Healthcare IT Consulting Is Broken

Somewhere along the way the word consulting in our field changed. Today consulting is about finding available freelancers on a just in time basis. The “consultant” is nothing more than a recruiter with a billing back office. Some consultants claim they screen the candidates, but there is no way that can be done effectively given the turnaround time to place people.

Furthermore, the consulting firms take very little accountability for the consultants they place. But, how can they when their experience is so varied and there is no standard for good service?

When I hire a consultant, part of what I am looking for is a well defined way of doing various types of work. I want the consulting group reviewing each engagement and revising their approach to work based on the lessons learned from each engagement. If I am going to hire a project manager, I want that person trained in the firm’s project management approach. If I hire someone to assist with a selection, I want that firm to have a clear written means to conduct IT selections. I don’t want someone that might have participated in one of these activities a while back and will try to mimic one the way a child mimics an adult.

Of course that means a large investment in people that develop these methodologies and take the time to train permanent staff. That seems to have gone the way of the dodo bird. Nobody has staff, they have home-based employee people working the phones looking for talent to place.

Update: In re-reading this post I recognize that it is too general. There are a lot of consulting groups that bring intellectual capital to the table. When I am introduced to a new consulting group the first thing I do is categorize them as a traditional firm with an investment in their staff, or a recruiter of free agents with no connection to the people they place.

Update 2: Too frequently someone claiming to represent a consulting firm, is really with a staff augmentation firm. There is a big difference between the two and I wish the staff augmentation firms understood this.

6 thoughts on “Healthcare IT Consulting Is Broken

  1. Totally agree, Will. I see this recruiter-mill especially in Healthcare and it creates a very fractured “consult” for the clients. It’s about time that HCP CIOs get the same ‘patient (client) centered care’ that you have to give your patients!

  2. Excellent observation – the only value I seem to be able to find is through boutiques. Even there, the screening needs to be significant. Only a few of them truly use consistent methods and fewer train their consultants in those methods. If you are lucky enough to find a long-timer from a ways back, they still have those methods, templates and tools handy. Fewer yet keep them current and even fewer pass them along to their “analyst” level resources.

    In my organization, so many leaders have become jaded to consultants or do not understand the value of methods. I believe we have all lowered our collective standards. There was a time when methods, especially surround re-engineering, were taken too far and not really trained well or tailored. That may have been the downfall?

    This is great food for thought.

  3. Seems like the biggest problem with this is that hospital systems are paying the recruiter mill “consultants” the same as the more qualified, more refined consultants. If you’re going to make the same amount of money either way, I imagine many wonder why they should change. Long term I think it will eventually catch up to them, but in the current frothy health IT environment they’ll be just fine.

  4. I believe this discussion benefits from the distinction of strategic versus tactical resources. Rarely can you find strategic workers, outside of an architect or two, from the bodyshops.

    Recruiter mill consultants (bodyshops) are usually niche players with a very specific skill set (tactical). Most organizations wouldn’t be approaching a bodyshop unless they couldn’t fill a particular position. We do it to ourselves by getting into positions with internal knowledge silos or failures to understand staffing and knowledge requirements. Our vendors should be held accountable to provide niche skillsets. This comes down to simple supply and demand as well as leverage. We have the leverage when we are negotiating with our vendors up-front, not after the fact with deadlines looming.

    On the strategic side, there are so few really qualified resources that it becomes difficult to find them and then really engage them to receive value. When you do, the bait-and-switch usually occurs where the senior (experienced) resource is there to make the expensive visit every once and awhile, but the junior local resource is there floundering and learning on the job.

  5. This is an interesting post. We are a retained boutique search firm, we are occasionally contacted by consulting companies that are desperate to bring a client a resource quickly, including interim CIO candidates. We specialize in CIO search but do not engage in the interim CIO search. We work very quickly but we also work carefully. That is so important. The concern I have is that if the interim resource is not highly qualified, the interim CIO may create more work later for the permanent CIO. When consulting firms are employed to bring interim CIOs in, I have the same concern that is voiced in this post. For that reason I feel very passionately that it is an important decision for the organization: go with an interim CIO or go with a retained firm that can get the right person into that role quickly. The wrong person in any role, especially the CIO role, can disrupt morale and create unnecessary work for others. Even if it is only a temporary role. I’d love to hear what others think.

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