Healthcare Consultants Get Creative To Survive

Over a year ago, HITECH legislation gave rise to concepts like the "meaningful use" of electronic health records and established Regional Extension Centers to help small healthcare practices in underserved communities select and implement EHR systems. At that time, I found the latter to be an especially painful example of just how destructive government interference in the private sector could be.I thought these federally funded consulting groups, which are permitted to charge whatever prices they want, would undercut private consultancies and put them out of business.

While this could still happen, it seems I put too little faith in the creativity and adaptive abilities of the average American business. Take, for example, Hayes Management Consulting. It recently announced services for RECs, it says, in response to their request for help. This means the organizations created to help small practices are asking the organizations I thought they would put out of business for help.

In a statement, Hayes' president Peter Butler makes clear the government project is recreating the wheel: "This initiative is more than installing technology. It is about changing a culture. We have been there, done that, and look forward to applying our experience … " he said.

Why the drafters of this legislation didn't just allocate money for practices to spend at existing consultancies is beyond me. At no time was the industry complaining about a lack of organizations to do the work; rather the issue has been a lack of trained HIT professionals. Investing in HIT educational programs makes sense, because these existing consultancies would have eventually needed more bodies to handle the HITECH-spawned work. But the RECs are a completely unnecessary addition and a permanent burden on the taxpayer.

When business slows down, businesses typically shed staff, much like an animal shedding an unneeded coat in summer. But what will happen to the RECs when business dwindles in 2015 or even 2020? Will they be dismantled? Anyone who has watched congressional fights over military base closings knows how this goes--"If it's employing people in my backyard, you can forget it."

So Hayes has done what any smart business does: It's looking for new customers. If the RECs are positioned to take away some of its customers, Hayes will make customers out of the RECs. And the RECs certainly need some help. They may have your money, but the workforce they were created to employ doesn't yet exist. In fact, just last week ONC got around to funding those programs.

The HITECH story thus far has been both disturbing and reassuring. The RECs constitute an unnecessary, massive and permanent blight on the American taxpayer. This money would have been much better spent if directed to providers for use with organizations that had already proved their merit in the market. But those established organizations are showing once again that capitalism has a creative side to it. They're putting a new twist on an old adage, "if you can't beat 'em, service 'em."

Anthony Guerra is the founder and editor of healthsystemCIO.com, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at [email protected].