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.

Client demand in Managed Services continues to grow.  As consultants we have to ask ourselves, are the deliverable oriented solutions we are supporting meeting our client’s expectations?  Are we providing service line agreements and resources that align with overall budget/costs?  It’s a challenge that I’m excited to be leading and supporting.

Most of us are seeing a demand for long term managed services that improve quality of support and reduce costs.  With continued resource constraints and retention issues, outsourcing provides clients with a different staffing and support option.  Here are some areas of growth that you may see this year and have engagement opportunities to support:

• Help Desk Services
• Legacy Support
• EHR Remote Application Support
• System Upgrade Managed Services
• Report Development and Maintenance
• Affiliate System Management

Regardless of what firm you are working at, almost all of the major players are already in this space.  As a consultant, opportunities to support clients 100% remotely, and long term, is enticing.  I think our responsibility to is ensure we understand the client’s expectations on deliverable outcomes and improved services first.  Then we have to think about cost models, usually fixed fee, and how that plays out.  Support resources are needed from Project Managers to analysts to trainers….which means we all have an opportunity for long term contract support work.

I know there are many of you out there that will say you don’t want to give up travel and you like the variations of contract to contract.  This type of staff aug support will continue in all vendor spaces…so you have options.  After being on the road for 15 years, I personally know that many will be eager to grab remote opportunities.  We might shed a tear over lost status on Delta or United, but its a small price to pay.

Are you currently on a remote engagement?  Seeing other lines of solution offerings?  Share your thoughts in the comments section below.

No one can say for sure how long this is going to continue.  The government shutdown is now officially in day 18.  Areas mostly impacted so far are National Parks, but over the weekend stories broke out of TSA agents calling in “sick,” creating a serious issue for airport security.  I just saw online this morning that my local airport is seeking temporary part time TSA staff.  Those of us who all travel weekly may be in for some serious delays starting this week.

This shutdown isn’t just TSA agents, its also traffic control staff.  If appropriations aren’t agreed upon by tomorrow, about 10,000 air traffic control resources will not get paid.  Additionally if you’ve applied for Global Entry, their offices are closed.  So no processing of applications or interviews being conducted at this time.

The good news is that about 10,000 air traffic controllers who work for the Federal Aviation Administration and about 51,000 Transportation Security Administration officers have been told to keep reporting to work.  But I would still be proactive.  I fly out tomorrow.  I’ll be arriving to the airport much earlier.  I can’t find any information on impact to Pre-Check or Clear lanes.  I have to assume priorities have to go to the larger group of travelers, so I won’t be surprised if Pre-Check is closed.

Anyone seeing any impact yet?  Share your experience in comments below.

I really enjoy watching the old classic Christmas specials.  I think Santa Claus is Coming to Town is my all-time favorite, and love that both Mickey Rooney and Fred Astaire lend their voices.  While watching Santa, Rudolph and Frosty this past week I noticed that they each had a character or two that made their jobs much harder.  Similar to some engagements we’ve all had, there is always that one person who makes our job more difficult.  Is there any lessons from the Christmas specials that we might apply to our job?  For those of you who know me, and my fixation with Christmas, I think there are several lessons we can apply for sure.

The young Kris Kringle only wanted to do his job by delivering toys to the children of Sombertown, but Burgermeister Meisterburger made toys illegal.  Doesn’t it seem like there is always someone trying to block you from doing what you need to do at work? Thinking creatively to find a solution is imperative to our success.  Santa takes the advice of a penguin to deliver toys down the chimney.  While he is discouraged several times, his song, “Put one foot in front of the other…”motivates everyone to take on the challenge and get those toys delivered.

Professor Hinkle is a classic bad guy who we all have had to deal with.  He had a magic hat, a wonderful tool that brought a snowman to life!  He was failing at his job as a magician and never knew how powerful his hat was until the children put it on Frosty’s head.  Hinkle later says, “if that hat has magic, I want it back.”  Isn’t it so typical to see that one guy at work only want to take credit after you’ve shown others the capabilities of the tools we are supporting? I think we have an opportunity every day to help the Professor Hinkle’s of our daily lives realize the potential of the tools that are sitting right in front of them.  Transfer of knowledge should be our number one focus at any client.

Have you ever been put in a role that you weren’t fit for?  Rudolph’s pal at the North Pole, Hermey, struggles with his job of making toys. It just wasn’t really his skill set.  The Elf manager finally does a great job later realizing they could use an Epic Wisdom expert and moves Hermey from the toy maker department to Dentistry.  We should all look at our teams and make sure we identify the strengths of each member to ensure best possible outcome and quality of the delivery of services.  I would love to go on with Rudolph, the Island of Misfit Toys alone reminds me of so many engagements over the years.  I’m kidding!!

Thank you to all my readers, we will see you in 2019.  Happy Holidays to you all and have a wonderful Happy New Year!

A recent posting of mine on LinkedIn has over 16,000 hits, 550 of them are from recruiters.  I am shocked to see there are even that many recruiters in the industry.  Imagine for a moment how competitive their world must be, and just think of all the calls/emails inquiring on your availability you might be getting.  Some are valid, some are fishing for information, and others are just a waste of time.  Let’s talk about some key areas that can help you decide what recruiters to work with.

First question that pops into all our minds is, what is the role or opportunity?  It can be so frustrating to get inquiries from recruiters for roles that don’t align with your skill set.  I see it every single day.  For example, your profile on LinkedIn clearly states you are a patient access and revenue cycle application builder.  Yet you get a call asking if you are interested in a clinical documentation training role.  Or for me, I’m listed as a member of leadership but I get emails asking if I’m interested in go-live support roles.  My philosophy is simple…if the recruiter can’t align my skill sets with opportunities, they are not worth talking to.

In an ideal world any recruiter will have full details of the client and opportunity, but in the real world that is rather rare these days.  Due to the competitive nature of recruiting, you likely won’t get the name of the client, just a region of the country.  I’ve often been asked, “Is this role being filled by your firm?”  The nature of the business is that many roles are being offered to multiple firms.  The client is looking for the best resource at the best rate.  I’ve written several articles on duplicate submittals, so be careful here.  Recruiters that are honest and forthcoming as possible are the ones you want to work with.

Many firms, especially this time of year, are building up there databases for upcoming potential projects.  We can’t assume a recruiters call means there is an actual immediate need, they may be doing proactive recruiting.  I personally like these conversations.  This is how you can hear about major implementations coming up and/or variations of potential engagements that you can align yourself with.  For example, we know a client in Illinois will be kicking off their Epic install in early 2019.  As a recruiter they’ve been asked to create a list of candidates who will be available and are interested.  Don’t write off a recruiter because they don’t have an immediate need. Get your name out there.

If you’ve read my blog before, you know I’m not a fan of signing right to represent agreements.  This can be tricky, and may inadvertently block you from being submitted from the firm that actually won the business.  When working with a recruiter who is asking for this, I suggest expressing your concerns.  Knowing that there are going to be other firms and recruiters calling for the same role, locking yourself into one firm may not work out for you.  An example I’ve seen over and over is a firm calls who bid on a proposal and is proactively creating a candidate list.  You sign a right to represent only to find out later the firm was not selected.  You turned down those other recruiter inquiries and now are stuck.  My suggestion is don’t sign unless you have confirmation that the firm has been selected and will be directly submitting you.

You should look into the firm they are representing.  Have you heard of the firm or know people who work there?  I often will look up the firm on LinkedIn.  From there you can see a brief summary of the company, how big they are, but most importantly…who you are connected to that works there.  I often reach out to those connections to ask them about the firm.  Take some time to look at the firm you may be considering and not just the role or opportunity being presented. While I know those of you who are project based and/or 1099, this isn’t as important…I do think it helps determine the legitimacy of the recruiter calling.

Lastly I do have to talk about competency of recruiters.  Just like any job, there are newbies who are aloof, have little to know understanding of our industry, and don’t know the difference between Cupid and Radiant or Grand Central and Bones.  Working with a new recruiter can be frustrating.  I don’t think there is anything wrong with stating that you are interested in the role and the firm but would prefer to speak with someone who understands the requirements of the role better.  I’m not going to walk away from an opportunity just because the recruiter is new or doesn’t speak perfect English….just ask to talk to someone else.

We all have different experiences in working with recruiters.  There are so many recruiters who have been doing this for years and are very knowledgeable, personable, and professional.  Unfortunately we don’t know which we are going to get, but we do know we can choose who we work with.

Have other areas you consider when selecting a recruiter? Share your comments below…

Having the opportunity to travel to a client the week of Thanksgiving, I worked myself all up to be in for endless lines of families with luggage the size of my car, delays, and miserable people everywhere.  I mean traditionally, I’ve always found Thanksgiving week impacts everything from traffic, to restaurants, to security…and well, pretty much anything to do with traveling.  Then there’s Black Friday which alone rises images of mothers fighting over Cabbage Patch kids (…I may be dating myself there).  My question here is what happened?  Perhaps my fears were based on the the stories you read about or see on the news. I know they always show those famous airport shots of millions of people.  Not the case this year.

Let me share my travel experience with you.  When I arrived at the airport the Sunday before Thanksgiving at 12 noon, it was empty.  I parked my car on the first floor right in front of the door. There was not a single person in the TSA pre line.  I had a quick lunch at Legal Seafood where I counted maybe 10 people in the entire place.  I was upgraded to first class 5 days before and noticed a lot of empty seats on the plane.  This all made me wonder, are my fears unwarranted?

My return flight was Tuesday evening from St. Louis to Detroit to Boston.  I was sure that I would run into giant crowds and delays on this trip home.  Surprisingly relatively normal mid-week volume, minus the business suits.  I landed at 1am in Boston and noticed a lot of cars waiting to pick up passengers, but it didn’t create any slowdown for me.  In fact I was out of there in record time.

I have to say, my travel experience was so pleasantly surprising.  I wish every week of travel was like this. As for Thanksgiving, it was a total success…and I personally avoided going anywhere on Black Friday, so I may have dodged a flying doll or two by staying away.  🙂

What about everyone else?  How was your Thanksgiving travel this year? Leave your comments below.

Most of us would love an engagement, from time to time, that takes us off the road.  The benefits of work life balance and increased time at home with family is significant. Not to mention being able to work in your pajamas, if you so choose, is enticing to some.  The question I hear often is why the hourly rate is so much lower for a remote engagement.  Below are my thoughts on what you may be facing when looking at remote project support roles.

Let’s start with the basics associated with the sales side and bidding on business and negotiating bill rates.  When positioning cost to the client, firms take many different aspects into consideration.  These include; skill set needed, level of expertise, years of experience, specific deliverable expectations, duration of contract, location of contract, required margins, and yes…is there remote opportunity.  From a sales perspective firms take these requirements and look at market value while trying to find opportunities to be competitive in their pricing.  The idea of working remote saves the client on costs related to travel for sure.  Knowing that working remotely is also appealing to consultants gives the firm another option to reduce cost to the client by cutting professional service fees as well.

Positioning the up side of working a remote project often falls on the recruiter.  They also have the challenge of getting you to agree to a lower hourly pay rate.  Just like a full time job at your local hospital, your annual compensation would be reduced as you are not traveling long distances every week and away from home during off time.  The answer to the question is simple, your hourly rate takes travel and time away from home into consideration.  You can expect an average of 10% reduction in hourly pay for remote work…which really isn’t bad at all.  So if you are used to making $95, you’ll likely be offered $85 for remote work.

Not everyone has this happen to them.  However, I believe it’s become more the norm to meet the demands of the client.  Take a look at the example below to see the big picture.

EXAMPLE

There are a lot of opinions on what is impacting project costs when using an outsourcing firm.  Without a doubt, as quality of delivery becomes a major focus for firms, clients will continue to look into remote options.  The trust of quality is there.  Moving forward you’ll see more opportunities presented to you that will be remote, but like come with a lower rate.

Have you take a lower rate for remote opportunities?  Leave your comments below.

I’ve seen a consistent increase in the request for contract to hire positions this year.  Firms are adding language to their service agreements to allow clients to extend an offer for permanent full time positions to consultants after 90 days of contracting.  Clients are using firms to find resources who are open to relocating and becoming a full time employee of the hospital.  It’s really a win win scenario for both the client and consultant.  The question is, if you accept a contract to hire role…do you have to accept the full time position?

I suggest candidates take these types of offers seriously and not waste anyone’s time if they are not truly interested in relocating or taking a reduced salary.  Too many times I see candidates begin the interview process but when it comes time to accept the offer, they turn it down.  Realize that these opportunities are meant to fill a permanent position and will come with a salary associated with being a FTE, not a contractor.  My suggestion is ask right away the terms of employment including relocation reimbursement (if any), firm to client transition time frame agreement, and expected salary.

That first 90 days is the time for you to begin planning your transition, including relocating.  Terms of your employment are typically agreed upon prior to you starting.  Timing on the transition may vary based on the firm’s agreement with the client.  Typically it’s 90 days, but may be less.  Regardless, once you’ve accepted and started, it is expected that you will accept the terms of employment and become a FTE at the end of agreement.  So my advice is simple…do not accept a contract to hire role unless you are 100% committed to accepting the full time position.

A couple more thoughts on variations of contract to hire.  Not all hospitals will make a full time offer before you start your contract.  In fact, many won’t offer information on salary prior to starting either. That first 90 days may be considered a trial period to determine if your skill set aligns with the position.  Your firm should know this is the expectation ahead of time, so you are fully aware a full time offer may not result from the contract.  You should also know that it is becoming more common to hear from clients that they want direct to hire candidates.  That situation obviously is much different…but worth mentioning.

Have you taken a contract to hire position?  Share your thoughts in the comments field below.

Our industry has several organizations that are focused on professional development, networking, and innovation.  Understanding these different groups and how your firm participates can greatly improve your awareness of industry trends, various client initiatives, upcoming projects, and other opportunities.  I’ve selected three that you should be aware of and understand how your firm’s involvement may help you with future placements and project support work.  Let’s take a look at CHIME, HIMSS, and MGMA first.

CHIME (College of Healthcare Information Management Executives) The College of Healthcare Information Management Executives (CHIME) is an organization created to serve the professional development needs of CIOs working in the healthcare industry and to promote effective information management within that industry. CHIME meets these objectives through networking and education opportunities as well as partnerships with health information technology vendors and service firms. The organization was formed in 1992.

More than 1,400 health care CIOs are currently members of CHIME. According to the organization, its members come from hospitals, clinics, physician groups, government agencies and health information exchanges, and their responsibilities include telecommunications, medical records and information services. CHIME members also often serve as chairpersons for IT steering committees.

CHIME’s current advocacy initiatives include helping CIOs implement the hardware, software and security measures necessary for digitizing patient records, which is one requirement for achieving the meaningful use of electronic health records (EHR).  CHIME’s Fall CIO Forum is being held in San Diego from October 30th – November 2nd 2018.

HIMSS (Healthcare Information and Management Systems Society) The Healthcare Information and Management Systems Society (HIMSS) is a nonprofit organization whose goal is to promote the best use of information technology and management systems in the health care industry.

Founded in 1961, HIMSS provides a forum for collaboration among the various stakeholders in health care IT, using advocacy, education and collaboration to further its mission. Its membership base of more than 44,000 individual and 570 corporate members includes health care providers, students, IT vendors, consultants and other stakeholders in the health IT industry. HIMSS currently focuses its attention on health IT topics such as electronic health record systems, HIPAA security and privacy provisions, software interoperability and technical standards.

HIMSS produces an annual conference that brings together health IT stakeholders for several days of education and networking. The organization also offers a research arm known as HIMSS Analytics and a philanthropic group known as the HIMSS Foundation.  HIMSS 2019 Annual Convention is being held in Orlando from February 11th-13th.  Regional conferences and events happen monthly.

Medical Group Management Association (MGMA) is a key element in perpetuating success throughout the healthcare industry. The organization provides resources to initiate change and drive results. With exceptional peer-to-peer and mentor-to-peer support systems as well as abundant hard-copy and digital resources, MGMA is spearheading the path to healthcare advancement. They are well known for providing members with consistent expert resources and solutions that include, but are not limited to:

• Educational collateral and certifications
• Success strategies for students, healthcare practices, and employment needs
• Innovative ideas and networking events
• Expertly compiled benchmarking data and statistics
• Access to industry experts and thought leaders
• Information and materials for making your practice more successful and profitable

There are several others that you may hear about.  Health Connect Partners (HCP) focuses on areas including IT, Pharmacy, Radiology, and the OR (Read More).  The Institute for Healthcare Improvement (IHI), provides insight and partnerships focused on health care improvement worldwide (Read More).  And Academy Health hosts its annual Health Datapalooza which is a large conference which exists to promote access to open data in the United States for the purpose of improving public health. 

As a consultant, we all should be aware of our firms participation and/or sponsorship of these organizations.  Let’s be honest, the primary reason for a firm’s involvement is expected return on investment by identifying new clients, building relations, and showcasing capabilities.  That directly impacts you and your future opportunities for placement.  You could be a self promoter by sharing with your client how your firm supports these organizations.  Additionally you could be asked to represent your company…so always be aware of your firms involvement.  

What organizations are you or your firm a member?  Share your thoughts and comments below.

Monday is Columbus Day.  A recognized federal government holiday where all federal offices and banks are closed.  However, it is not recognized in 27 states.  Interestingly enough not one west coast state celebrates the holiday while all of the east coast states minus Florida, New Hampshire, and Vermont do.  Then we have states that use the same day for other holidays.  South Dakota has Native Americans Day and Hawaii has Discoverers’ Day for example.  Both are official state holidays. Every year I am asked the same question, “Do I get the 2^nd Monday of October off as a recognized holiday.”  Sadly, the answer is no for most consultants.

There are 11 federal holidays which include; New Year’s Day, MLK Day, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving, and Christmas.  Hospitals often provide these but allow for a “float holiday” to be used on any day.  If you are in one of those 27 states that does not recognize Columbus Day you are out of luck.  However the list may also contain various religious holidays like Easter or Yom Kippur, which is a public holiday in Texas by the way.  There are several state holidays to consider as well.  Massachusetts and Maine celebrate Patriots Day for example.  I strongly encourage you to ask your firm and your client for a complete list of recognized holidays.

Regardless of all these variations of holidays, you should plan your travel around the client’s expectations for their full time employees.  While being a consultant who lives in another state may warrant you wanting the day off, I suggest you follow the client’s normal process. Ask well in advance…and plan accordingly.  Even for those big holidays like Christmas…is the day after or day before recognized?  Are you required to travel if the holiday is mid-week?  These are all things you should get clarified well in advance.  IT offices don’t shut down in hospitals, ever.  You may be asked to work on those holidays you would otherwise expected off.

Have you ever thought you had a holiday off but didn’t at a client?  Share your experience in the comments field below.