The majority of physicians I know are very protective of their personal workspace. They do not like outsiders traipsing through their practices, potentially compromising patient privacy. They also do not like having anyone mess with their computers, servers, EMRs, and billing software. After all, if it is not broken, why fix it? In a solo or small medical practice, it can be difficult to justify the expense of regular computer and network maintenance, particularly when it comes at a cost that exceeds the medical practitioners’ hourly revenue-generating capabilities. However, without maintenance, both short- and long-term costs of an EMR can be significantly higher.
It can also be very challenging to find the right IT support services for your practice. In some settings, choice may be significantly limited by geography and availability of skilled personnel. In addition, hiring an IT consultant requires a different approach compared to the hiring of a full- or part-time employee. An IT consultant is generally brought in to complete a specific task in an area in which he/she has domain expertise. They are expensive contractors and, as a result, it is important to find the right person for the job at hand. Medical practices have certain unique requirements from a workflow and patient privacy perspective and ideally your IT consultant should have a basic understanding of medical privacy rules and practice operations. In addition, to extract the maximum value, you should clearly define your expectations upfront to ensure that the work is completed satisfactorily and according to plan.
How can you limit your risk and find the most appropriate person to assist with your IT needs?
Consider the following:
- Do you need an IT consultant to support your hardware and computer network in your practice on an ongoing basis or do you intend to hire someone to assist your practice through the entire EMR selection and implementation process? In these two settings, your needs will be very different.
- Pure technical support skills and services will be more widely available either locally through a small independent contractor or through a larger IT support company. These individuals know how to maintain hardware and networks and ensure that backups are done correctly in addition to replacing hardware components such as hard drives before they fail. Think of them as your preventive maintenance support. These individuals are also valuable to recommend new hardware (computers, printers, scanners, wireless routers) when these pieces of hardware need replacement as they work with technology and get to know the best and most cost-effective products.
- Full service consultants are more difficult to identify and are in lower demand in Canada in comparison to the United States. These are individuals who have the skills and knowledge to conduct a full assessment of your practice (clinical and administrative needs) and lead the selection, product evaluation, implementation and early support when the product is implemented. In busy practices, the task of evaluation is frequently delegated to a staff member (medical office assistant or practice manager), the full service consultant would take over these roles on behalf of the practice. From a practical standpoint, hiring this type of individual is only cost-effective in a large practice (20+ physicians) in which there is a great deal of complexity and specific requirements that are may be difficult to meet. Smaller practices should carefully evaluate the costs of this type of employment contract as the time frames to select and implement EMRs are generally long (6 months+) and this could be an expensive proposition in addition to duplicating some of the support services that are available at no cost to the practice through a provincial EMR program (e.g. POSP, PITO, OntarioMD etc.)
- The most common scenario is one in which a practice will need an IT consultant to support the office network, computers and related hardware. How can you identify a trustworthy company or individuals to provide this kind of support service?
- First, expect to spend some money for support on a regular basis. Having a consultant available only during a crisis does not make good business sense for either a consultant or for your practice. If your hardware gets to the point that it is riddled with viruses and hard drives are reaching the end of their lifespan, this is not a good time to call for help.
- Speak to local colleagues in your area. Who have they used as an IT consultant and what is their experience? Quality of support, availability both on-site and by phone, cost of call outs as well as ongoing maintenance. Is the agreement for a certain number of hours per month or per quarter or do they have a fixed maintenance contract in which the consultant is paid a monthly fee to maintain the office hardware and network and is expected to do so on a regular basis?
- If there is an EMR program in your province, speak with your designated practice advisor and find out if they can put you in contact with practices that use IT consultants. The EMR programs tend to remain agnostic and will not recommend individual contractors or companies, but they may know of practices that can provide some guidance.
- Check references carefully. Do not miss this important step and ensure that when you speak with references, you find out whether they individual concerned has a good understanding of medical practice settings. Do not forget to ask the most important question, "Given the choice, would you hire this contractor again?"
Have you had experience with IT consultants? Do you have suggestions for colleagues? Add your thoughts by clicking on the 'Comments' link below