Providers Seek Consulting Firms For Smaller EHR Projects

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Healthcare organizations seeking to meet Meaningful Use Stage 1 requirements are much less inclined to hire consulting firms to fully install an electronic health record (EHR) and more likely to turn to these firms to help with smaller projects that enhance the features and functionality of their EHRs, a new KLAS report reveals.

Rapid Growth of Meaningful Use Consulting: Why Providers Are Reaching Out examines the performance of third-party firms during the last two years. These firms are involved in preparing providers to attest to Meaningful Use Stage 1 requirements, which health providers must meet before they can qualify to receive payments under the federal EHR Incentive Programs.

The report identified 51 firms that have conducted at least one Meaningful Use related project, offering a variety of services. The research shows, for instance, that in 2010 there were 40 large EHR installation projects that consulting firms were engaged in, which rose to 63 projects in 2012. By comparison, smaller projects, including adding functionality to EHRs or providing additional IT staff, moved from 33 engagements in 2010 to 147 in 2012.

According to the report, providers who thought they could implement an EHR on their own have found themselves to be "overstretched and overwhelmed and are scrambling for third-party assistance." However, the type of consulting work being sought by providers is changing. And fewer sales of EHR systems convey only part of the story, said Erik Westerlind, KLAS analyst and author of the report, in an interview with InformationWeek Healthcare.

[ What is the role of EHRs in clinical research? Read Health IT's next challenge: Comparative Effectiveness Research. ]

The report identified four areas that providers say present the greatest challenge to their efforts to attest for Meaningful Use Stage 1: --Quality measures and reporting --User adoption, which consists of go-live support, training, computerized physician order entry (CPOE) assistance, and clinical transformation --Software upgrades --Understanding Meaningful Use requirements, which involves using a consulting firm's advisory services.

The data also revealed that only two firms--Deloitte and Impact Advisors--are seeing increases in the number of engagements since 2010. The report notes that this is primarily due to their focus on Epic implementations, the EHR vendor that continues to dominate new EHR sales. All other firms, including Dell Services, CSC, Accenture, CTG, and Xerox, have seen a decrease in the number of large EHR implementations since 2010, and in the case of IBM and Coastal, these firms have "virtually disappeared from the market," according to the report.

The top-rated companies competing for smaller EHR-related projects include Cumberland, Innovative Healthcare Solutions, and Peer Consulting Dearborn. These firms offer mainly advisory support, as well as significant implementation expertise. The research cited Navin, Haffty & Associates, ESD, and Beacon Partners as the top three firms offering staff augmentation support.

KLAS researchers predict that providers will continue to rely on third-party firms to help them navigate the rules and regulations of Meaningful Use Stage 2 and beyond, which will require more detailed reporting requirements, greater interoperability between systems, and more internal collaboration.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)