After more than half a century of doing things differently, Southwest Airlines has officially ended its open seating policy. I’ve refused to fly the airline for the last 20 years because of this crazy policy. My one experience was a quick LAX to LAS flight, and it was a nightmare. They’ve never been really an option for those who live in Boston or the Northeast in general, but they’ve been huge in the South. Thought I would share a few key points on this change that were worth

On January 27, 2026, the airline completed its transition to assigned seating, closing the door on a system that had defined its brand for 54 years. I’ve known so many consultants who loved their Southwest, and frankly, I still can’t wrap my head around it. They were the only major U.S. airline without seat assignments. I’ve heard that this supposedly helped speed boarding and keep fares lower than my beloved Delta. But to no surprise, Southwest’s press release stated that in a survey they conducted, 80%+ want assigned seats for predictability and less stress during boarding.

The other thing that I absolutely hated was what I called the “Cattle Call”…the A-B-C boarding groups, and finally, that is also gone. Not unlike other airlines, it will be replaced by a structured process featuring eight boarding groups based on seat location, fare type, and loyalty status. This change also eliminates the need to check in exactly 24 hours before departure just to secure a better boarding position. I mean, who thought that was ever a good idea? Ugh!

Another reason I hated Southwest was the lack of first class seats. If I have to travel every week on flights that are over 5 hours, I want first class. That’s why I avoid JetBlue as well (the few flights with “Mint” do not count). As part of their changes, Southwest is introducing a “Comfort” seating section, offering extra legroom for travelers willing to pay a premium. They finally get that this will not only boost revenue but also attract new customers, including consultants and other business travelers. This still only aligns with JetBlue, so it’s a start, but not enough for me to even consider buying a ticket.

I’m hoping to hear some comments from the few remaining loyalists. Curious if you’ll miss the old system.

Southwest ends open seating after 54 years. We took the last flight

https://apnews.com/article/southwest-airlines-assigned-seats-open-seating-ends-0f131c413349a14072f78288e5c056b2

Sometimes I get emails or calls asking if I would meet with someone I’ve worked with in the past. Sometimes I get asked to meet with someone I’ve never met. And sometimes, I get asked to meet with leaders from various firms in our industry. This month I’ve had 6 such calls, and they all had one thing in common: “I’ve been laid off, what suggestions do you have?”

Let’s all agree, the world of consulting has never provided job protection for any of us, whether on contract or in a full-time role. Project budgets change, client priorities shift, sales quotes can be missed, revenue targets might be unachievable, or firms might just decide to go in a different direction. None of this is our fault, but the end result often does translate to layoffs.

My suggestions for all has always been to take as much time as you need before jumping into your next role. Financials may be a driver on timing, but there are still three basics that need to be answered. Let’s take a look at those three suggested questions/considerations before moving forward.

1. What do you want to do? Ask yourself what you’ve liked about all your roles and companies thus far in your career, and then formulate what you want next. Define the work effort and deliverables you have successfully provided in your past, and highlight the ones you loved to do. The next step is find job descriptions that align with what you want to do. Two calls I had this month aligned with titles like Director of Customer Success. Aligning what you love to do with real-life job descriptions will help you align with open opportunities.
2. What type of environment do you want to work in? The Healthcare IT industry is a highly competitive market space with companies that range in services from staff augmentation to project-based support to wholly owned project oversight and accountability. The size and capabilities across these types of firms vary considerably, but most provide the same thing…consultants. Consider the dynamics of larger firms, if they are privately owned, how long have they been in business, if they are ranked by KLAS, and what is the culture like. There are a lot of choices, so ask around to find out what you can about the people, expectations, and the overall company’s direction.
3. Finally, what are your requirements, restrictions, and must-haves? Outlining your salary requirements, including hourly vs salary, 1099 vs W2, is a must. Look at benefits, retirement, and time off needs. Consider travel, time zone variations, hours of availability, and weekend efforts.

I can only say we will all react differently to being laid off. There are some great resources out there that talk about how to tackle the emotions, logistics, and planning that come with the situation. I’ve listed several below.

I’ll say that I personally have always struggled with acceptance…and sometimes go through a week or two of being really angry. My experience is that nothing positive comes out of that. By focusing on those three questions I highlighted above, you’ll find yourself in a better spot, both mentally and physically, to move on to your next adventure with a positive outlook. I also wanted to add that I did have one call this month that was about being offered a promotion, and whether to take it or not. Thanks to everyone who reached out and shared with me. Feel free to leave comments below.

Here are some great resources:

Understanding the 5 Stages of Grief After Job Loss: A Guide for Professionals | Ahead App Blog

Navigating Layoffs: Stages of Grief, Career Reinvention, and Resilience Strategies with Steve Jaffe

How To Manage Your Finances After a Job Layoff

What to do after you’ve been laid off: A checklist : NPR

After 20 years in consulting, I’m excited to share that I’m returning to where my career truly began, working directly with a major local healthcare system right here in my hometown of Boston. Coming back to the city feels both familiar and energizing, and I’m grateful for the opportunity to make a difference my own backyard and honestly….not have to go to the airport!

I want to express my sincere appreciation to the healthcare IT consulting industry and the many leaders, colleagues, and clients who have shaped my path over the years. Your guidance, partnership, and trust have been instrumental in my growth, and I’m deeply thankful for the experiences we’ve shared.

At my core, my passion has always been working with and for hospitals by supporting consultant teams on various client initiatives. Empowering operational teams while helping the client by ultimately improving the end user experience has been such a great experience. This next chapter brings me closer to that mission, and I’m looking forward to contributing more directly across broader platforms for multiple hospital and ambulatory facilities.

I also want to acknowledge something foundational: none of this journey would have been possible without Epic and its EHR platform. Epic has been the backbone of my career, opening doors, shaping my expertise, and connecting me with incredible organizations and people across the country. I’m grateful for the impact it has had on my professional life.

And while I’m stepping out of consulting, my consultant blog isn’t going anywhere. I’ll continue writing about the ongoing changes shaping our industry, from the evolution of healthcare IT and EHR strategy to the rapid rise of AI and automation. I’ll also keep sharing insights on career development for both consultants and full‑time professionals navigating this fast‑moving space. My goal remains the same: to help others grow, adapt, and thrive in a field that never stops changing.

Here’s to the next chapter — grounded in purpose, shaped by experience, and focused on the communities we serve, with plenty more to explore and write about along the way.

Hospitals continue to prove that some of the most meaningful innovations don’t come from vendors; they come from the people closest to patient care. I came across a great article and example this morning that talked about University Hospitals’ recent work inside Epic to proactively identify patients at risk for axial spondyloarthritis, an underdiagnosed inflammatory condition. Their approach, highlighted in the Becker’s article, shows how clinical teams and IT can use Epic not just as an EHR, but as a true engine for early detection and better outcomes.

As someone who has spent two decades in consulting, these stories always hit me in a particular way. They remind me that every time a hospital builds something like this, a screening tool, a new way of surfacing risk…it expands what’s possible inside Epic and raises the bar for the rest of the industry. It also pushes consultants to keep learning, adapting, and staying ahead of the curve so we can support organizations as they design, refine, and operationalize these new capabilities. I think of the workflow impacts, application dependencies, and overall change management approach.

This is the kind of innovation that strengthens the value of an Epic investment while creating new opportunities for advisory work, workflow redesign, and clinical adoption support. And it’s a reminder that the future of healthcare IT will be shaped not just by software releases, but by the creativity of the hospitals and those consultants who know how to turn technology into better care.

Check out the Becker’s Article – Why University Hospitals built an Epic application to detect arthritis – Becker’s Hospital Review | Healthcare News & Analysis

2026 is off to a big start with news in the Healthcare IT world. Tegria’s sale to Altaris is an interesting headline for sure. I had to do some reading to understand Altaris’s positioning in the market, and now I think I get why this is worth talking about. Thought I would share some thoughts.

With Altaris now backing Tegria as a fully independent company, the firm is stepping into a much more ambitious role in the healthcare IT market. They’ll no longer be tied to Providence’s internal priorities as Tegria now has the capital, freedom, and strategic mandate to scale nationally, expand its service lines, and compete directly with firms like Nordic, Chartis, Accenture, and Optum. Well, I list Nordic but remember, Nordic was acquired by Bon Secours just a few years ago. Interestingly doing the exact opposite of Tegria. I think this shift creates a very different landscape and certainly creates variances in priorities of their mission to the healthcare community.

For independent consultants and even small boutique firms, there could be an opportunity. Tegria’s growth strategy will likely include acquiring niche capabilities, expanding its subcontractor network, and partnering with specialists who can help it win larger transformation and outsourcing deals. This is exactly what we did when we sold the EHR division of Nuance. As the company broadens its footprint across EHR optimization, revenue cycle modernization, cloud migration, and digital transformation, it will need talent and expertise with external consultants and/or small companies who are uniquely positioned to provide support.

Their top areas of focus, based on what I’ve read, include:

•          EHR implementation and optimization

•          Revenue cycle technology services

•          Digital transformation support

•          IT outsourcing and managed services

•          Analytics and interoperability solutions

I always scratched my head when Providence Health bought all these consultant firms and created Tegria in the first place. Seemed like a conflict of interest. But now they are no longer just another regional IT services group. It has an opportunity to become a bigger national player with private equity momentum behind it. Consultants and small companies who understand where Tegria is headed, and can align their offerings with its expanding portfolio, will find themselves well positioned for potential partnerships or contracts. This will be fun to watch and I wish them luck. Does anyone have thoughts or ideas, maybe who have worked with Tegria? Leave comments below…

Here is the Press Release – Altaris Acquires Tegria | Altaris, LLC

Many of us have not been flying as much due to hybrid or remote contracts. Its been over 6 months for me and this week while looking at flights, I found myself scratching my head on how the website was showing flight costs that were not what I am used to seeing. The little red X marks had me concerned about changes in cancellation fees and upgrade eligibility. After some digging, I knew some of us would have stories of being tricked.

All major U.S. airlines have had a policy in regards to no change or cancellation fees for standard economy tickets since Covid. Delta was one of the first to make this permanent, eliminating fees for Main Cabin and premium fares on flights originating in the U.S. American and United followed with nearly identical policies, and today all three allow free changes on most tickets. Southwest, for those who love this airline, has never charged change fees for any fare class.

But the real story sits beneath the surface. While Main Cabin flexibility has become the norm, Basic Economy remains a highly restricted product across all major airlines. Delta, American, and United all block changes and cancellations for these fares, and low‑cost carriers like Frontier and Spirit still charge fees that the big airlines have abandoned. This creates a two‑tiered experience: a flexible “consumer‑friendly” Main Cabin and a rigid, no‑changes‑allowed Basic Economy designed to look cheap but feel costly once the restrictions become clear.

That’s why airline websites almost always display Basic Economy as the default lowest fare. It’s not a glitch…it’s a revenue strategy. By leading with the cheapest number, airlines anchor the customer on price, then reveal the limitations only after you click on the lowest fare. Consumer advocates have criticized this as confusing or even “bait‑and‑switch,” especially in cases like American Airlines, which has been called out for making fare transparency harder to navigate. And while each airline handles the presentation differently, the pattern is consistent: Basic Economy is intentionally positioned to drive upsells to Main Cabin, where the no‑change‑fee promise actually applies.

In other words, the industry has embraced flexibility, but only for the fares they want you to buy. The headline policies sound generous, and in many ways they are, but the digital storefronts still steer travelers toward the most restrictive product first. Understanding that dynamic is the key to understanding modern airline pricing: the flexibility revolution is real, but the marketing strategy hasn’t changed at all

Most of you know I am a Delta loyalist, so I did some reading just to spell this out, and not favor Delta over other airlines…well, as best as I could.  The bottom line that we all need to be aware of is it is deceptive across all airlines.

The pattern is industry wide, though some airlines are more aggressive than others.

• Delta, American, and United all prominently display Basic Economy as the lowest fare, even though it does not allow changes or cancellations.
• The restrictions are often only visible after clicking into the fare details.
• Analysts and consumer advocates have repeatedly criticized this practice as confusing, opaque, and intentionally designed to push upsells.
• Southwest is the only major U.S. airline that avoids this issue entirely because it does not offer Basic Economy.

Has anyone find themselves fooled and stuck with a ticket they can’t cancel or get upgraded? Share in the comments below.

In a meeting I had just a couple of weeks ago with a Chief Innovation Officer of a healthcare system, I learned of their internal development of a new AI solution. It made me wonder who else might be doing this, and after just a few articles, I found there was a big trend in AI and overall technology development happening internally, vs hospitals going out to buy the solution needed. I wanted to share just a few examples here and my thoughts on potential impact to consultants.

Organizations including Mass General Brigham, Mayo Clinic, Cleveland Clinic, and Stanford Medicine are all building platforms inside their clinical environments, validating them on real patient data, and then exploring commercialization pathways, whether through spinouts, licensing, or joint ventures. These new tools are proving valuable enough that they can scale beyond their home hospital. The common theme I found appears to be that newly internally developed technology is being treated as strategic intellectual property, not just an internal tool.

These systems also share a similar pattern where they build a solution that solves deeply operational problems. In reading multiple articles, the focus appears to be on workflow automation, unstructured‑note extraction, population health risk stratification, and care‑pathway optimization. Before any commercialization step, the tools are deployed internally at scale, stress‑tested across multiple specialties, and integrated into clinical workflows before turning it into a company with a product.

For those of us in Healthcare IT consulting, this shift is going to reshape the landscape in a pretty fundamental way. As more health systems start building and commercializing their own products, we won’t just be advising on technology adoption; we’ll be helping organizations evaluate, integrate, and even compete with tools that originate inside other hospitals. It changes the mentality of just supporting Epic or Oracle because the clients we support may now be both buyers and creators in the AI/technical marketplace.

Hospitals spinning out tech companies will expect consultants who understand not just EHR integration, but IP strategy, go‑to‑market planning, interoperability standards, and the operational realities of scaling technology safely. In other words, the consulting value proposition shifts from implementing tools to helping health systems become technology-driven organizations, or in this case, even an AI/technology vendor.

Regardless of your area of focus as a consultant, we’ll all need to adjust to a broader capability of support.  All these changes imply that hospitals are becoming product creators, not just adopters. I just wrote about continued learning as my new year’s resolution, so hearing about all these hospitals taking on development of their own technologies only reinforces the need to keep up on all these great new tools being developed. 2026 is going to be an interesting year in Healthcare IT!  

Anyone working with a client that this is a priority? Please feel free to share in the comments area below.

Here is the Mass General Brigham Press Release – Mass General Brigham Announces New AI Company to Accelerate Clinical Trial Screening and Patient Recruitment | Mass General Brigham