How have you Adopted to working from home?

Hard to believe it’s been exactly 6 months ago today since my last work trip and flight.  It was a quick client visit in San Francisco to kick off an Epic go-live.  Then, like a flip of the switch, all travel was canceled due to Covid.  Projects were suddenly delayed, staff were asked to work remote, and quarantine forced us to stay home for months.  I haven’t written a blog entry since, as priorities in our world of consulting have all shifted.  This was new for me, and many of us had to majorly adjust how we tackle each day.  Let’s face it, it’s been a struggle to adjust, but I think after 6 months…I’ve finally adopted to the new norm.

I thought I would share my thoughts on a few areas that really required a change in how I approached continued client support, while adopting to my new work environment in my home office.  Let’s start there, setting up a conducive office space.  I myself am lucky, I have a physical office.  My laptop and PC are running all day with both my cell and home phone ready.  My husband on the other hand did not have an office, so we had to convert the guest bedroom.  We are on opposite sides of the house, and with doors closed we have a good set up.  I have seen colleagues struggle with challenges including their kids, pets, internet connections, and non-conducive environments.  I’m lucky, I had none of those issues. Would love to hear how those of you with these obstacles adopted.

Attending back to back Zoom meetings was another big adjustment.  I wasn’t prepared to suddenly be on camera at 8am with my boss!  First couple days I found myself throwing on a baseball hat, but quickly realized others were dressing professionally.  I would say by week 2 I was taking a shower first thing and wearing a dress shirt for the day….and yes, I always had shorts or pants on.  I noticed my background was cluttered with office shelves full of tchotchkes and picture frames.  My laptop did not support the green screen option to fade the background, so I had to clean up the shelves and change some artwork.  When I meet with clients, I move my laptop so that I’m in front of a plane white wall.  I’ve seen some pretty funny backgrounds, and even a couple really inappropriate ones.  Curious what the funniest background you’ve seen has been.

My biggest challenge these past 6 months was quickly and effectively transitioning our normal service offerings to new delivery models and net new services due to Covid patient care, travel restrictions, and pop up hospitals.  In my role at work I lead our consulting services efforts for go-lives, training, implementations, optimization projects, and Managed services.  Almost overnight I watched project after project get delayed and/or totally canceled.   

We had to quickly adjust our focus areas to meet a sudden new demand in the market, support services for Telehealth.  Within days we set up an extended version of our Epic MyChart service desk to now provide full patient prep support for telehealth along with provider support.  My go-live leads and Epic builders were moved to answer phones with an increase in call volumes off the charts.  It was, at first, a crazy rapid response model to get our customers up and running on support.  Months later we’ve improved our processes, staffing models, and quality of delivery.  We’ve also successfully converted our go-live and training services to a virtual model option, but most our customers are asking for a hybrid version.  I’m sure you all have been asked to change the way you deliver your consulting services, and no doubt will need to continue to bend and flex as we identify the new “norm.”

The biggest loss, from my perspective with all this, is the loss of face to face networking opportunity.  Every event I had planned these past 6 months have been canceled including multiple client visits, HIMSS, CHIME, Epic UGM, KLAS Collaborative, and our own company sales meeting.  Many of these were offered at some level in a virtual setting, but it really is not the same.  Client meetings are on Zoom, but rarely do I get to see their face.  I find it unlikely any of our industry events will return anytime soon.  HIMSS21 has already been delayed from March to August 2021 in Las Vegas.  I expect others to follow that lead and push out their event dates.

I will admit that there have been some considerable advantages to working from home.  While I miss traveling, I do not miss sitting in traffic, fighting for overhead bin on a plane, or sitting for hours and hours in the terminal for delayed flights.  I’ve never had a cleaner home and have advanced my cooking skills considerably.  Being able to spend more time with my husband has been wonderful as well as safe social distancing small gatherings with friends has also been really nice. 

I’ll admit in April I was fighting depression, but looking back now at the last 6 months, I have to take the whole experience in and look at how well I’ve adopted to the changes.  To close out, I have to say I’m so lucky that my colleagues, employees, family and friends are healthy.  We are all dealing with various challenges and the current political and cultural clashes in our country aren’t exactly helping our cause.  Let’s continue to work together, face the ever shifting challenges in our industry, and lend support whenever you can at work, to your community, and to your colleagues in the industry. 

Want to share how you’ve adopted?  Share your comments below.

How will Covid19 Impact your Travel Plans for Work or Fun in 2020? A quick survey…

photo of woman standing near glass wall
Photo by Palu Malerba on

Companies around the world have sent their employees home, closed their offices, and grounded their traveling staff. Remote efforts are in full swing and clients are depending on creative, urgent, impactful solutions for patients and physicians a like. The countless press releases and articles on these variations of offerings are everywhere. But I started to think about what the future will hold for us, both professionally and personally. What decisions will we, our companies, and family be making in regards to future travel once quarantine is lifted?

I’m eager to hear what your plans are. Please take just a quick survey to assist with collecting some additional data to share. Click on survey here.

Consultants Need to be Prepared for Alternate Client Support Work


We are in a state of emergency. There is no doubt that every industry is being impacted worldwide. For those of us who travel regularly, we are seeing empty airports and planes. Masked passengers and reduced services to protect us from getting sick. But the industry that we work in, Healthcare, will only get busier and busier with demands of testing, emergency services, and an enormous increase in call volume. As consultants we need to be prepared to provide support in any manner our clients see fit, and you can bet most of that will be remote and different from what you are used to doing.

Offices are closed and full time IT staff are working remotely to keep EHR systems running for clinical staff. It’s likely that major initiatives and go-lives are being delayed. Other project delivery efforts around optimization, upgrades, and training will need to take a back seat as priorities are realigned to meet the demands of patients. If you were supporting any of these types of projects, you may be stuck for a while with no work for some time. However, there are other urgent needs that our clients will be facing, and you need to be flexible and available if called upon.

Exhibiting flexibility and willingness to step in where needed will be essential to helping our customers, for as long as this takes. It may be simple work like triaging patient calls, patient portal support, prioritizing incoming tickets, tier 1 help desk level support, and/or other “keep the lights on” type of efforts. You can bet that Epic, Cerner, Meditech and others will be prepared for requests, and so should we. No doubt customers are looking to the experts for immediate EHR workflow changes specific to the testing and treatments associated with COVID-19. I would expect quick turn around on these efforts, and training support will be essential here.

If you are not heading to the airport tomorrow ask yourself, what services is your firm offering during this emergency that you might be able to support?  What other “roles” can you fill in and help with?  Reach out internally to your managers and leadership and extend an offer to help.  Let’s get through this, and help our clinicians focus on what they need to do, stop the spread of this virus.

Know your State Rules and Request your Absentee Ballot Early

i voted sticker lot
Photo by Element5 Digital on

Voting season is upon us, and our participation is absolutely essential this year. Many of us travel weekly which impedes on our ability to go to our assigned polling location. The good news is that regardless of what state you live in, there is a quick and easy way to request your absentee ballot. I recommend simply visiting From there you can select your state and complete the form. This will take all of about 1 minute and you can move forward with booking your travel and focusing on your engagement.

There are different deadlines based on the state you live. Click here for a list of each states requirements. Most states recommend you request your ballot a week in advance if doing so online. However there are some states that require two weeks. You can also request a ballot in person to be mailed in. Also be sure to follow the “mailed by” requirements for your state. Some allow post marked date of election, but others require 3 days prior.

There are all different considerations for voting by the way.  Most states recognize; Polling place voting, absentee voting with excuse, absentee voting without excuse, early voting, in-person absentee voting, all-mail voting, provisional voting, overseas absentee voting, and military absentee voting. Absentee voting by mail without excuse is allowed in 27 states and DC. In 20 states, an excuse is required. No-excuse permanent absentee voting is allowed in 6 states and in DC, and 3 states (Oregon, Washington and Colorado) conduct all early voting by mail.

There is no reason you can’t vote this year.  I promise not to preach on this site, nor will I share my views on candidates.  Instead I’ll just encourage you all to be proactive and request your ballot now.  I’ll end by also mentioning that if you haven’t registered to vote, and want to do that as well as request an absentee ballot, visit and select your state.

How to Plan Your Attack of HIMSS Exhibit Hall and Sessions


With just over 1,400 exhibitors and an attendance of 42,000 healthcare professionals, you really have to be ready with a plan of attack. Whether you are attending as an exhibitor, speaker, member, or first time newbie…we are all facing challenges with how best to tackle this huge event. This is my 10th year in a row attending, and I think I finally have a process that works pretty well. I thought I would share some thoughts and give a couple tips learned.

You’ll need to start by answering the question, what do I want to get out of the show? Education is typically the primary walk away including exposure to new technologies, vendor demos, attending educational sessions, and participating in various events. As an exhibitor, I have a clear structure and purpose which is to educate current and potential clients with services and technologies offered by my firm. Secondary opportunities for me are to capture competitor details, take advantage of partnership and networking gatherings, and catch up with colleagues and friends in the industry.

Your plan of attack should be narrowed down to 3 or 4 areas of focus and outline time expected to achieve each of those focus areas. Create an actual schedule of what and when you are attending sessions, demos, and events. Most importantly, have a map of where these are…the convention center is 7 million square feet. My Fitbit averages 12 miles a day, and I spend half my time on booth duty!

Here is the main exhibit hall. But don’t forget there is the West Hall level 1, Rosen level 3, and the Hyatt across the street.

First thing to tackle is education events. If this is your first time attending I highly recommend you go to the “First Timer’s Conference Orientation.” I’ve gone several times, as the Las Vegas venue is more spread out and very confusing. I also suggest you review the agenda on the HIMSS2020 website and take a look at all the options to help build up your schedule. No doubt you’ve already identified top sessions and/or events, but you may find dozens more here. Keynote speaker events are always full to capacity.

Networking and social events are always fun and free. Plan to attend the opening Reception Monday evening. It’s a fantastic way to kick off the show with opportunity to meet and greet fellow colleagues as well as meet new people, it’s a huge ballroom and very conducive for the event. The Exhibit Halls Social Hour on Wednesday will have free food, beverages and various organized regional HIMSS gatherings. As a HIMSS member, you are invited to your regional hosted event. Be sure to go online to your regional specific HIMSS website for these invites, they are not on the HIMSS2020 site.

My suggestion for another area of planning is meals and social gatherings. The convention center offers dozens and dozens of food carts both inside and outside the exhibit hall area. There are food court on level two. There is a restaurant upstairs on level four and three restaurants at the Hyatt across the street. It’s not enough. Lines for coffee alone in the morning are crazy. The food court will be packed from 10:30 am – 2pm non-stop. Restaurants have lines out the door prior to even opening. My suggestion, bring snacks and bottles of water.

Want to get together for a drink with friends or your team? There are three bars at the Hyatt, and unless you plan on cutting out mid-afternoon, you’ll have to fight to get in to any of them. Plan on dinner and social gatherings away from the convention center. Restaurants within walking distance are usually closed for private events, so the further away you get from the conference the better. Make reservations now. Use OpenTable now to look for places that still have availability. This is the one reason I prefer the event in Vegas, food and beverage options are far greater and easier. Guess we can look at that in 2021.

Let’s wrap up with the last, and biggest challenge, the exhibit hall. No doubt this is the #1 driving force behind the entire event. As mentioned, there are over 1400 booths ranging from small first time sponsors with 6 foot tables to major vendors having 12,000 – 14,000 square foot giant offices. IBM usually takes the top spot with Epic right behind costing over $200K just for the space, not including shipping, furnishing, or services. You could fill a dozen suitcases with tchotchkes from pens, socks, binders, stuffed animals, and sweets….to just name a few. There is a reason they give you a backpack when you register, you’ll need it!


The real value is not the freebies, it is the opportunity to obtain market trending information, training, and materials relevant to your business. My suggestion is to review the attendee list and determine their location. Use the interactive floor plan to search for those companies you want to visit and lay out a path that shows their locations by booth number and Hall area.


After you’ve determined who you want to visit, go to their website to see if they are offering demos and/or meetings. Most vendors will have an option to proactively set up a meeting so you don’t have to stand in line waiting. Many vendors offer ongoing demos that start every 30 minutes or so. Additionally, you could benefit from gathering materials and taking pictures of booths signage to bring back to your staff. I take dozens of pictures of the various EHR booth signage to share with my consultants and team members.


There are probably 50 articles out there on the subject. This will be my 10th year in a row attending. Hopefully my lessons learned help you a bit with your planning a method of attack. If you are attending, please come by and say hello.  I’ll be at both CHIME and HIMSS all week.

Have other ideas and suggestions to share? Please leave your comments below.

EHR Opportunities Exploding Internationally while Managed Services Grows in the US


As I watch so many of my colleagues take long term International engagements, it dawned on me that we are seeing two opposite spectrums of opportunities being presented to us. The first is remote, work from home or office, in Managed Services offerings including tier 1/2 help desk, patient portal support, or application management. The second, is to agree to be sent far away for months at a time for International engagements. Talk about one extreme to the next. The question really is, what offering has long term benefits for you as a consultant? Let’s take a minute to think about both.

Managed Services is booming right now. Clients are looking to outsource IT staffing in a remote capacity to manage their systems. This reduces overall costs, staffing head count, retention concerns, and enables prioritization of major projects while the outsourced firm “keeps the lights on” for day to day maintenance. Allowing yourself an opportunity to expand your skill set into this type of work opens doors for stable, local, long term, non-travel related consulting work. Don’t limit yourself to traditional client travel based contract work. I have way too many colleagues who have been between projects. While the pay is not as high, the work is steady, and you will maintain your skills, and possibly expand your marketability.

Introduction level Managed Services is a huge growth area right now. Tier 1 and 2 help desks are being offered by firms all over the country in traditional office spaces. We’ve seen in several recent press releases in the news about firms investing in facilities and expanding into both internal and patient facing support centers. These offices need leadership and management from experienced EHR application experts. Training and development of teams is a huge opportunity for those looking to get off the road and lead teams of resources into customer service and technical support.

On the other side of the coin, for those of us still loving the road warrior adventure, is international travel opportunities. Major implementations are happening in countries including Canada, Norway, Denmark, Finland, and Germany…to name a few. Epic is growing in the EU and Middle East while MEDITECH expands in Australia with 66 hospitals now across platforms (mostly CS). How many of those customers in Australia will be looking to transition from CS to Expanse? Did you know Epic is in Lebanon and MEDITECH is in Kuwait? There are tons of opportunities across the globe right now.

Understanding travel requirements and tax implications is essential prior to making any decision on international support engagements. Talk to your firm’s recruiting resources and review their policy on obtaining visas, extended travel durations, and any potential out of pocket costs to you. Additionally many firms use third party contracts to manage the international aspects of the business. Larger global firms usually have international agreements with the major EHR vendors but often outsource to other firms for consultants and application specialists. Be sure to gather all the details of how that would work and impact you as well.

What are your thoughts? Ready to stretch your wings in fly across the world…or thinking maybe something remote? Share your comments below.

The Best and Worst Airlines of 2019 Report is Out…No Surprises

Delta chart 2

It’s that time of year again, and once again Delta takes top spot while both United and American fall last, again. How does Allegiant and Spirit score better than American? I don’t consider either of those real contenders…so let’s just pretend they are not on the report. However, to compare the top to the bottom just look at flight cancellations. Delta averaged only 36 a day in 2019; American averaged 159 a day. Not that we ever check luggage as consultants, but another huge difference is in mishandled baggage. Delta averaged 1,345 late or lost bags each day; American mishandled more than twice as many.

Here is a quick look at results…

Delta Chart

Because I’m a huge Delta loyal fan, I’ll just share a few awesome numbers with you. Delta improved its on-time arrival rate to 83.4%, up from 82.9% in 2018, according to masFlight. Delta airline canceled just 0.7% of its flights in 2019, including regional partners, down from 0.9% in 2018. Southwest, American and United all canceled more than 2% of their flights last year, and the industry average was 1.85% in 2019.

Having tried JetBlue about 10 years ago I am all to aware of cancelations.  They continue to not let folks down being one of the highest in daily cancelations.  Delta on the other hand had 281 days with zero cancellations last year, 30 more than in 2018. Factoring in regional partners, the total number of days when 100% of flights were completed was 165, up from 143 in 2018.

The #1 reason I will never ever fly American. In 2019 American Airlines started each day with about 50 planes out of service for mechanical reasons. Normally the airline has about 30 aircraft needing repairs even after overnight work by mechanics. Being short 20 airplanes a day means the airline had to cancel about 80 flights for maintenance. That is just crazy!!

The Scorecard doesn’t measure factors like seat comfort, gate agent and flight attendant service, add-on fees, frequent-flier programs, upgrades or route convenience, except when complaints show up at the Transportation Department. For that we’ll need to wait for the JD Power’s North America Airline Satisfaction Study. Alaska Airlines often take the #1 spot with Delta every single year in #2. So really this report is more about dependability vs customer service.

I have to ask, why are people flying American? I see complaints on Facebook every single day. I am really thankful I don’t live in an American hub city. Direct or not, I would take Spirit over American if it came down to it. Share your comments below.

How Well Do you Know Your Firms Products?


This time a year a lot of companies will start sending out year-end summaries that list their accomplishments and growth from the prior year. I’m seeing all kinds of details on LinkedIn and other sites already. I started thinking about all the different products and services my firm offers and realized I am lucky, I received some great training and have a real sound understanding of those products. As a consultant, you never know when a client may inquire on areas not directly related to your role. The ability of being able to speak to those may benefit all parties, including you.

Regardless of our role, we all should be able to speak to the capabilities and products/services offered by our organizations. I remember years ago when I worked for another firm that sales and I would talk about our government division. My favorite, when talking about go-live and training services, was that our company trains more dolphins (a mining military protective service) then Sea World. I would go on to say, “So see, whether its Epic consultants or dolphins, we are committed to the highest quality of training experts.” This would get the biggest laughs and open the room right up for further discussion.

But all joking aside, there are a lot of moving parts to your firm and obtaining knowledge only adds to your credibility and growth potential. An easy example is other EHR practices. Epic, MEDITECH, Cerner all have variations on focused services. Your client may have Legacy systems still in play through data archiving and/or other work around data extraction and reporting. Does your firm provide variations of Legacy support? Another might be non EHR support in areas of ERP, Revenue Cycle, and/or Managed Services. How knowledgeable are you about your firm’s capabilities in these areas? Are their cross-overs that may have interdependencies on what you are doing that could result in an extension? Setting up long term Managed Services offerings for example often need direct consulting support to transition planning and implementation.

I know some of you will say that you are not in sales. I hear it all the time. I’m not in sales. I’m an operational delivery, strategy, and quality assurance manager. But understanding my clients and all the initiatives and dynamics of their projects makes me more credible. While providing a billable service, knowledge of capabilities of all areas of support may open doors for dialog that you are leading. This aligns nicely for growth into Project Management roles for example. Even if you are not in sales, your firm may provide bonus incentives for identified leads that end up closing due to your direct assistance. Do you know if you firm offers anything like that?

Don’t inadvertently box yourself in to a role, show your interest and capability to expand your skills by being knowledgeable. Read your companies updates as they come out over the next month. Ask questions and keep updated on your own company’s initiatives and focus areas for 2020. While it may not be in your direct area, that doesn’t mean there isn’t potential there for you.

MA Introduces New Handheld Device Driving Laws…What About Your State?


It was only a matter of time for us here in MA to start seeing stricter laws regarding phone usage while driving. Massachusetts has passed a new law banning the use of handheld electronic devices while driving, barring looking at text, videos or images while driving. Drivers may continue to use electronics in “hands-free” mode.

The law goes into effect on February 23, 2020 with a grace period for violations until March 31. Penalties will be a $100 fine for a first offense, $250 fine for a second offense and a $500 fine for subsequent offenses.

Drivers will be permitted to use electronic devices under certain conditions, including:
• If you are in a stopped vehicle, and the vehicle is not in a public way intended for travel by motor vehicles or bicycles.
• If you are in or responding to an emergency situation.
• If you are using your device to view a map for navigation purposes and the device is mounted to the vehicle’s windshield, dashboard or center console.

That last one is tricky for those of us who rent cars on a regular basis.  I depend on my GPS app everywhere I go, but I don’t carry a mount for my phone.  I usually put it in the cup holder.  What tricks do you have for this?

Do you know the laws for your home and client states? There are different laws for usage for minors, talking, texting, and public drivers. Kansas, Florida, Missouri, Montana, and Wyoming are the only states with absolute no restrictions. Click here for a complete chart, but don’t assume its 100% accurate.

Please don’t text and drive regardless of the law. Wishing you all a very safe and fun Holiday Season.

Who owns Final Decision on Winter Weather Related Flight Delays?


As Boston prepares for its first winter storm, I thought I would do some research over the holiday weekend on the impact to flights and decisions made based on conditions. I was thinking that there must be some standards to when a decision is made to delay flights due to weather…especially snow storms.  My quest was to find out what, and who, determines a delay or cancelation to flights. Let’s take a look at what I found out.

First of all, snow delays occur when the Federal Aviation Administration, the local airport or a pilot decide that the weather conditions are too dangerous for safe travel. The problematic weather may occur at the departure or arrival airport, or en route. A delay may also occur even when your airport has perfect weather. Each commercial airplane makes several trips a day and a previous flight that the plane was scheduled to undertake may have been cancelled or delayed by weather. The Federal Aviation Administration requires every airport that receives more than 6 inches of snow a year to create a snow and ice control plan and a committee to create guidelines for winter operations.

Below is what I found out regarding who decides the impact to flight schedules. It’s interesting to see the different decision makers for each of the types of conditions.  Winter weather is broken down into three considerations; accumulation, winds, and ice.  There are different impacts to flights for each.

SNOW – The FAA considers a runway to be “contaminated” when standing water, snow, ice or slush are present. Standing water, snow or slush can make it difficult for a plane to take off or land safely as they can cause friction, reducing traction which can lead to hydroplaning/aquaplaning. Landing distances required are different for wet and dry runways, meaning some planes may not be able to land safely on their usual runway when snow is present. Capability of removing snow directly impacts decisions as well as visibility, icing or turbulence problems during flights and landings. The airport determines the conditions of the runway when deciding on flight delays.

WIND – Strong winds can cause visibility issues for pilots even when snow is not falling. While the FAA determines safe parameters for crosswinds during flights, primarily for landings and takeoff, a local airport may need to cancel flights due to blowing or drifting snow. A strong wind might be OK for landings or departures on a sunny day, but when combined with ice may cause problems. Winds from winter storms can be strong and can lead to what meteorologists call “bomb cyclones” or “bombs.” This type of wind can prevent take-offs and landings, or cause extreme turbulence in the air, leading to flight delays.

ICE – While planes can be de-iced if still at the airport, icing is an extremely dangerous weather condition for flying, landing and take-offs. The runways become slick, making safe landings unlikely. Additionally, ice build-up on the aircraft itself can lead to mechanical or functional problems. In-flight icing is a bigger problem for small aircraft, but it can still cause issues on large planes. If freezing rain is occurring, it is likely that flights will be delayed or canceled as ice can build up on the wings, windshields and runways. The pilot often determines the potential impact to the plane and can request a delay based on these conditions.

Many of us are getting ready for several months of winter havoc impacting our travel.  Being aware of conditions at your airports and flight patterns may help you make better decisions in advance before heading out.  Be prepared, dealing with delays is just a part of our job.

Have a favorite snow delay story? Share your comments below.