Why do Recruiters only post the “Region” of the Country for opportunities?

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Almost all recruiters provide details on opportunities including a vague description of the actual location of the client. The issue is that not everyone uses the same language to describe the “regions” or states within that region. I was recently asked if I could be more specific than just saying the “Midwest.” It got me thinking, almost all opportunities are spelled out in the cryptic manner. What is the answer to this inconstant use of territories within our country? Let’s start by looking at the variances of regions.

Technically there are five regions of the country including: North East, South East, Midwest, Southwest, and the West. They are broken down as such:

The West Region includes:
– Alaska — Nevada
– California — Oregon
– Colorado — Utah
– Hawaii — Washington
– Idaho — Wyoming
– Montana

The Southwest Region includes:
– Arizona
– New Mexico
– Oklahoma
– Texas

The Midwest includes:
– Iowa — Missouri
– Indiana — Nebraska
– Illinois — Ohio
– Kansas — North Dakota
– Michigan — South Dakota
– Minnesota — Wisconsin

The Northeast Region includes:
– Connecticut — New Jersey
– Delaware — New York
– Maine — Pennsylvania
– Maryland — Rhode Island
– Massachusetts — Vermont

The Southeast Region includes:
– Alabama — Louisiana
– Arkansas — Maryland
– Florida — Mississippi
– Georgia — Kentucky
– North Carolina — Tennessee

Seems simply enough…but, many recruiters use 7 regions instead of the traditional five. These are broken up as:

New England Region
Mid-Atlantic Region
Southern Region
Mid-West Region
South-West Region
Rocky Mountains
Pacific Coastal Region

To make things more complicated when using 7 regions, no one seems to agree on what states belong in what region. For example, the Rocky Mount Region always includes Colorado, Idaho, Montana, Nevada, Utah, and Wyoming. Sometimes it includes Arizona and New Mexico as well (according to Wikipedia). So what the heck does “sometimes” mean? I would like to suggest that all recruiters use the census map…this would put us all on the same page!

Census Map.png

Typically there are enough hospital systems within a state that recruiters should be able to be more specific. I may not be interested in opportunity in North Dakota but have no problem going to Indiana. The Midwest is so big, candidates need to know more. My bad for only saying the “Midwest.”  Imagine finding out an opportunity identified as Pacific is actually in Alaska.  Hopefully that would never happen.  Lets not waste each others time.  As candidates, ask where is the client within the region you posted?  As recruiters, get down to the closest state/city level as you can.

Have you ever inquired about an opportunity with just the region provided as the location? Share your thoughts in the comments area below.

How much “Consulting” do we actually do as consultants?


A candidate recently called me and mentioned that she thought the engagement opportunity sounded more like a temp job than a consulting opportunity. After thinking about it, she might be right, many of our opportunities are like temp staffing placements vs a true consulting role. As I think about our industry and the various roles I’ve filled for clients, I think I’m probably split on roles that were project support roles vs consulting roles. It really beckons the question of whether we are positioning opportunities correctly to candidates. But I also think we need to ask; are we filling temp roles to do the work or providing a higher level of service with a greater potential of deliverable outcomes?

Regardless of whether we are being placed in an analyst, testing, training, or go-live support role…we are being brought in for our expertise and knowledge. Our experience truly warrants a higher level of deliverable than simply filling an empty chair on a team. I always say that our primary responsibility should be transfer of knowledge. As consultants, we provide services that both help our clients hit their goals while also ensuring ongoing success once we depart. If all we are doing is the same work as their full time employees, we are not consulting, nor delivering the quality level of work that should be expected.

With that said, we do need to be aware of the client’s expectations of our role. Overstepping boundaries and self-appointing project work may not align with their needs. I once had a consultant walk into a leadership meeting, uninvited, and starting making suggestions to the group. The IT Director was, needless to say, not happy and asked that consultant be removed from the project. There is a fine line between providing consulting level services and actually “consulting.”

There are tons of engagements that are very much consulting roles. These vary from advisory services, vendor selection, assessments, performance improvement reviews, and project management type roles. While application analysts and builders don’t really fall under these types of services, there may still be opportunity to provide consultation on best practices. Certainly talk with your recruiter about the opportunity you are looking at to clarify the level of “consulting” the client is looking for. Client culture often dictates the type of role needed for the project and whether truly they are just in need of a resource to keep them on time for the project.

I remember my first day as a consultant. The client was going through a design session with Epic. All the consultants sat in the back of the room as Epic walked the client through various functionality and workflow designs for their implementation. A fellow consultant leaned over and told me to just sit in the back and don’t say anything…”they don’t want us to say anything.” I was surprised at this as I’m sure they did not just fly me from Boston to LA to sit in the room and say nothing. Needless to say, I didn’t just sit back and watch, I engaged both Epic and the client in discussion around some suggestions I knew would have a negative impact to the project.  Shortly after the client asked me to take on a team lead role. It was a great “consulting” project.

What have you seen at your clients? Share your thoughts and comments below.

How are Epic Trainers being impacted by Quarterly Upgrades?

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There has been a lot of conversation around analysts completing work associated with Epic’s quarterly releases. We are coming up on another release and several clients are still looking at variations of project vs maintenance staffing models to meet their needs. For an analyst, we’ve seen scope of work that includes Nova note and change control reviews, building, testing, and implementing. What I had not heard a lot about is what are clients doing for training? I had a few great conversations this week with both clients and clinical Epic trainers in regards to quarterly upgrades and thought a few items where worth discussing.

Epic has committed to minimal functionality and workflow impact with each release. The point of the quarterly releases is to keep the upgrades simple and less stressful for the analysts and end users. Rotation of specific applications will also assist with keeping other projects and initiatives uninterrupted. However, the trainers have a big task in front of them due to the typical interdependency of cross clinical applications. Their scope is not only to update current curriculum materials and training environments, but also a significant amount of development of training tools across multiple applications. Regular development of quick reference guides, cheat sheets, eLearnings, and other tools will certainly be a big commitment. Therefore, coordination of efforts across teams will be essential and Superusers will play a key role in end user support.

Post implementation staffing models for training teams are typically reduced to a single PT per application, and sometimes one PT for several modules. Superusers will be imperative in supporting quarterly upgrades for both training of end users and go-live support as the trainers will be owning many moving parts during each cycle. With quarterly releases the impact of operations needs to be considered as Superusers are pulled from their duties to attend training and support the piers for several days. This is not anything new to Epic clients, but is certainly a more regular usage of employees in the Superuser role.

As a consultant there is opportunity here for sure. There are a lot of firms who have stepped up with development of methodologies and staffing models to support these quarterly upgrades, including activation and training. Clients are looking for solutions from firms that can provide coverage that allows their teams to continue with other priorities and commitments to their internal departments/customers. Epic is routinely offering their Boost program as a solution as well. Internally they will still need to directly participate in note reviews, workflow agreements, and superuser support…but the reduction in day to day work associated with regular upgrades is making a positive impact all around with these solutions.  Be sure to understand what your firm is doing to assist clients in these areas.

Have you been involved with quarterly upgrade support? What types of models are you seeing clients use? Share your comments below.

J.D. Power Airline Satisfaction Results – United in Dead Last (again)


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The J.D. Power 2019 North America Airline Satisfaction Study was released yesterday. I look forward to seeing these results every year so I can remind myself that my loyalty and decision to exclusively fly Delta continues to be the right choice. The big news from the report this year is that the overall satisfaction ratings went up by 11 points to an all-time survey high. Speculation is passengers have seen huge improvements with new planes, lower prices and improved in-flight amenities.

No major surprises with the ratings which are based on responses from 5,966 passengers who flew a major North American airline between March 2018 and March 2019.
Among the US carriers, Alaska Airlines ranked the highest with a score of 801 followed by their partner, Delta Air Lines, with 788. It’s not apples to apples as Alaska has limited options for flights on the east coast and so I can’t give Alaska Airlines huge kudos. I mean who does fly them?? SEA to LAX sure, but how enough voters came in to name Alaska #1 makes me scratch my head.

I was surprised to see American Airlines come in third with a score of 764 as they are so often complained about. Another one that makes me chuckle is Air Canada, who came in with a score of 729. My favorite result, which was no surprise, is last place…United Airlines, with a score of 723. The huge score difference between United and Delta is significant enough to make me smile cheek to cheek.  I feel bad for my fellow travelers who still fly this airline.

Among the low-cost carriers, for those few consultants who actually fly them, include Southwest and JetBlue tied at 817, followed by WestJet (758), Spirit Airlines (711) and Frontier Airlines (702).

The biggest disappointment of air travel according to the survey? In-flight services, such as seatback entertainment, food service and Wi-Fi, continue to be ranked the lowest. These are all areas that are always being improved, so I get that you won’t make everyone happy.

Where did your airline rank? Agree with these results? Share your comments below.

Drug Testing…a Cannabis discussion for Consultants

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While I don’t use any cannabis products I have a lot of friends and professional colleagues who do.  I was thinking about the impact to those in our industry of consulting and client policies regarding use and screenings.  There are tons of articles on traveling with pot, but what about drug testing requirements for consulting firms and/or clients and use while on engagement?

First, a quick snap shot of the law.  5 years ago Colorado became the first US state to legalize marijuana. Today a total of 9 states (and District of Columbia) have legalized marijuana for recreational use including; Alaska, California, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, and Washington.  These states allow you to have 1 oz of usable marijuana in possession and you can even have up to 6 plants in your home.  Plus there are 33 states that have legalized for medical purposes.  So, if you are engaged in one of these 9 states, or have a medical card, you should be permitted to use…right?

Without a question marijuana is becoming as normal as smoking cigarettes or drinking a glass of wine.  And we all know as a consultants, these activities should be limited to when off client time and property, which is obvious.  The question however remains, what are client requirements for drug testing…and how do these laws impact us as consultants when traveling?  Let’s take a look at testing.

Testing conducted, according to the Substance Abuse and Mental Health Services Administration (SAMHSA) guidelines, check for five illicit drugs including; Amphetamines (meth/ecstasy), Cocaine, Opiates (heroin/codeine), Phencyclidine (PCP), and yes…THC.  Several hospitals have an 8-panel test that also adds Barbiturates, Benzodiazepines, and Methaqualone to the list…especially in states like Indiana, Georgia, Alabama, and Texas.  Almost all drug testing is completed via urine, but could include blood or hair, which looks at a longer history of use. While levels of detection requirements vary, the presence of any may result in a review to determine eligibility of employment.

You’ll also want to look at the potential engagement state laws regarding drug testing.  Louisiana is an interesting state, for example, that while private companies may request drug screening, they cannot discharge or refuse employment based on results.  However, right next door on both sides in Texas and Mississippi employers can terminate based on results and/or candidate refusal to have test completed.

In interviewing several consultants, representing 10 different firms, only 2 firms have drug pre-screening requirements for employment.  The other 8 base drug screenings, and immunization requirements, based on client requests.  So while you may get hired for a firm, you may not qualify for certain engagements with certain requirements.  One engagement that I remember not qualifying for was Dayton Children’s Hospital, as they tested for nicotine (which is unprecedented). I could not find details on their THC requirements, but you can guess what it is.

I would say you want to familiarize yourself with the state laws, client, and the firm’s requirements.  This map showing legalization status may help when talking to recruiters if you are a cannabis user. I think there is an argument to be made that if one consultant can drink wine then why can’t the other consultant smoke marijuana.  There are several articles out there stating that employers are no longer testing or reviewing results for THC…but that’s in states like CA, CO, MA, and NY.  Ask your recruiter what the expectations are to be on the safe side. I’ve seen consultants be escorted off property after being screened…it has to be a terrible experience.

What are your thoughts?  Share your comments below.

Does this drive anyone else crazy??


After years of being handed two sets of keys that are bonded together, I finally inquired at National by simply asking…WHY?? The answer still has me dumbfounded.  The attendant stated, “All cars have two sets of keys and we need to keep them together.”  That has to be the stupidest thing I’ve ever heard!! What if I lose these??  Now you have no keys!  I didn’t want to argue, so I just walked away.  Does anyone else think this is just silly and drive you crazy as me?

I don’t carry a bag or briefcase to most my client meetings, so these big bulky things usually have to go in my pocket everywhere I go.  This weeks gems are 3.5″x2″ each with a warning tag and a large metal wire key ring.  Very uncomfortable in my suite pants, too big to go in my suit jacket, and awkward to put on table with my phone and notebook.  I know my female colleagues are laughing at me, but they all have a purse or bag, so it’s not the same.  I know this isn’t earth shattering stuff here folks…just need to know I’m not alone out here.

Been handed these monstrosities before?  Share your comments below.

A Slushy Winter Wonderland expected at XGM


The joys of winter travel….wait, isn’t it almost May?? Both American and United airlines are already offering vouchers and free exchange for flights today through Monday to Illinois and Wisconsin.  While the brunt of the storm and snow accumulation is expected to happen today, it may cause havoc for travelers tomorrow and Monday as well.  Southwest Airlines is also offering to waive change fees if traveling today or tomorrow to MDW or Milwaukee (MKE).

Most of us have to connect through ORD, but DTW is going to be the best option for Sunday travelers if you don’t have a direct option into Madison.  You could also just wait and see, but the risk is being delayed for hours and/or canceled flights.  I would suggest be proactive and call today.

Madison could get up to 10 inches, making Epic’s campus a winter wonderland for their guests at XGM.  However, it’s going to be in the 50’s on Monday and rain all week…making for a slushy messy week.


Delta reduces how far you can recline…Thank You!


The frequent flyers I’ve talked to this week are happy about this announcement.  Most of us want to work during our flights.  I barely have enough room before my fellow passenger infront of me reclines to the full extent on our 60 minute flight to Detroit. Really??  You need to recline the minute we get in the air? I personally think the only time to recline is on a red eye, when everyone else is sleeping.

Starting April 13th, Delta will change all their airbus A320 planes (60+) to reduce the recline of coach seats from 4 inches to 2 and first class from 5.5 to 3.5.  Doesn’t sound like much, but looking at pictures of it online, it should help with the laptop issue.  If this was legroom, we would have an issue….but not the case here.

What are your thoughts? Are you one of those who recline all the time?  Leave your comments below.

Epic XGM 2019 – How Consultants might Participate


With Epic’s series of Advisory Councils and Roundtables kicking off on April 29th, clients are preparing to send their teams to Verona, WI to share and obtain information with other clients across the country. This time of year I am often asked how as a consultant can we participate and benefit. No doubt these sessions are extremely valuable to Epic’s customers with opportunities to exchange best practices, success stories, and hear from Epic directly on a wide range of topics including upcoming system enhancements. But with attendance limited to clients, how can we benefit?

I had the opportunity in the past to participate in Project Managers Advisory Council (PMAC) as I was leading efforts on an implementation. Typically consultants in PM or Project Director level roles may be able to register to attend as representatives of their client. Rarely are analysts, builders, or trainers given this opportunity. However, your client will no doubt be looking to send teams of resources over the 2 weeks of sessions, and you should be prepared to assist anyway you can.

One way, is to inquire on your clients level of participation (i.e. presenting), and ask if you can assist with pulling those materials together. XGM is meant to be an exchange of information and clients are presenting case studies, best practices, and lessons learned to other organizations. By assisting with developing these materials, you are not only contributing to the event, but will likely receive the feedback from the team when they return. Comparisons to approach and methodologies are essential to keep your skills up to date, so ask to hear how the presentation was received and what variances of success stories where shared by others.

The council and roundtable sessions are application area focused. The number of application groups is pretty impressive and include areas for clinical, financial, ancillary, Oncology, Home Health, Pharmacy, Population Health, Scheduling, Security, and many more. Be sure to go to the UserWeb and find out when your groups event is and inquire who is going from your client (click here for a full schedule). Then based on your focus area, ask how you can learn from those attending. If you are a trainer for example, inquire on who from your team will be attending the Training Advisory Council (TAC). The expectation for this group is usually panel discussions and sharing of materials. Ask if you the materials obtained can be shared when the team returns.

Much like UGM, XGM access is primarily limited to clients. As client partners, advisors, and team members, we all can benefit and learn much from these events. Clients make difficult decisions on who they can send and have an expectation those who do participate will gather information and return to update the teams. You are part of the team…be sure you are updated and educated as well.

Plan to attend XGM or already assisting with presentations? Share your thoughts and comments below.

Time flies by…A quick look at last months HIMSS19 Conference

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Thank you to everyone who has reached out to inquire on my blog status.  Between conferences, client proposals, and various trips…I took some much needed time.  I’m eager to jump back in to weekly discussions and ideas on current trends and activities within our industry as well as some more travel related stories.  Always open to suggestions, so certainly let me know your thoughts.  First, a couple thoughts on last month’s HIMSS19 conference.

HIMSS19 – This year’s HIMSS conference was just as chaotic and exhausting as ever.  Held in Orlando Florida, themes included hundreds of vendor exhibits, cybersecurity overload, and emerging tech in areas of AI, blockchain products, interoperability technologies, and telemedicine offerings.  I thought the most surprising part was EHR vendor signage that called out competitors and were far more aggressive with accusations of misleading statements and favored products.

I lost count after seeing over 30 consultant firm booths ranging in sizes and shapes.  The big guys like Deloitte, Accenture, Leidos, and Nordic had extensive booths that had luxurious furniture, cubicle offices, endless signage with looping videos and dozens of employees.  My firm, and many others, had variations of conference space outside the vendor showroom for client meetings and education sessions.  My favorite is always Epic, sorry…don’t mean to show favoritism, but it’s warm and inviting and fun.

I always wonder about the value of attending these every year.  For me it was first and foremost about vendor education/demos for Epic, Cerner, and Meditech.  Second is catching up with colleagues and friends, hearing what’s happening at their shop and comparing notes to industry trends.  Finally, meeting with clients.  My favorite part of the trip was spending 30 minutes chatting with Judy Faulkner at CHIME.  We spent that whole time talking about how she took care of us (CHB team) during UGM on 9/11 and the ever growing campus in Verona.  I feel fortunate to have that type of access to people at these events.

Check out Healthcare IT News article here for a deep dive into the key note speakers and education sessions.  Did you attend?  Other take away thoughts?  Share your thoughts in comments section below.