctor reading my article on EHR consultants.

I love their use of technology in this way. I wish computer voices would improve and then I could easily publish this whole blog as a series of podcasts. Would be pretty cool.