For the past year and a half, I have worked as an Epic consultant, supporting physicians and nurses as they learn their new EMR system immediately after their health system "goes live."
As a burnt out physician too cynical to stay in medicine, I have discovered no shortage of reasons to remain a cynic in this new industry. A fellow Epic consulting colleague approached me on a recent project. She inquisitively looked at the client's promotional material for the Epic implementation (or Go-Live [layhv]), which was plastered throughout the hospital, and asked, "What is a go live [liv]?"
I responded, "Oh, no, it is pronounced go live [layhv]."
She followed up with this question: "Well, then, how do you spell live [liv]?"
The following day we were discussing our backgrounds (yes, she was still employed) and how we each became involved in Epic consulting. After I discussed my hands-on experience using the software as an internal medicine intern, she chimed in, "Oh me? I was a trainer and have a bunch of certifications."
When pressed for the specific modules she was certified in, she responded, "Oh, I don't know. It was so long ago that I can't remember – it was decades ago." This was a curious comment in reference to an IT product that only took off in the past decade.
On another project, I was working overnight as the only consultant in a critical care unit, and my shift overlapped for one hour with the hospital's day shift. After helping a nurse optimize the display of her patient lists, she stated, "You know, I learned more from you than I did from the two consultants who are staffed here during the day. When I asked one of them a question he didn't know, he just turned around and walked away!"
On a different project at an outpatient OB/GYN clinic, I was trying to calm down a stressed medical assistant. She was frustrated due to the inevitable workflow slowdown that is expected when learning a new enterprise IT system. When I inquired about what she had already learned from a prior consultant that morning, she responded, "Her? She didn't know anything. When I asked her a question, she brushed me off and continued to stand behind me while watching YouTube videos on her smartphone."
In light of these past experiences and what I have witnessed as an Epic go-live consultant, I have some advice for organizations hiring implementation support:
1. Do your own background checks. Amazingly, fraud and misrepresentation are rampant on resumes per my conversations with recruiters. Call some of the consultants or their references yourself, even if you outsource the staffing to a third-party.
2. Strongly consider consultants with actual end-user and clinical experience. Certifications and credentials are nice. However, I'm willing to bet that the millennial nurse from the hospital down the street with years of Epic end-user experience will add more value than 90% of consultants I've met on these projects. Plus, when your staff has to explain how Epic is impacting a critical patient care issue with clinical terminology, they won't have to spell out every other word. ("Pyxis is not recognizing this order the doc just put in Epic. That's versed, V-E-R-S-E-D.")
3. Emphasize quality over quantity. You are better off hiring fewer high-quality consultants at a slightly higher rate than numerous inexperienced consultants at a bargain. What proud executive likes to brag about how cheap their consultants are? Furthermore, I've yet to meet a client say during a Go-Live, "If only we had more consultants sitting around doing nothing..."
4. Talk to your staff on the ground. Don't ask middle managers that are removed from everyday operations how the implementation is going. Talk to a blunt nurse or physician who isn't afraid to speak his or her mind. That will be the best gauge of the return you are getting on your investment in Epic support consultants.
Ultimately, our job as Epic end-user consultants is to increase speed of adoption, improve efficiency, and lay an extra set of eyes on the EMR, so the clinician can still focus on patient care. Cutting corners and bringing in uneducated, inexperienced consultants only breeds cynicism and undercuts your organization's morale when it is most needed.
Patrick McCormick, MD is a freelance Epic consultant and can be reached at patrickmccormickmd@gmail.com. He is not affiliated with Epic Systems.
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