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.