What is Epic Consulting?
Epic Consulting is focused on advising clients how to best manage and implement Epic (Electronic Medical Record software) to meet the objectives of the health care organization. Like many other lines of information technology consulting, this field requires in-depth knowledge and expertise of both industry and technology in order to succeed. Successful consultants are able to navigate between the complexities of the health care industry and system design to implement a system that is for the best interest of the client.
Epic Consulting can be regarded as a fast and growing market. Big box firms such as Deloitte and Accenture already have their own Epic practice. Many major IT consulting firms have Epic practices as well. In addition, there are also over a dozen boutique firms that work specifically in Epic consulting.
Epic and its EMR
Epic is a privately held health care software company headquartered in Madison, Wisconsin. Over the past decade, Epic has seen a dramatic rise in its market share among all other EMR vendors due to its highly successful integrated software. It currently employs over 6,000 people and its revenues are estimated to be around $1.2 billion as of 2011. To put things in perspective, the company employed only 400 people in 2000. Epic is focused on targeting large health care organizations with clients such as Cleveland Clinic and Kaiser Permanente.
Epic prides itself in delivering the best software that is focused on the patient at heart. With that strategic vision, the company was able to develop a product that is highly integrated. Enterprise clients can manage patients when they first walk through the door, see the doctor and out the door all in one system. Because all of the software was developed in-house, the big selling point is the seamless transition between different modules whereas Epic’s competitors that have grown through acquisitions struggle to transmit information between modules.
Epic also claims that another competitive advantage is in its consistently high KLAS scores, a research organization dedicated to evaluating health care IT products/vendors. KLAS reports are highly regarded in the health care industry and many CIO’s and IT managers use these to help make purchasing decisions.
Epic’s software comprises of over 35 different applications or modules. Each application requires specific technical knowledge to know how to successfully configure the system. Depending on the size of the application, training can range from 8 to 50 hours per application.
In sum, a large portion (but not all) of these applications can be classified by its role in the patient cycle:
Access – Applications involved in registering the patient when they first arrive to the logistics of scheduling and patient movement around the organization.
Clinical – Applications involved in the caring of the patient and assisting health care providers document their findings and results and administering treatments.
Revenue – Applications involved in patient billing and transmitting of billing information to collect and monitor claims to the insurance companies.
Certification in Epic is on an application-by-application basis. One is not simply certified in Epic. Many consultants specialize in one or multiple applications and may spend their entire career working with a select few apps.
In the eyes of the IT industry, Epic implementations can be seen as unique. Depending on the buyer power and influence, Epic strives to have its hand in as much of the implementation process as possible so implementation of the software leans to being vendor lead. Only in the hands of highly influential clients do they stray from their project management methodology. Epic has been known to devote a copious amount of resources to ensure budgets and deadlines are kept.
Flight Plan vs Project Management
Epic’s standard project management methodology is branded as “The Flight Plan”, a 5-phased Waterfall implementation model that some may consider too rigid for an IT project.
- Kickoff/Discovery – requirements gathering phase
- Validation – prototype phase
- Build/Reengineering – software config and development phase
- Testing – testing the new software configurations
- Go-live – turning on the system in production mode.
One would argue for a more Agile approach, nevertheless, Epic has had success in managing projects and within deadline. The Flight Plan incorporates many traditional project management tools such as risk registries, a work breakout structure and project plan. However, one criticism of Epic project management is that most of the implementation specialists are not trained on how to properly use those tools. Since many health care organizations don’t have a project management office or proper PM expertise on staff, the CIO is more often than not to oblige by Epic’s implementation strategy despite its shortcomings.
Within the context of Epic Consulting, there are three groups of players in this market, Epic, Epic client, and the Epic consultants. Each of these players will be described in detail to highlight their roles and how they interact with each other.
Epic Systems is a bit unique in terms of the vendor/client/consultant relationship. The company maintains a list of consulting companies that are allowed to send consultants to become certified in their software with or without a client request. However, there are no Epic consulting “partners” and they do not refer clients to specific consulting firms and do not favor one over another.
Overall, the Epic implementation staff is apprehensive about the use of consultants mainly because of potential power clash and the potential to usurp a vendor lead project by introducing conflicting methodologies. To understand this mentality is to understand their corporate culture. Epic believes strongly in growing people from the ground up. This is mainly the reasoning why almost all their employees are hired entry-level, regardless of background. Therefore, Epic consultants need to be mindful of how Epic does their implementations because it might affect the firm’s reputation if there is conflict.
In Epic consulting, Epic certifications are KEY and Epic has an iron grip on its certification process. Clients will only bring in consultants who are certified and you must be sponsored by a client. All training takes place in their headquarters in Madison, Wisconsin and it involves 2-3 weeks of classroom training plus 2-3 exams and a project. Because of the demands of training, certified individuals require a significant time and monetary investment.
As previously mentioned, consulting firms cannot simply send their employees to get trained. They must either be sponsored by a client or the firm is in “The List” of what Epic considers are reputable firms. Because of this, many consulting firms struggle to break into the Epic market because of the dilemma of winning client work without previous success in Epic because they don’t have certified individuals.
Recruiting resources for Epic projects can be a significant challenge for Epic clients, highlighted by the artificially controlled supply of certifications. Large implementations are usually staffed with the following best practice. Current IT staff maintaining a legacy system rolls off and gets trained in Epic headquarters. Maintenance of the existing system gets backfilled by legacy consultants until the system shuts down. This allows current employees to develop and retain Epic knowledge. The client usually signs a huge blanket service contract with an IT staffing firm such as Encore, TEKSystems and maxIT because these firms have a national presence and can assemble a staff quickly.
In addition, since an Epic project is very demanding on resources. An Epic implementation usually requires additional system analysts in the area of business expertise, project management and area leadership. Depending on the client, they can pull existing resources and hire new analysts to get trained in Epic or hire consultants specializing in Epic.
Epic Consultants are in demand because of the surge required to properly staff an implementation. Epic requires that anyone working with their software be certified. This is a blessing and a curse because clients can quickly vet these people based on what Epic Certifications they have but suffer from the limited pool of resources available.
Background and Roles
Epic consultants typically originate from being part of a client that implemented Epic in the past. They received their certification from being sponsored by the client and they are allowed to go into consulting after a period of time after their client’s go-live. Big box IT staffing firms such as Accenture and Deloitte are also a source of consultants. In addition, former Epic employees who are certified during their employment with the company go back to consult for clients after a period of time.
Roles and skills needed depend on the status of the implementation.
For new implementations, consultants need to possess the following skills: Change management, training/mentoring, workflow analysis and system build
For optimization projects, consultants need: software analysis, performance metrics, reporting and analytical skills.
In addition, consultant roles typically follow the paradigm of Analyst, Team Lead, Project Manager. These are the most needed roles and most consultants fall into one of these categories.
Having alluded to this already, the Epic Consulting is currently the hottest EMR consulting niche in terms of demand. However, salary remains comparable to consultants of other EMR systems.
Nevertheless, Epic Consultants are enjoying a steady supply of work due to accelerated EMR adoption and Epic’s lead in the market. I have reason to believe the EMR market is behaving in a winner-take all fashion.
There are signs the Epic market is slowing down. Average salary is a good indication of increase supply versus demand from the end of last year to now.
However, consistent with my previous hypothesis is a sign that hospitals are needing more and more reporting expertise after the EMR wave. Epic Reporting experts are seen commanding some of the highest salary in the category.
As a result, Epic Consulting firms need to come up with a strategy to scale back on Epic staffing and potentially enter into the Reporting/Business Intelligence/Database Warehousing field, which is a highly contested market and an obvious next move for many healthcare organizations. I hope you enjoyed this brief look into the Epic Consulting market!