One-on-One W/Beacon Partners CEO Ralph Fargnoli (I)

As hospitals of all shapes, sizes and complexity sprint for HITECH dollars, many are looking at consultants to fill gaps in their healthcare IT intellectual capital repositories. Offering everything from system selection expertise to contract negotiation to temporary staffing augmentation, many organizations won’t best Meaningful Use without outside help. To gain insight into just what type of work is being requested, healthsystemCIO.com editor Anthony Guerra recently chatted with Beacon Partners President and CEO Ralph Fargnoli.

BOLD STATEMENTS

So what we see is hesitancy in organizations, because they really have to first take a look back at what they put in place for strategic plans before they look forward.

… you have to consider whether these organizations have the resources to get certified, and that they won’t just become another victim of a merger or acquisition, and then all of a sudden be sunset.

… if you stop education and you stop support of these systems, physicians just won’t use them. They’ll find an excuse not to use them.

GUERRA: Over the last three months, why have most clients engaged you?

FARGNOLI: What we’re seeing is definitely a move towards strategic work. Clients are trying to understand how this stimulus money is going to impact their organization, and how it impacts an IT strategic plan or a business plan that’s already in place. We are also seeing the need for staff augmentation, especially in the fourth quarter of last year. And the other thing that I find interesting is assessment work. Assessment work in a sense of, “I have existing systems, I have these legacy systems, or I have some new systems, what directions do I need to head in, and do you think the system can meet the Meaningful Use requirements, or should we move to a search and selection process,” and so forth.

GUERRA: So people don’t just need help with implementation, but system selection too.

FARGNOLI: They’re saying, “What do I do with what I have, and should I go forward,” and I think they’re looking not only in terms of the systems in place, but also from a resources standpoint. So it’s the resource planning and budget planning. It’s the vendor perspective. It’s a combination of all those things, and then hopefully that guidance can help them get off the ground with the project and point them in the right direction.

GUERRA: Can you give me a better idea of your service offerings?

FARGNOLI: Our main focus has always been in the IT market, and when I talk about IT, our company is focused on the strategic planning and use of IT to support the business goals of an organization. So we work with organizations to develop a plan by looking at the financial goals, patient access goals and then we determine the IT tools that you need.

The other things we focus on are staff augmentation and project management. So we’ll provide employees, if you will, to a client organization, either to help them implement a new system or support an existing legacy system — that’s a new trend in the market. The new trend is that the consultants come in and run the old stuff while my employees, speaking from the organization perspective, focus on implementing and learning the new system.

The third thing we do is what we call operational performance improvement, where we focus on workflows, patient access flow, accounts receivable and revenue cycle work. So we cover a gambit of services. We used to be just an IT firm, but now our perspective covers consulting services to support the business operations of these organizations, whether it’s in clinical areas or the business operations areas.

What we are not is a headhunter firm; we’re not a staffing firm. So we’re not just going to find people for organizations and put them in there. All of our consultants go through a training process, and we have high expectations of them.

GUERRA: Do you have any protocols in place that prevent customers from hiring your people?

FARGNOLI: In our contracts, we insert language that says, “We agree that for a year or eight months that neither party will hire from the other party without agreements to that move.” It’s a tough situation, but we try to say that we won’t hire from a client people who have worked specifically on the project that we’re engaged to do. So we try to narrow that down and the clients usually like that. So it’s reciprocal.

GUERRA: If you don’t take those precautions, the hospitals might hire away many of your consultants, correct?

FARGNOLI: Right, so we make it reciprocal, it’s a balanced agreement, and we find all of our clients appreciate that.

GUERRA: What about Meaningful Use is giving providers most concern?

FARGNOLI: I think it’s actually putting their arms around the whole Meaningful Use concept and getting a sense of what it’s calling for. You have to be looking towards the future, and when you look at the future, you have to worry about vendor sustainability issues, you have to worry about governance and communication. A lot of it is for dollars and cents that will come in 2011-2013.

So what we see is hesitancy in organizations, because they really have to first take a look back at what they put in place for strategic plans before they look forward. We’ve really put together a roadmap that gives them a clear path to identifying the challenges of meeting Meaningful Use and pointed out what we call speed bumps. The speed bumps are those items that you have to avoid on any strategic plans.

GUERRA: What are some of those speed bumps?

FARGNOLI: They have to do with the pace of adoption already underway in an organization.

It’s important to ask, “Are your physicians cooperative, are they participating — with champions — to adopt the IT strategy? What about governance; how will these organizations govern the ARRA strategy across all levels of the organization? Is the leadership fully invested in the plan or are you moving toward organizational chaos?” And then the whole HIE concept, such as, “How are we going to align our community physicians so that we’re competitive in the market, so that we won’t lose market share?”

GUERRA: Let’s talk a little bit about sustainability. An IT plan can look wonderful on paper, but may not be sustainable because there are interfaces all over the place connecting disparate applications. What are your thoughts?

FARGNOLI: It’s becoming clear to organizations that sustainability of these EHR systems is something they have to consider very seriously. First off, the healthcare market is highly fragmented with many, many vendors. So you have to consider whether these organizations have the resources to get certified, and that they won’t just become another victim of a merger or acquisition, and then all of a sudden be sunset.

The other thing is that when they adopt these systems, we’re seeing they have to add another 10, maybe 15 people to the IT staff. And this is for supporting the education, training and change management issues that go along with these advanced clinical systems. So yes, I don’t want to call it a budget buster, but I would say they need to take into account some changes in their budgeting philosophy and what they should expect when adopting these systems if they hope to make them highly utilized. Because if you stop education and you stop support of these systems, physicians just won’t use them. They’ll find an excuse not to use them. It’s a big part of any assessment we do.

Part II