healthsystemCIO.com Survey Finds More CIOs Turning To Consultants

As hospitals and health systems scramble to attest for Meaningful Use Stage 1 and begin gearing up for Stage 2, the need for outside help is constantly growing, and just under half of CIOs plan to take advantage of consulting resources, according to the February healthsystemCIO.com SnapSurvey. Specifically, 46 percent say they will spend “a significant amount” on consultants, with Meaningful Use identified by several respondents as a driving force, while 54 percent are opting to leverage internal resources. Of those who are seeking outside help, 62 percent cite a “lack of resources or experience in my organization,” while others cite the need for specific experience with a particular system, or the need for more helping hands within the organization.

Interestingly, the majority of CIOs (69 percent) say they haven’t had to forego outside help due to a lack of budget, and that it has not been more difficult to obtain approval for consulting dollars than for the software investment. The survey also found that 58 percent of CIOs believe that “smaller organizations are at a disadvantage” to qualify for Meaningful Use “due to their limited ability to bring in consulting help,” with some respondents noting that allocating dollars for consulting means having to spend less in other areas. Others, however, contend that smaller organizations also have less complexity, which can help facilitate quicker decision-making.

(SnapSurveys are answered by the healthsystemCIO.com CIO Advisory Panel. To see a full-size version of all charts, click here. To go directly to a full-size version of any individual chart, click on that chart)

1. Have you recently, or do you plan to, spend what you would consider a significant amount on consulting resources?

Yes

• We are getting ready for a complete replacement of our best of breed platform.
• We hired multiple consultants to help us install and support applications to get to Meaningful Use.
• We just performed a conversion for our clinical and revenue cycle systems at four hospitals. We augmented our staff with resources from our vendor but also spent a significant amount of consultants. We are now winding down from that.
• We spent money on CPOE readiness and that has ended up not being the most critical issue with Meaningful Use. The electronic delivery of e-measures and discharge instructions and patient records is the biggest issue.
• Mainly vendor supplied implementation and project management resources.

No

• Surprisingly, we are not spending a lot on consulting, even though we are implementing Epic.
• Funding is very tight and presently there is no money in budget for consulting services.
• It depends on the hospital’s ability to hire and support technologically qualified full-time IT staff.
• Not significant but a lot more than in the past on special needs
• We did, but it was before HITECH kicked in, so we were able to find qualified resources at a reasonable cost.
• We do not have the funds available for external consulting services, so we rarely use them unless we have been able to get grant funding for specific projects that allow us to use consultants.
• We have in the past, but we are well along the path to MU now.

2. What is the primary reason for having to seek out external help?

Lack of resources/experience in my organization

• It is usually a bandwidth issue and not necessarily a knowledge issue for us.
• We have a growing IT department — timing with the ongoing/expanding requirements of HIS projects.
• Project management time and physician support at go-live.
• It is usually related to special projects
• The number of projects is starting to take its toll on the internal staff.
• The key is experience. We don’t have funds to make mistakes when implementing technology, so in some cases, we need someone to guide us that has the knowledge to keep us from making mistakes.

Vendor’s lack of resources

Other

• Typical project approach
• Need more people on a project
• Internally developed systems so we’re doing remediation ourselves
• Resource augmentation
• Specific domain expertise when lacking internally
• Temporary nature of projects
• Augment skills for staff turnover
• To lead reform strategy discussion and objectively examine how we are structured, staffed, and manage business units
• Physician attitude (our administration did not believe anyone but an outside entity would have credibility with the physicians about the WHY’s of CPOE.)

3. Was it, or do you expect it to be, more difficult to get approval for consulting dollars than for software investment?

Yes

• For consulting or any type of spend, I think with the continued squeeze on reimbursement, that the glory days of IT are going to be curtailed a bit.

No

• High-level support from teams within the governance structure understood the issues and requirements for success.
• We anticipated the need and budgeted for it.
• Not for our recent projects, but it will be in the future.
• Most of our initiatives have tight deadlines, so support for consulting is available.
• We built the costs into a “total cost of ownership” model that we developed and presented before getting the project approved.
• We do not want to hire their expertise — only utilize their knowledge and do a knowledge transfer.
• If the project is strategically significant, then a case can be made to hire expertise as well.
• Software is permanent.

4. Have you had to – or do you expect you will have to – forgo needed consulting help due to a lack of budget?

Yes

• Our budget is very tight.
• Increasing financial pressures on our organization will have us trimming our consulting help a little earlier than we had planned.

No

• Not yet.
• It’s possible, but we will maintain the focus on must-have items to support HIS success and meeting MU stage 1 and 2.
• Not yet, but it most likely will occur in FY13
• The consultants have been covered outside of IS.
• It depends on the project.

5. In qualifying for Meaningful Use, do you feel smaller organizations are at a disadvantage due to their limited ability to bring in consulting help?

Yes

• Just to understand the regulations as a starter. I really pity the smaller organizations, as we did have help in this area and I’m not sure how we would have qualified for MU dollars without it.
• Absolutely, knowing several, I understand they are expected to spend a higher proportion of their annual budgets to achieve MU.
• I suspect the answer is yes. Consultants are very expensive and smaller organizations will naturally be more challenged to afford what is needed to get the job done.
• Absolutely! The cost is prohibitive, which means we end up trying to do things ourselves, which can lead to costly mistakes or missed opportunities.
• No doubt about fewer dollars available. However, smaller organizations can turn on a dime easier.

No

• Not necessarily; it depends on their staffing
• Smaller organizations with less complexity may be closer to achieving MU than you would think.
• Not for stage 1. If you look at the attestation stats, Meditech is in top two. I do believe that stage 2 will start to separate the smaller organizations from the larger organizations.
• A smaller organization can reach consensus on approach earlier. Part of our problem being a large academic delivery system is that there are multiple opinions on how to proceed or even whether to proceed. The consultant resources can help reach a consensus.
• I think the rate limiting factor will be the consulting firms’ ability to have a stable of good quality (experienced) consultants. I also think it will become difficult to separate the wheat from the chaff.
• I do not. They are also far less complex of organizations to manage.
• The question presumes a disposition.