Independent EMR/EHR Implementation Specialist

RHONDA MORGENSTERN
Independent EMR/EHR Implementation Specialist
Philadelphia, PA

Rhonda Morgenstern
INTRODUCTION:

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.


JOB DESCRIPTION:

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 TwitterAll 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.


CAREER ADVICE:

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)


FINAL THOUGHTS:

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.

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20 Comments

  • Rhonda,

    What a fantastic overview of a job that so many aspire to! It’s very difficult to sum up a position such as yours, where you are called upon to be such a Renaissance woman – thanks for sharing your life with those of us who wonder about it!

    What’s next on your agenda? Are you living your dream or is there a new mountain you’re hoping to climb?

    G.

  • Hi Rhonda,

    Enjoyed reading your blog. I am looking for an EHR Implementation Consultant for a project we have in Baltimore, MD. Bulk of the work can be done remote with some frequent trips to my area – easy train ride to Penn Station (smile). I’d like to chat with you… email me then I will pop you my phone number. I’m always online so don’t be shy ;-)…Yes, I am real…not a BOT or SPAM

  • Hi Rhonda,
    Thanks for sharing. I am undergoing a government funded training program for the position of Implementation specialist. But once concern is that …..travelling and odd work hours… is there any scope of working like any regular job 5 days a week 8 hrs a day….

  • Hi Rhonda,

    Thank you for sharing. While I love working on a consulting basis, I don’t think people realize how much effort is involved in constantly lining up new clients 🙂

    Andre

  • Hi Rhonda, I have not forgotten about you. I wanted to reach out and say “hi” and thank you again for traveling to Baltimore and helping us with our HIT/EHR client engagement meeting. We have picked up alot of HIT related work and I will be contacting you next week to discuss.
    Amy Coleman, EVP CoVet Solutions

  • Thanks Rhonda – That is a very in depth description of those of us who make our living as independent healthcare IT consultants.
    The need for a very broad skillset is often under addressed, and even more often under appreciated. Most folks going through an implementation don’t (and probably couldn’t) appreciate the benefits of having someone on the implementation team who can configure both the back and front ends of a system and address issues as they pop up.

    Like Andre, my issue over the last 20 or so years has been one of feast or famine – we spend fully 1/3 of our time developing the next project, often with large gaps in between them.

    With so much emphasis on healthcare IT in the last few years, our ability to drive new projects has been severely diminished. We find ourselves competing with a wide variety of vendors, many of whom are in it purely for the the profit, which may make the pain of EMR/EHR much more difficult for the client.

  • Rhonda,
    Thanks so much for sharing your journey. My background is both clinical and administrative in healthcare as well as IT with focus in Information Assurance and Security. I am looking for my “foot in the door” as well so your suggestions have been very helpful. I have signed up for that certification through AHIMA and been checking on EMR/EHR vendor options as well. Thanks also for laying out the real deal of what your day looks like in this world.

    Healthcare has been my passion since age six and I was planning to go to Med School myself but opted to take a different route. Now working on my PhD, I am hoping to very soon combine my Health, IT, and Security skills and shaping my career journey to effectively assist and lead my clients into the successful implementations as well. Great information!!!

  • Hey Rhonda,

    Thanks so much for sharing. I am just starting out in the EHR field and will be starting a Health Information Technology program at a local college here in my area. Do you have any advice for those of us who don’t have the experience you have but want to follow in your footsteps.

    Thanks again for all your sharing.

    JB

  • Hi Rhonda,

    I just read your success story and I am so excited about your success in the E H R and E M R implementation.
    My name is Charles Ukah and I am pursuing my Masters in Health Informatics at the University of Maryland University College. I also have a certificate in Medical Billing and Coding. I am keen on working in the field of health care software implementation, more specifically EMR/EHR implementation. Hopefully, after I graduate I would like to work as an implementation manager for a Health care company. I am looking for internships or training programs across the United States where I can gain some experience in the implementation process. I believe with your experience you are in a better position to advise me .

    Your suggestions will be appreciated

    Charles Ukah

  • Hi Rhonda,

    I enjoy reading your article. I completed the HIT program in NY. I will to speak you. e-mail me and I will pop my number to you. I am real dont be afraid.

  • Hi Rhonda,
    Just read your article and I found it very helpful. I am about to interview for an EMR Implementation Specialist job in NY. Do you have any tips for the interview. I’ve gone through four different Go-Lives but with hospitals. This is a company that supplies the systems. Thanks for any tips or helpful hints, if you have time.
    Audrey

  • Hi Rhonda,

    Thanks for sharing your article, it is a true motivator for me. My name is LaToya W and I am currently pursuing my MBA and have over 13 years of healthcare experience. I work as an EHR/CPOE Senior Clinical Analyst for HCA and prior to joining HCA, I designed Laboratory Information Systems. During the CPOE implementation and dictionary building process, my main focus was not to focus on what the system won’t do, but what I can make the system do. I spoke with a physician who has a Free EMR system (Mitochon) and he recommended that I become an independent contractor for Mitochon and implement templates and training to physicians and their staff. I thought to myself, “I do that now for HCA”. The thought never crossed my mind to work for myself. But after reading your article, it has encouraged me to step out on faith and give it a shot, doing something I enjoy. I have taken the first step by signing up for training and have also setup an account to access the system for hands on practice so I can learn how to maneuver around in the system. Any advice or helpful hints would be greatly appreciated to help me get started and strive for excellence.

    Thanks Rhonda for your inspiration and letting me know, it can be done!
    LaToya

  • Hi Rhonda,

    Thank you for sharing your work experiences and I am into EHR field since last 4 years as Clinical Content Specialist for one of the CCHIT, MUG passed EHR vendor. I am planning to move to implementation verticle, your article gives me a constructive insight. Thanks a lot for your tips and hints.

  • Hello Rhonda,

    My name is Tammie I came across your name on a blog. I am very interested in learning more about EPIC implementations. I have a masters degree in information technology and has been if the field since 1997. I have my MCP and Oracle Certification but have been looking for ways to get EPIC certified. From what I can see, you have to get hired by EPIC and they send you through training. Do you know of any independent trainers or if not, how do you suggest I get my foot in the door?

    Kind Regards

    404-384-5782

  • Thank you very muh for putting this into prospective. I have been a nursing student for the past 2 years and ever since i have came across health informatics i found myself extremely interested in it. Recently i have made the decision to pursue HI fulltime and put my RN goals on hold until i am finished with this degree. Next goal is to start networking with IT people and others in my hospital (i currently work in the ER). I will continue to read these blogs, they are very helpful.

    THank you

    JP.

  • Reading this just solidifies my interest in pursuing a career in the HIT field. I have a Bachelor’s degree in Computer Information Systems with 15 years of experience ranging from Desktop Support to Training to Programming and have struggled for some time now trying to decide what direction to take my career. I have been reading about the HIT Grant offered through the Community Colleges and believe I will sign up for the ‘Implementation Manager’ courses. I thoroughly enjoyed reading your synopsis of the field and appreciate your candidness on the topic. I am nervous about a change but excited as well. I will continue to follow your blog and appreciate any other advice you can give. Thank you and I look forward to seeing what doors God will open for me!

  • Hi Rhonda,

    Excellent glimpse into your lifestyle, and it does sound as much a lifestyle as a career! I have just made the leap into healthcare IT after 15 years of general IT employment. My focus has been on HL7 interfaces from the hospital side, but am about to transition into a vendor specific role as EMR specialist. My question is this: how do you go about getting knowledge/skills for other vendors’ EMRs, without having access to the software?

  • Hello Rhonda,

    My name is Annette Spears I saw that you are doing support for consulting group. I would love to do support. I work at Tampa General as a System Analyst but my heart it not in it. I was working at Cincinnati Childens with a support team and I love it. Can you please tell me how I can get in to support. I have 5 year of Go-live experience I’m also A trainer for ADT perlude and Ambulatory certified with some build experience. I Currently work with Transplant right now.

    I woud be greatful with any information you can give me.

  • Hello Rhonda:

    It was so refreshing to read your blog as I have been drifting on my journey to become an independent EMR consultant. I have been searching for new entry points into the healthcare IT space after experiencing some career derailments and an unsuccessful attempt to become Epic Ambulatory certified. I didn’t have a plan B in place as I never saw failure as a possibility, but it happened in October 2012 when I fell short of passing the AMB 400 exam by 5 points. Since my hire was contingent on achieving the certification, my job ended after 6 months and my recovery has been a painstaking reality since then.

    I am now attempting to employ the certification training that I obtained both from Epic and the ONC’s workforce development program. I have also been evaluating the benefit of acquiring a PMP, but had been hesitant because I had major test anxiety from the Epic experience, which I saw as the chance of a lifetime.

    Looking for ways to leverage the certification training with my healthcare background has been a major challenge because the market requires build or project management experience. My healthcare IT background is a combination of trainer and user support as a non-clinical superuser following the implementation of Cerner at my organization. My job classification fell under clerical/administrative support with primary responsiblities for documentation such as creating templates, forms, typing policies and procedures, but like you, I was more drawn to how my unit could optimize EMR technology in our operation.

    Would you have any suggestions on how I can get involved with projects related to meaningful use, go-live or implementation support, learning and development documentation etc. where my skills can transfer? It was truly encouraging to read of your journey and only wish I could mind stretch my aptitude to your altitude!

    I would really appreciate your feedback.

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