Independent EMR/EHR Implementation Specialist
My Name is Rhonda Morgenstern (No relation to Rhoda from the 70s! I am an independent EMR\EHR Implementation Specialist. I have had the privilege of working for more than 20 Health Care systems in the past 6 years.
As an independent consultant serving the EMR Implementation market, my job varies with each contract. I may be called in near the beginning to help with the business needs analysis, usually starting with identifying current state and future state clinical processes. Early or midway I may be called in to develop the training and/or communication plan and materials, often serving as a trainer/educator. I have been involved in determining and configuring the security access to the EMR system, and just prior to go-live oversee the integrated software testing, making sure all works as it is expected to. During go-live I work either on the floor side by side with clinicians and ancillary personnel to help them get through the first few critical weeks on the new system, or in the command center doing triage on the help calls.
BACKGROUND, EXPERIENCE, and HOW I GOT HIRED:
20 years ago I was a pre-med major and graduated with honors. I think my studies and my internal motivation of always wanting to understand processes and how things work were a great springboard leading to this type of work, certainly it has helped me be very good at it. My early career after making the decision not to go to med school (Honestly, I was afraid I might kill someone when I heard about the 36 hour shifts for Med Students!) , was as a biomedical research assistant, where I took to the newly emerging computer systems like a duck to water.
One day our computer support team asked me how one of the programs worked and I realized that maybe I knew a bit more than the average computer user, even amongst academic scientist geeks (and I say this with affection and respect for my former colleagues). It may have been all those hours online at Q-Link and CompuServe (all pre – Internet and World Wide Web). I decided to take a course on computer networks at my local community college, and at the end of my 1st semester I was asked if I wanted to teach there! One thing led to another and before I knew it, I had acquired alphabet soup after my name. I became an MCSE and a CNE (Microsoft Certified System Engineer, Certified Novell Engineer); I also earned teaching credentials becoming an MCT (Microsoft Certified Trainer) and a CNI (Certified Novell Instructor) and even became a certified teacher for the state of Pennsylvania.
I worked two simultaneous careers for a while, both as a technical trainer and network implementer through the dot.com bust at the turn of the century. Throughout, I satisfied my continued interest in biomedicine by keeping up with scientific advances through magazines and journals and staying in touch with my classmates and former colleagues. One of them gave my name to a recruiter who was looking for a consultant who would be able to quickly learn an electronic medical system for a University Hospital System in a pinch for resources. I fell in love with the work; it was a perfect marriage of my interests, skills and experience. I wasn’t a Dr., but I was able to help them do what they do best – even better! And I did the same for Nurses and other hospital – based service providers. In 2005 I was hired as a full time Clinical Applications Trainer. With my technical background, and people skills developed from years of teaching, I was quickly invited to be a participant in other phases of an EMR rollout. I never turned down an opportunity to apply what I already knew in new ways.
DAY IN THE LIFE:
I became a traveling consultant in 2007 and have an absolute ball on each and every assignment. Without a doubt, my sense of humor, innate curiosity, and commitment to leaving a positive impression have served me and my clients well through the often stressful adoption of new EMR/EHR systems. Obviously there is no such thing as a typical day in my world, except that they all require focus on the big picture as well as the details.
The first day at a new client site is always exciting. It is the day you get introduced to dozens of people, many of whom you will not see again, but you rarely know on day one who might be a key resource for you, or who you could end up helping the most or becoming new friends with! Most people are welcoming, and every site has a unique culture. In the beginning it was something I stressed about, always afraid I might inadvertently offend a key player, but I have found that as long as I keep looking for ways to serve above and beyond what is expected, and quickly assess where my efforts will have the greatest impact on helping the client achieve their goals, everything always works out. This of course becomes easier the more experience I accumulate.
My hours will vary depending on the assignment and client timelines. Analyst and training roles typically provide 40 hour work weeks. Analyst and Integrated Testing positions typically are 4 day work weeks, Monday through Thursday, 10 hours each at the client site. Travel is usually Sunday evenings and Friday mornings, though every once in a while I get to work remotely in my PJs! Training jobs are usually 5 days a week, 8 hour days, but often involve evenings and weekends. Activation support (Go -Live!) almost always involves 12 hour shifts, usually with a string of 6 or more consecutive days.
The length of my assignments also varies. Activation support is usually the shortest duration, though they are really so much fun, it’s great to finally be able to see the culmination of everyone’s efforts. Typical assignments are up to 3 weeks, unless it is a large hospital system doing rolling roll outs (How does that roll off your tongue?) which may take months. Training assignments and integrated testing are typically 3-4 months in duration. Analyst positions can run from 6 months to several years.
As an analyst and/or training designer, I may attend meetings with key representatives from various departments within a hospital or Ambulatory practice, gathering information on current workflows and the folks who carry them out. I might spend time translating requirements from the terms the end users use to the technical language the other analysts need. I may spend the entire day at my computer configuring security, or orders, or clinical documents. I may create a training schedule, and training agendas, job aids, or web based training.
Integrated testing usually involves writing test scripts, recruiting and scheduling testers, training the testers on the EMR, coordinating with project leads to find out what functions will be able to be tested when; even with the best project management, software will be software and sometimes things just aren’t ready according to plan and so off to rewrite the scripts I go. I also spend time making sure all supplies are on hand and a good communication loop exists between the results of the testing and the analysts who work on resolving issues.
One drawback to being an independent consultant is that one always has to prime the pump to line up the next gig. So whether its an 8, 10 or 12 hour day for the client, I also spend time each day contacting my networks of recruiters, other independent consultants and consultant contracting companies to let them know of my availability for a new assignment. I may send off my resume to online job posters and squeeze in time for phone interviews (how I get most of my work), or updating my resume. I also spend time each week keeping up with the news on EMR related matters and sharing them with my followers on Twitter. All this “extra-curricular” activity is of course, on my own time. I never divert my attention from the job on site, though sometimes lunch does get skipped. There is no way I could do all this without my faithful Blackberry.
There are many points of entry one can take to get involved with implementing EMRs. The bulk of people involved to date who do not hold clinical credentials have excellent analytical, training, or project management skills along with great computing skills. If you currently work within a hospital or physician practice make sure you show an interest in utilizing the computer systems you currently have access to. Learn the program well, network with not only the IT staff but with other users, be sure to include those with different job functions. Make it a goal to start offering tips, tricks and encouragement to others. Demonstrate your skills at every opportunity and show that you are motivated to help get the most out of the systems.
If you are hoping to transition from a field other than healthcare, working your social network may bring opportunities. You can start submitting your resume to 3rd party consulting companies who can sometimes help sell your skills and ability even though you do not yet have direct experience, or it is limited. You may also want to explore 1st gaining entry through one of the EMR Software vendors – check industry sites for rankings and size.
Recently there have been a number of certification (American Health Information Management Association (AHIMA)) and college programs ( University of Illinois – Chicago, Northwestern, and Drexel) launched to ease career transitions and the government has even provided funding. Check out the excellent resource section on Healthcare IT Central as a starting point. It may take some time and effort, but the opportunities are going to be rapidly expanding over the course of the next few years (see the Bureau of Labor statistics occupational outlook http://www.bls.gov/oco/ocos103.htm)
My final word of advice is a reminder and a summary of my approach.
EMR adoption is not primarily about technology adoption (though you do need to have expertise in best practices), the biggest challenge is change, big change. The better you are at articulating the true benefits that each person you interact with will experience directly, on a day to day basis, the more successful you will be in your career.
Everyone knows the media and governments marketing mantras of EMR Benefits, and though important, they are big picture goals that many have difficulty relating to. All levels of Hospital and Ambulatory practice personnel need to be guided with the certainty that their work lives will improve once they go through the initial awkwardness of all the changes.
One of the reasons for my success has been that I never forget what truly occurs through the implementation process. People go from being experts sure of every move in their day, to novices on Go-Live day. The main job of the EMR Implementation Specialist is to get everybody back to being experts more quickly than they anticipate.