To Be an EMR Consultant or Not To Be An EMR Consultant

I recently posted about my little job trip to Arkansas and the possibility of me being an EMR Consultant. Cory asked if I took the job or not. The short answer is no. Here’s the long answer.

It was a great opportunity for me in Arkansas. However, I honestly didn’t feel like it was what matched my own personal interests. The interview really clarified in my mind that what I love doing is working with technology to change the way people to do business. That’s not what I would have been doing in Arkansas. At least not for a long while and not for the majority of my job.

However, thinking about being an EMR consultant has been absolutely intriguing to me. In fact, in the past few weeks I’ve been giving it some very serious thought. In fact, I’ve pretty much decided that I’m going to write up a business plan for an EMR consulting company. Here in Nevada they have a business plan competition called the Donald W. Reynolds Nevada Governor’s Cup. Well, last year I won the cup and I hope to win again this year. Unless I can find a better business idea then I think I’m going to do an EMR consulting business.

I don’t personally see it as just a consulting business. I see EMR consulting as a feeder into a number of other services that I consider commodity services. Let me described the type of business I’d like to create. Essentially I would find a practice that is looking at implementing an EMR. I would work with them to select an EMR. After selecting an EMR, I would help them design all the technology that is needed to implement the EMR. Of course, I would then assist in implementing all of that technology. This sounds pretty much like a consulting service right? Well, to this point it is.

After implementing an EMR I think there is an important service that all doctor’s offices should have. At least monthly, each doctor’s office should make sure that they have done all their Windows Updates, Anti-virus Updates and scans, Adware and Spyware updates and scans and verify the backup is working properly. These are the type of commodity services that I think many doctors would find useful to have someone else do monthly. In fact, doing these things is pretty much required by HIPAA. I know that many doctors can do it themselves. That’s fine too. However, I believe there is a significant market where doctors would want to have this type of service done for them.

The other service I’d like to add to my quiver of arrows is HIPAA security audits and reviews. I think this is another possible source of revenue if I started doing consulting. Plus, this type of service would be a great way for me to meet people who have already implemented an EMR and need the update/virus/adware/backup services I described above.

Any thoughts? I imagine there are a number of people already doing this, but I think there’s still a large enough market available to make some decent money doing EMR consulting. I have a few other ideas, but I don’t want to share all my secrets. I’d love to hear feedback from those already doing this.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

18 Comments

  • I gather that there are a number of impediments to implementation of an EMR — incompatibility of systems that are used by other medical practices, integration into existing workflow, difficulty of transitioning existing records to electronic format, ramp-up time (training, familiarization) — that stump many doctors, and keep them from doing this. The buzzphrase is ‘how does this improve my practice, both financially and procedurally, and how can you guarantee that it ABSOLUTELY not impact the care I provide now’. Have you a plan to address those? Clearly, you’re going to want to use some doctors as a sounding board for your thoughts — how will you make it worth their while to be helpful to you?

  • bill,
    You’ve highlighted a number of things that have to be thought about by a doctor. That’s exactly why I think an EMR consultant is useful for a doctor’s office. I think your question is very good. Although it is probably to good for a comment reply. I’ll plan on addressing a number of the things you point out in future blog posts like how to show doctors that implementing EMR is worthwhile and answering your buzzphrase. I absolutely have a plan to address that question. I think it’s essential to being a successful EMR consultant. The real question will be how good my plan is. Luckily, I think there are other pressures(ie govt) that will be involved too.

    One thing I should make clear is that I’ve already implemented EMR from top to bottom for one solo doctor’s office, one large clinic with about 8 providers, GYN, 2 dermatology PAs, dietitian, 2 sports medicine fellows, and 2 athletic trainers, a full functioning lab and pharmacy along with a 14 counselor counseling center and a psychiatrist. I believe this is a great foundation for getting into EMR consulting. In fact, I wouldn’t have to just work with doctor’s offices. I believe I have a unique set of skills to implement an EMR in a counseling center or psychiatrists office. Of course there will always be something more to learn.

    I think the above experience has been a great learning experience for me, but I’ve got the best EMR sounding board there is in EMRUpdate.com. If I have any questions about EMR and how it impacts a doctor’s office then all I have to do is pose my question on the EMRUpdate forum and I’ll get plenty of good information. I know since I’ve posted nearly 1000 comments on those boards.

    I look forward to addressing more of your points in the future. For now, the wash (translate: my wife) is calling me.

  • You’ve listed pretty much the scope of what we do here at Calyx (luckily not too close, geographically). Implementing software and hardware solutions and monitoring the network on a continuing basis. The key, in my opinion, is ensuring that the physician doesn’t have to worry about their IT infrastructure or about the security of their sensitive data. It sounds like you’re well poised to take the next step. Good luck to you on the business plan competition and on the burgeoning new business model!

  • Hello –

    Of the vast amount of EMR software out there, and as of yet no standard, the challenges become integrating disparate applications, and building interfaces to these apps. I worked for a prominent pediatric specialty hospital, and the constant challenge was interfaces. It seems a software company in Verona, WI has made good strides on the standardization issue, and Sen. Bill Friest called Kaiser Permanente’s implementation (which used Epic Software) a model for the nation. Even supplanting his own ver of EMR. So the challenges that are faced in the next 5 years or so would be a standardization of the interchange. (read: NOT EDI (that has issues of its own))

    One of my reasons for writing here is that I too want to be a EMR Consultant, and am interested in gaining exposure & training on Epic’s software modules. How might one go about this?
    )

  • Integration will be the key over the next couple years. I don’t see any really great solutions to integrate disparate EMRs anytime soon. I like CCR and its potential, but time will tell what actually gets adopted.

    As far as Epic training, I think the best thing you can do is find a job with an organization that is implementing Epic. On the job training is the best. You can search for some of those jobs at EMR Jobs. They will probably want someone with Epic experience, but if you have other EMR background and they have a need then you could maybe get in and get experience. Otherwise, I’d suggest contacting Epic itself and see what they have to offer.

    I think it’s also important to make a differentiation between hospital EMR software and EMR software for ambulatory medicine. There is some overlap, but there are significant differences.

  • I absolutely believe there will be EMR consulting at a large scale. Our job will be to move the practice manager into EMR more than the doctor. Having been involved in a 200 practice roll-out of EHR with money from BCBS, I can tell you the doctor’s were only 10% of the process. The other 90% is medical business process, which is and will be guided by the managers and insurers. So hail to all who push for helping guide this forward.

  • Based on my experiences, I’ve found that there is some market for EMR consultants. However, I don’t think it’s a worthwhile investment for most organizations. Rather than paying for a consultant, and then paying for the product, you’re better off buying a customized EMR. A number of consulting firms will develop specialized software based on customer needs, for a comparable cost. Practice Charts is one customized EMR that some of associates at Columbia deal with, and they’re quite happy.

  • Hi,

    I have been reading your blog for sometime and have been thinking in terms of developing a business model which will allow my company to be in all the three areas of an EMR implementation.

    The three areas as you have already pointed out being, EMR Product Development, IT Infrastructure management, Software Maintenance.

    Having these three areas as part of the business plan will ensure revenues from these three “Verticals”.

    Additionally, i think the “Product” based approach for an EMR which caters for all the areas of work within a hospital is becoming essential. I believe within a hospital one should run at most 2-3 aplications (HIMS, PACS, FINANCE) catering to all the requirements of a hospital. This will allow for better integration between the systems. The notion of best of breed systems allows for more headaches in implementations and providing integration mechanisms (which is again a cost).

    I think that the Big HIS systems should move into that realm. Additionally as mentioned in your blog there should be different systems for the ambulatory and hospital setting.

    Manish

  • I am a consumer and I have been denied complete copies of my EMRs whenever I request them and pay for them. The screens they are holding back are always the one where informal notes are made about the patient. I know they exist because I have had inappropriate comments made to me based on these informal notes in their EMRs. I’m talking about EMR systems in hospitals and university hospital systems. I am told that they gave me “all records allowed by law” however, perhaps I’m not using the correct terminology since they keep withholding these particular records. Also, they tell me I’m “the very first person” to request/demand this info on me and they act like I’m paranoid. I”m not being paranoid; I know for a fact that these notes exist because ACTION HAS BEEN TAKEN ON THEM. Please advise as to what I’m doing wrong. Thanks.

  • I have talked to lawyers and they all say it would cost me thousands of dollars to do anything. They say it would be a medical malpractice case. I did hear that they call these “file notes” but I’m just wondering if there is another term I’m not using to make it clear. Every time I talk to the copying company, they are totally confused about this, and say “the hospital CANNOT withhold notes” and yet they are and they have and they do. Do you have any idea of what else I could call them?

  • Sorry Susan. I think it’s a tough case to make. It will cost money to get it. It’s a sad part of our system.

    I don’t know any other terms for the notes. Maybe some of my readers will. I’ll consider making a post just about this topic.

  • I, too am seriously considering going into EMR consulting. I have 15+ years as an IT PM and done quite a bit of S/W and H/W implementations. The key is to solicit solid requirements from the office staff – the ones who do the day in and day out work. Secondly, do the research and be prepared to either take on the whole implementation or partner with someone/group that has the experience. I have been fortunate enough to interview doctors and their staff about EMR – ALL of them said it would have been great if they had a consultant to work with them!

  • Akur,

    From where I sit, looks to be wide open. As you can see though from some of the posts, the requirements are often along the lines of, “easy to use”, etc.

    Might come down to “Beauty is in the eye of the beholder”. If you ask HIT to get you across the river, some will build a bridge and some will build a boat.

  • Here are a few things to keep in mind before jumping into the EMR consulting business:
    -The trend in the industry today is to find consultants with medical backgrounds. A lot of consultants do not have a medical backgrounds (me included) and are too “IT” for companies. They generally want someone to understand their workflows and tweak the software to fit. The vendor can usually provide all the technical expertise needed.
    -The best way to get experience as an EMR consultant is to either work for the vendor who creates the EMR/EHR, or work in a medical field for an organization who installed an EMR/EHR. It would be rare for an organization to hire a consultant to do their EMR install without either of these.
    -EMR consulting is very competitive now. It is hard to be a startup without offering a key differentiator, such as a specific service or product.
    -The “commodity” idea would work well for smaller operations, but these are also the places that would be least likely to hire an outside consultant for their EMR implementation because of the expense. They would probably use the vendor for their EMR implementation support, and a local IT contractor for their IT needs. Larger organizations who generally hire EMR consultants have full IT departments that take care of these things.
    Best of luck to you!
    Aaron

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