How Managed Services can support your EHR extension partners [podcast]

Show notes

[00:00] Intros
[03:50] What is managed services?
[04:55] How a fixed-fee model can help organizations plan and predict costs
[06:15] Ways organizations are leveraging managed services for extension projects
[09:21] How organizations can benefit from managed services support
[12:32] When managed services may not make sense
[15:15] How Nordic can provide tailored support for your rollouts, extensions, or other strategic projects

Transcript

Scott Isaacson: Hi everyone, thanks for joining us today. I'm Scott Isaacson, Director of Affiliate Solutions here at Nordic. On today's episode, we're going to be talking about some of the ways that managed services can be a helpful resource for your organizations and your affiliate. I've asked two of my Nordic colleagues to join us today, they're both experts in affiliate and managed services, and we'll be talking about some of the benefits of remote support.

Before I move over to them, I'll tell you a little bit about myself. I started my career at Epic in 2006, and eventually made my way over to work as a full time employee at one of our local Epic clients. I started consulting in 2012, where I met a bunch of really great Nordic folks, and decided to turn that company about five years ago. While I was on the road, I focused on Community Connect, mergers and acquisitions, and optimization, and then I moved to the Home Office a little over three years ago into my current role.

Joining me today, we have Andrea Schmeichel, another Director of Affiliate Solutions, and Andrew Conley, a Managed Services senior team lead here at Nordic. Welcome folks. I'd love if we can introduce everyone, and Andrea, I'd like to start with you.

Andrea Schmeichel: Thanks, Scott. I'm Andrea Schmeichel, I am also a Director of Affiliate Solutions at Nordic. Started my career also at Epic where I did large scale implementations for about nine years, the last two of which were spent in the Netherlands implementing the Dutch Enterprise Health Record. Once I moved back to the United States, I worked at both Kaiser and Providence as an FTE, working in physician informatics and helping Providence lead their Community Connect program. I've been at Nordic about three years, and I also worked together with Scott on any kind of client needs when you're extending your Epic system, whether that be Community Connect, mergers and acquisitions, or to own sites after the initial go-live.

Scott: Thanks Andrea. Andrew, over to you. I'd love to get to know you a little bit better.

Andrew Conley: Hey everybody, my name is Andrew Conley, and I'm a senior team lead on the Nordic Managed Services team. I got my start at Epic as well, so I was on the Hospital Billing team and Home Health Billing team while I was at Epic. I've been at Nordic for the last three years, the first of which I was on the consulting services team helping with an implementation there, and then from there I actually naturally rolled over onto the managed services team, and have been there for the last couple of years.

Scott: Well, thank you folks. Really appreciate you joining us today. We're going to be covering a lot today. So, as a quick little agenda, we're going to start with the foundation of what actually is managed services and how we can look to help support our affiliates with managed services. We'll talk a little bit about the benefits of that service, and then we'll also talk a little bit about where managed services may not make sense for your organization as well, and then we'll tie it all up with a nice little bow, and talk a little bit about how Nordic and can actually help as well.

So, as part of that foundation, Andrew it would be really good to hear from you a bit more about managed services, and how it might be a little different than the normal consulting model that many of our partners might be familiar with.

Andrew: Sure. Managed services, our goal is to provide quality system support for hospital's Epic systems at the lowest cost that we can. So, really what our team does is we take over the maintenance and support of a system so that hospitals' IT teams can work on more strategic initiatives, they can work on more projects that they want to get going as well. We do that with a fixed-fee model that we have. That's one thing that hospitals like, and it's part of our mission to make sure that we can keep costs lower and predictable, and we do that by having a mixed bag of experience levels on our team.

I think hospitals will find that they've got different levels of work that need to get taken care of, and so we can match the right level of expertise with the right things, and then make sure that we've got our proper quality controls in place to make sure that we're providing the highest quality of service for our customers.

Scott: Thanks Andrew. You had mentioned a little bit about a fixed fee, could you give us a little more information and maybe frame it in terms of how that might be interesting for our folks doing affiliate work?

Andrew: Yeah, absolutely. I think hospitals have certain different strategies, one thing that they might do is they'll be rolling out to different hospitals, or bringing on different systems, or different clinics into their group, and they're not sure exactly what those long-term costs might look like to make sure that they can maintain and support it. I think they're thinking about initially bringing those folks into their group, getting them up on their systems, but it's kind of a question mark about what's that going to look like for the long-term support. So, one of the things that our department can do is we can estimate what that workload looks like, and what that cost is going to be for them. So, in the long run we can say, hey, for the next five years for this type of support, here's what it's going to cost you each month to do that. We actually take on the risk of doing that support to say, we're going to take on a scope of work that we're going to cover.

So, in this instance, you've brought someone else live on Epic, we're going to support all of the needs for that system, and we can say we'll take care of whatever that need is, however much work that is, and give you a predictable cost on a monthly basis so that it's just a simple line item in your budget.

Scott: Yeah. I think that predictable costs is something that's going to be really attractive to our partners, so I appreciate that we do that. It sounds like there's some really great opportunities to leverage managed services in the affiliate space. Andrea, I'd love to toss it over to you to talk a little bit about your experience, how you've seen managed services tie into the affiliate standard approach, and maybe start with that, and how we approach most projects.

Andrea: Yeah, so the most common way people use managed services on affiliate products is for that support after go-live. So, especially as we're seeing our clients reach out to larger and larger affiliates and get more ambitious with their affiliate programs in their Community Connect targets, then we see that one of the considerations is how are we going to support if we bring a hospital live, or a large clinic with multiple locations that can really weigh on us and our resources that we have, and how are we going to support that after go-live. So, one of the things that can remove that concern is thinking about Nordic managed services, and really moving that support over to the managed services team, so then they know as we're planning ahead, that we can automatically know who's going to take over that support after go-live. So, that can remove that concern, and ease those fears a little bit.

But we've also seen managed services be used in some really unique ways on affiliate projects. For instance, it can be a phone-a-friend expert, if we have some consultants in the field, and we like to run with lean teams because healthcare organizations are being asked to do more with less, and we try then to limit the number of people that we put on site because that's more cost effective. So, if we can limit and really just have those key people that we need on site, but we can have some experts back at the home office who are knowledgeable in certain areas, let's say we have someone who is a great cadence prelude person, but maybe they need a little bit real time eligibility expertise. They can call back to the home office and get a managed services phone-a-friend, and really help them augment their knowledge without us having to bring another person on site.

Another way that we found that it works is if we have managed services actually help us on affiliate projects with some of the build remotely. We find this works in some key targeted areas. So for instance, security, if we need some help applying security templates for potentially a larger site, or maybe an ambitious timeline, or like I said, some of that limited expertise. We really want to have most of our knowledge and experience onsite because affiliates and Community Connect projects are very face-to-face endeavors. But we find there is some really important and some appropriate roles for some people that can do some work remotely, and we're really glad that our managed services friends are there to help us.

Andrew: Always happy to help.

Scott: Yeah, it's great to hear in the affiliate world we really think about relationships and especially between our larger partners and their affiliates, and having a right balance of efficiency and cost effectiveness, but also being able to have the right key folks on the ground is really important.

Andrea: It allows us to be flexible and modular, and I think that that's really important as we're looking at the affiliate projects that we're being asked to do.

Scott: At this point I think it'd be really interesting to talk a little bit more about how our partners can benefit from engaging with managed services. Andrew, I think I'd like to start with you, and get your opinion there.

Andrew: Sure, and as Andrea was talking, I was thinking of a couple of interesting stories that I know or have heard about how we've interfaced with affiliates, and tied right into being partners for our customers. The first one that comes to mind is myself. I started in the consulting services side of the world, and we were doing an affiliate rollout for a customer, and at two months post go-live, we were as consultants sitting there going, "OK, we've got them live, it's been implemented, the go-live has gone well, they're starting to stabilize, but who's going to take on the long-term support?" That was actually when I got a call from managed services saying, "Hey, actually we just won a managed services contract with this customer, and we're going to be taking on that long-term support." That was really appealing to me. I got to work with the same customer, I had already developed all of those relationships, and I knew I'd be a valuable asset because I'd been there for the implementation, I'd been there for the go-live.

And so, I rolled right onto the managed services team from there, and was able to be a knowledgeable expert just for relationships at the customer that we were supporting, and at the same time, just having a deep level of understanding of the build that we'd put into place, which really helped our team get started at the beginning. I think we've seen that on the flip side as well, I think we've had some instances where managed services has actually been supporting folks, and then we've had the customer wanting to do an affiliate rollout. And when managed services is already on the ground, the affiliate folks can work with the managed services team to get an understanding of what's currently in place, what does the system look like, what are their processes and procedures? It really gives the affiliate team a leg up to get up-and-running on the rollout and implementation that they're going to do.

Scott: I think that's a really great point. Something we talk about a lot with our partners is if we have Nordic resources in multiple areas, we always expect that they're communicating behind the scenes, and that transition between affiliate and managed services I think is an important one. Something else that I really appreciate about that in general is if you're starting to segregate your implementation and your support teams, it also means that if you're offloading things to managed services, the implementation team isn't worrying about support. They've moved on especially as we're looking towards a repeatable model.

Andrew: That's absolutely right, and with managed services, if affiliates are coming on to do an implementation, we know at the end of the day that we're going to be taking on the support of that too. So, we have every incentive to make sure that they're doing as good of a job as they possibly can so that we have the best system to start working with from day one out of the gates.

[Commercial break]

Scott: So Andrea, we had talked a little bit about how affiliate projects are very relationship-focused, and I think it would be helpful for us to talk a little bit about where managed services might not make the most sense in terms of support, and if you have any experience there.

Andrea: I think this is a great point because what we see at clients is they're getting more and more creative with remote roles in an effort to control costs, and I think that's really smart. We need to figure out how do we do things at a lower cost point. However, there are some roles that simply need to be onsite, and we collectively have learned the hard way as we've gotten forward. You try to get creative, you try to do a little bit more remotely, and then you realize, nope, we need to be onsite. So, certainly, I would say key analysts that are working on the implementation need to be on site. They need to be face-to-face with that practice to do the discovery, ask the right questions, be able to do follow up and build those relationships with the lead physician, with the office manager, with the biller. There has to be that trust involved that as you're building the system, you really can look the person in the eye who's going to build it for you, and understand that they're going to do a good job for you and they understand your needs.

Certainly, things like project management that has to be face-to-face as you're working with the leadership, and you're running the project. And then, the key position in any Community Connect, implementation and support is the account manager. That's the person who is really the point person during the implementation and moving forward, to make sure that that site is doing well, is happy with the system, has a person to escalate to, and that person is going to carry that site forward throughout their whole relationship in the Community Connect program.

Scott: Absolutely. We look to that account manager to own that relationship from discovery, all the way through go-live, and really be there for escalations, own that relationship, tickets, all of those sorts of things. So, it's kind of a one-stop-shop, that very critical role. Andrew, from your perspective, are there any areas that you feel managed services might not be a great fit for some of our affiliate projects?

Andrew: Yeah, well, and I think Andrea hit the nail on the head too. What I would say is that managed services support, our goal is to really take on the maintenance and support for the hospital team, so really the steady flow of tickets and any of the day to day work that needs to happen to make sure that the system is well maintained. I think our partners, other business lines in Nordic, anything where you're introducing some type of change, whether that's a new implementation or some type of advisory or workflow changes, or things of that nature, that's going to be a little bit more outside of our bread and butter of what we're going to want to work on, and we think it'd be better for our other business lines to take on.

Scott: Great. Thanks so much. So, we've set the stage today talking a little bit about managed services, and some of their ability to support affiliate projects, I think it would be great, Andrew, from your perspective to talk a little bit more about how Nordic can actually help our customers.

Andrew: Sure, absolutely. If you're a hospital organization out there, and you're struggling to find talent, or you've recently done some type of a rollout, or implementation, and you need more folks to help support the day to day maintenance of your system, or maybe you're just trying to free up your hospital, IT team so that they can do more value added projects and work on strategic initiatives, I think that's absolutely where managed services can help support. We've got a lot of folks that would be happy to chat with you about the support that they've received for managed services, and the work that we've been able to do for them as well. I think that's a lot of the value that we can add, and ways that we can help out. Andrea, how about for affiliates?

Andrea: Yeah, thanks Andrew, and I say it's managed services that is creating the need for us to move into our new, larger offices in Madison. So, thank you for that. I think for affiliate, we are really proud to say that we are one of the most experienced consulting firms when it comes to affiliate projects and Epic extensions across the board. We have worked with 50 plus clients, over 300 of our consultants have extension experience, and we help clients across the board, whether that's setting up your Community Connect strategy from an outpatient or inpatient side, doing the planning for how you're going to implement all of these sites, and how you're going to market to them, and then deployment. So, implementation, getting you from kickoff to go-live, and then kicking it over to our managed services, friends for support. So, we also work with hub organizations, so those large healthcare organizations that want to set up their own Community Connect program as well as affiliates who have asked for help as there are larger and larger affiliates, they may have the funds to hire some consultants to get them some advice as they're going through this process and they really want to be advised on how to make the best decisions for their implementation of this new EMR.

Scott: I think what I appreciate about what you both said is it gives me the impression that we can really right size services to whatever our clients' needs are, whether it's very large in terms of strategy and deployment, or those folks who are just looking for more of a phone a friend, or limited resources. I think that's pretty exciting.

Andrew: To further that point, I know Nordic’s, one of our bigger goals is to provide all the options that we possibly can to be a true partner for our customers, so we're constantly adding different initiatives, whether that's more advisory or things like managed services to make sure that we can offer all of the different solutions that our partners need. Even for some of the newer stuff that we're seeing, Epic's been moving to the quarterly upgrades, and that's something that we’ve been coming up with solutions to say, hey, this is something we can help you out with, something that fits well into the managed services model as well.

Scott: Great. I appreciate it. Well, Andrew and Andrea, thanks so much for sitting down with us today, really appreciate your insights on this topic, and you've definitely shed some light on some of the ways that managed services can be an important piece of your organization's affiliate strategy. So, really appreciate your time and insights today.

Andrea: Thanks, Scott.

Andrew: Yeah. Thank you, Scott.

Scott: If you're interested in learning more, please definitely don't hesitate to reach out. You can also learn more about affiliate or managed services solution on our website, which is nordicwi.com.