re: Health IT Proves Economic Mettle, Research Says
I respectfully dissagree with Jay on the use of consultants for HIS system implementations, at least in part.
Having been involved in three major system implementations (Mediserve, Meditech, Cerner) between two hospitals I've found that most CIO's do not properly calculate TCO in terms of both temporary and permanant FTE positions needed for the implementation and maintenance phases, cost in terms of time, productivity adjustments, and data entry ramp downs remaining higher, etc. This miscalculation then inflates the value of a consultant group as those staffing increases are required regardless of either decision.
During two of those implementations, a consultant group was brought in. The one project that saw the consultant group doing the discovery and module level coordination ran into a 65% modification for financials, ultimately deemed too costly and risky, and was abandoned at a 4+ million dollar loss.
Bringing in a consultant group to perform the implementation brings short term gains but long term risks.
A few things come to mind regarding putting the organization at risk with this regard:
1. Increased ramp up time to learn the specifics of the business and organization increasing the overall cost of the engagement.
2. Additonal cost to an already burgeoning IT/Clinical staff required for the new software and loss of ability to duel purpose FTEs.
3. Experience and knowledge walks out the door with the consultant. This is probably, in an anecdotal way, one of the biggest costs in terms of hospital staff understanding the overall flow of the business and process improvement.
4. The push to sell additional services, staffing takeovers, and other costly items that would be a fraction of the cost with the right FTE's.
With regard to FTE's, it's a good idea during the planning stage to begin looking for clinical informatics folks, preferably internally that not only understand the clincial requirements, but have a decent working knowledge of technology without having to be a guru, but more importantly, the organizations culture and staff.
On the other hand, there is value in consultants that have experience with certain venders and can certainly lend some value.
1. Familiarity with vender power brokers. They know who to leverage to get client requests honored or issues addressed.
2. Ability to understand typical hang up points and decision routes specific to the software.
3. Agnostic approach to siloed processes (which can be also avoided with the right IT staff).
In conclusion, what I've seen as the best approach, or at least one that seemed to work well was limited consultant roles and engagement being limited to HIS system liason, adoption and system analysis (ie: Best of breed, Single Vender, Hybrid) for organizational HIS system approach, and limited consulting engagements for additional and/or ancillary systems.