Electronic Health Reporter

Guest post by Ben Weber, managing director, Greythorn.

This is the time of year when people are looking into their crystal ball, and telling all of us what they see happening in the next 12 months. Some of these predictions will be wild (aliens will cure cancer!) and some will be obvious (more health apps in 2016!). But how many will be helpful?

As I gaze into my own crystal ball, I have to admit I’m also peeking at my email (I like to multi-task). I can’t really say if it’s inspired by the swirling lights of the magic orb on my desk, or if it’s because of the inquiries from clients, messages from my management team and RFPs from various hospital systems … but I also have a prediction for the New Year: 2016 will be the year of migration for Epic and Cerner consultants.

The United States healthcare industry has made great progress in EHR implementation—to the point where implementation is no longer the primary conversation we’re having. Now we’re discussing interoperability, if we’re using ICD-10 codes correctly, how and if we should integrate the data collected from wearable fitness technology, and more. Those discussions—and the decisions made as a result—will continue to require human intelligence and power, but in 2016 there will be a decreased demand for consultants on these projects. Healthcare IT professionals who have grown accustomed to this kind of work will either have to settle into full-time employment—or turn their nomadic hearts north to Canada.

Our neighbors on the other side of the 49^th parallel are ramping up their EHR implementations, which is good news for consultants interested in using their passports. Implementations in the US are slowing down, and while there is still work available, it is not as constant and may not command the same hourly rates as in years past. Meanwhile, several leading Canadian healthcare IT organizations have already warned of a looming talent shortage in their country (source), the effects of which are beginning to be felt.

Epic and Cerner specialists are particularly in demand, as there is a dearth of experienced talent. Out of the Canadian healthcare IT professionals who have worked with an EMR, 28 percent report familiarity with MEDITECH, 13 percent with Cerner, and 7 percent with McKesson. Only 4 percent have worked with Epic, according to the 2015 Canadian Healthcare HI & IT Market Report.

Although an overwhelming majority of full-time Canadian healthcare IT workers have expressed interest in consulting (81 percent, according to the HI & IT Market Report), it is unlikely that they will give up permanent employment if it also means giving up their pension. Hospital systems won’t be able to lure talent away for contract work, and it just isn’t cost efficient for them to acquire full-time staff members for every role needed during an implementation.

This presents an excellent opportunity for experienced US consultants … but it won’t be perfect (you knew there’d be a catch).

The most significant obstacle I foresee is the strength of the US dollar against the Canadian dollar. As of this writing, this difference is the greatest it’s been in 10 years. Good news for tourists, but bad news for consultants who won’t budge on their rates.

My crystal ball is fuzzy on what will happen regarding compensation, but in my opinion the best path forward is for all parties to offer a little flexibility. Canadian hospital systems may need to accept that their US consultants will come with a higher price tag—but they also come with several projects under their belts and can help contribute to best practices for the implementation team. Smart consultants will also bend and recognize that although the rates in Canada may not be quite as high as they’re used to, their money goes further while they’re there. Meeting in the middle could be a win-win-win: for the hospital, the consultant, and Canadian patients.

My crystal ball has fogged up, so my healthcare IT fortune telling is over for now. If any healthcare IT consultants want more insight into what 2016 could hold, however, feel free to check out Greythorn’s website and reach out.