What the best health IT consultants do at the end of their contracts [podcast]

HIT_BreakdownMixer.jpgDoes my client want to extend? Is my resume up-to-date? What do I want to do next? If you're a consultant, these are just a few of the questions that should be floating around your head as you reach the end of your current contract. What do the best healthcare IT consultants do to make sure their transition from one client to the next is a smooth one? Find out in this episode of the HIT Breakdown in which Nordic’s VP of Consulting Services John Manzuk talks with Nordic Senior Consultant Dan Mau about the best ways to prepare yourself for an upcoming end of contract.

Also, the full transcript is below.



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Show Notes

  • [00:00] Intros
  • [02:23] When do you start thinking about end of contract?
  • [04:00] Thinking about what role/project is right
  • [07:20] The evolution of your experiences and your goals
  • [08:56] Extensions
  • [13:20] Transitioning: preparing yourself, preparing the client
  • [17:24] Leaving the client better off - mentoring
  • [21:40] Client expectations
  • [22:30] Recommendations, LinkedIn, networking
  • [26:30] Evaluating the consulting firm you are working with
  • [30:00] Being financially wise
  • [33:50] Other areas of career growth
  • [39:10] Does your firm have a take on the evolution of health IT?
  • [42:25] What's next for the future? 
  • [43:25] Your resume
  • [46:36] Closing thoughts


John: I'm John Manzuk from Nordic. I'm one of the VPs of consulting services. My background is I've been working with Epic going back close to 10 years now. I went to Epic right out of school, worked there for a couple years. I've been at Nordic for closing in on five years now. I started as a consultant and then moved into the home office where I've been basically in consultant management and engagement, I guess you'd call it, for the last couple of years. I'm here with Dan Mau, who is one of our Senior Consultants. Dan, you want to go ahead and intro yourself a little bit?

Dan: Yeah. Hey, everyone. Hey, John. My name's Dan. I, much like John, got my start in Epic, right out of school working for Epic. My application backgrounds are in some of the ancillaries, so I started out in Radiant and moved on to do some Cardiant at the time, now Cupid. I worked at Epic for a while and then ended up moving back to Minneapolis, which is home for my wife and I. I did some project management there, focusing actually in web development, which was fun to do something a little bit different. Then, I suppose like a lot of consultants, I got sucked back into the Epic world. It tends to get you a little bit. I've been with Nordic now for closing in on four years, focusing primarily on consulting work and various different roles and clients. It's been just great so far. Excited to chat with you guys.

John: We're here to talk about end-of-contracts, because it's, unfortunately, an inevitable part of being a consultant. The gig eventually comes to the end. The project comes to the end.

Dan: It's the season for it right now.

John: Yeah, it is. It happens and it's something to be prepared for. I guess to kick it off, when do you start thinking about what we'd call the end of your contract? Is it 60 days? When are you saying, 'You know what, it's hit the point where I need to start preparing myself and my client for what's coming next'?

Dan: It's a good question. It's one of those that's going to have some variables. Of course, when you have a contract, you're going to have an end date. Maybe this is a six-month. Maybe it was a 12-month. You're going to have an eye on when that end date is. I suppose end-of-contract starts to turn into a gray area, because something we talk a little bit about is, as we get toward that end date, there's always the possibly for extension. I think one of the first things that you need to start thinking about is not necessarily just about the contract itself but thinking about what exactly you want to do next. Are you interested in extending with the client? Maybe you're ready for a change, and you're looking for a new style of project.

For me, I suppose always having that end date in mind, I truthfully start thinking about it probably close to a couple of months toward the end of it because at that point I'm trying to determine, 'Do I want to extend? Has this been the right client? Is there something new, a new opportunity that I want to try to explore?' That's about the point when I can start thinking about it because that's an appropriate time to start having those conversations with the client, because there's also times, too, where maybe the client wants you to extend, but you might be looking for something else too. You want to make sure that you're going to give them enough lead time in those situations. For me, I'd say probably about two months to give yourself enough time and also to give the client enough time.

John: When you come in on that two-month mark, what aspects of your current contract or potential other contracts are you thinking through to say, 'Is this the match for me? Is this where I want to be the next couple months, long-term?' That sort of thing? What are you thinking through?

Dan: That's a good question. What I try to do ... Actually, it's interesting. I end up having this conversation with a lot of different consultants, just talking after hours and such. For me there's three main variables that I think of when I'm thinking about my contracts. The first thing that I'm thinking about for me is the role and the position that I'm in at the client. What I mean by that is you're going to be either maybe in an analyst position, or maybe you're project manager, or maybe you're a team lead, or maybe you're working in a different role altogether that doesn't fit some of those typical molds. I like to think about, 'What type of role am I in? What type of role would I like to be in? How does that align with my career trajectory? Where does that put me maybe in the next contract? Where does that put me five or 10 years from now?'

Next thing I like to think of is the type of project that I'm on. Me personally, right now I'm on a new big-bang implementation. Before this project I was at a post-live customer. They'd been live maybe five years. We were in a maintenance phase. They were complete polar opposite types of projects. As I came to the end of that last contract, being in the maintenance, the idea or the allure of a new implementation grabbed me a little bit. Consider the type of project that you're going to be on.

Finally, for some consultants it becomes more important than others, but travel, contract length, remote time. Some consultants really enjoy the frequent travel. They like going to new places. They like the perks, the points, getting to go on free vacations. There's other consultants where they might be at a point in their life where having a higher balance of remote time for family, or maybe they've got a child on the way, maybe that completely outweighs everything else. Maybe the type of project or the length of contract is not important.

I take those three attributes and I weigh them for myself. I think that's something that's really important for a lot of consultants to really consider. I think when you get towards that end-of-contract, that mode in your mind, you start to get nervous, you start to maybe think, 'What are the next contracts? How long could I potentially waiting?' Some consultants will tend then to rush a little bit into that next contract. Those are important conversations to have with your practice director at your firm to understand what the business is like and how long you might need to wait, but you need to consider how important it is to yourself to have that right contract because I've seen plenty of consultants and I've probably even done it myself to some degree — rush into a contract that maybe wasn't the best fit.

Knowing what's important to you before you enter that contract is, I think, pretty critical in making sure that you're fulfilled in that contract because if you're not happy, you're not going to deliver the best results for the client.

John: Those questions that you're asking yourself, 'Is this or the next contract I'm considering, is it the right role position, is it the right type of project? Are the travel, location, are those things matching up?' That's not necessarily a new conversation or something new you're thinking about every time. That's an evolution that's happening for you. When you get into consulting, you've got a background in either implementation or in support for maintenance customers, and so you know what you've done, and you know what you want to do. It's adapting that plan, 'Well, here's where I am currently. Here's where I see myself six months, a year from now,' and then matching that up with either the extension that's on the table in front of you or the different contract options being presented.

Dan: Yeah. I suppose it's really an evolution. You're mentioning that you're going to have a certain ... Maybe when you first get into consulting you're going to have a certain background. Maybe you were in implementation, or maybe you were a technical support person, or you were an FTE, so your background is more in maintaining an existing application. For you, your first contract, you're going to gravitate more towards something that is what you're used to doing. I think as you move through your contracts and become more experienced in the field, that's when you might want to change. You might want to do something new. You might want to have a new challenge to learn some new skills.

That's why I mentioned these attributes might be something that you have to begin with, but for me they change at the end of every contract. I get done with a contract doing one thing, now I want to do something new. I'm looking for a completely different type of project, and I'm letting my firm know that when they're looking for the projects for me. That's why I think it's important not to think about just once when you begin your career but to be continually reevaluating that, and then also framing that up against the target of where you want to be in five years.

John: Let's say you, Dan, have entered that 60-day window where you're starting to think about those things for yourself and then also what could be available to you either through your current client or the next. At what point and how does the conversation as you've seen it start with, 'Is an extension even on the table?' I know what I've seen from the Nordic side, but you, being a consultant day to day, when do you usually see that conversation brought up? Who starts it? What's the best way to go about it?

Dan: In my experience, most consultants it depends on the project and the management structure but most consultants on site are going to be closer to their team lead, their client manager, or whoever holds the budget, than your firm is. Nordic or any consulting firm is going to try to partner up with the client and understand their future needs, but ultimately you as a consultant are there working with them day in and day out, and you most likely are going to be closer to that manager. For me personally, in my experiences, it's always been fairly transparent to me whether or not an extension is going to be on the table, but that's also because I really focus on maintaining a close relationship with my client managers and with keeping that networking at the firm.

I should have a mutual idea of, 'OK, my contract is ending at the end of December. What type of work is still ahead of us? What's in January? What's in February? What type of workload does the client have?' Clearly, knowing, 'OK, coming in January or February maybe we finished all the projects and there's not going to be as heavy of a need for a consultant to augment their staff,' I should have a pretty good idea that an extension might not be around. On the flip side, you might be there and of course you can see there's a ton of work still on the table. That might indicate that there's a chance for an extension, but that doesn't always guarantee it because, of course, then you've got client budgets and other external factors that you need to consider.

I think the point I'm trying to get at there is that you, as a consultant being on the ground, should probably have a pretty decent idea of it, and by maintaining a close relationship with your manager and your team lead on the client side, have that conversation.

John: The reverse is probably true, too. If you're not surprised or shouldn't be surprised by an extension being offered or not being offered, they probably shouldn't be surprised by you being willing to extend or not being willing to extend. As a consultant, you end up being a pretty integral part of an implementation or a rollout or whatever it is, and so if you, as a key staff member, are going to be leaving in two months, that probably shouldn't be the first time that that conversation has happened. That groundwork should've been laid. 'Hey, this is not exactly what I'm seeing for my career. Of course, I'll transition out the right way.' It shouldn't come out of the blue if that's the decision you end up making towards the end of a contract. Would you say that's true too?

Dan: Yeah, that's actually a really good point, because when it comes to extensions it really is a two-way street. I think a lot of consultants, myself probably included, you're going to tend to think of it from your vantage point, 'Am I getting extended or not?', but on the other side, you're going to have the client, where, 'Is this consultant going to extend or not?' Again, knowing when that end date is going to be and thinking about what you want to do for that next contract and knowing already that maybe continuing on this project or this client or doing this type of work isn't exactly what you want to do and knowing that, post that end date, that the client still is going to need some help, have that conversation with them. Don't let it be a surprise. That's a really good point that you've made.

I have personally been in a situation where I've been at a client where my contract was coming up. I knew that they wanted to extend, they were going to offer an extension, but I knew that I was looking for a new experience and some new challenges. It can be a difficult conversation, but it is one that you need to have because if you're not going to extend, and they're offering extension, that means the client has the budget for it, and you want to give them enough lead time to find a quality candidate that can replace you.

I say two months. Two months is generous. Myself, I end up having a lot of longer contracts. I would say you're going to want the client, give them a good six to four weeks so they can start that search. It's going to take a client two to three weeks to get through the interviews. Who knows when they can finally going be able to onboard him. Ideally, if they are going to bring someone on, you give a little bit of an overlap where you can help transition to that new consultant, if the client is amenable to that. Definitely a two-way street. Don't leave the client blinded.

John: Any professional wants to wrap up well. This industry, wherever you're at, it's too small. You always want to do a good job. You never know when your current manager or your current leadership ends up at the next client that you want to go work with in a couple years down the line. It's always good to build a good network around you. Finishing up well or finishing through a project is always the wise thing to do, or at least, at a minimum, transitioning out well.

If you are coming up on the end of a contract in let's say 60 days out, and you either don't know if you're going to get extended, it's up in the air, or it's definitely clear that, 'Hey, the project's done, we're moving to maintenance, they need me to roll off and hand off to the team,' what does that start to look like for you? What are the first couple steps you take there?

Dan: Of course, if you know you're going to extend, you're going to extend, so your contract is going to keep going. If I know that the contract, either it's going to end, or I'm going to transition off, there's a couple of main buckets of things that you need to do. The first, if you're going to be moving on, is you need to prepare yourself. The second thing that you need to do is you need to make sure that you prepare the client. Since we've framed this in the perspective that the client might want to be extending you or that they still have work to do, let's maybe talk a little bit about how we transition to a client. Even if they're not looking to extend, and you've finished up some major projects, there's still going to be a lot of work that you need to do during that transition period.

I really think that this is critical. Maybe it sounds cheesy or pandering, but I really believe that, as a consultant, and particularly the experienced consultants, that we are coming from Nordic, that what we do as a consultant and our success is not necessarily what we're able to achieve at the client, but it's how we've made that client better off when we leave. Whether we were building a brand new implementation, helping them implement some new functionality, or even if we were just maintaining the system, when we're done with that, we've maybe achieved something. We've built something, but now that we're gone, the client is going to need to maintain that.

There's a couple of pieces to that, but I'd say one of the major things there is just transferring that knowledge. It's going to depend on the type of contract you're in, but let's pretend that you were brought on to help add on or build a new module or do some kind of a rollout. You're probably going to be doing a lot of unique build or some new builds. You're going to be doing a lot of work autonomously that the client is not always over your shoulder watching you doing.

What I like to do with that, you don't need fancy tools, I just use OneNote. I love Microsoft OneNote. As I'm doing different types of build or projects or something that might be unique, I throw all of my notes into a template. I actually created a little template in OneNote so that whenever I'm building something new I can describe what I built, why I built it, any impacted records. I just save these things. I record them throughout the project, because I think, one, they can be very daunting if you're rolling off a contract, especially a long contract, is if you don't keep a rolling log of this information, it's very hard to conjure it all back up from memory. I write this down not only for myself for the notes, but knowing that I want to hand this off to the clients later. Recording the information as you go so that you can hand that off.

Then what I do with that documentation as the contract's coming to an end, I'll just schedule some meetings with my team. I'm familiar with my team. We're friends at that point. We'll schedule some meetings and we'll go through this. I'll export these PDFs or the Word documents, what have you, and I'll go over what we built so that they're familiar with the new functionality and they're able to better support it, because one of the worst things, I think we've all heard this, when we've been at a client and you're digging into something, opening the hood a little bit, and you're like, 'What's that?' They're like, 'I don't know, X person built it,' or, 'I don't know, my Epic person built that.' Then there's really no one there. You're trying to reverse engineer it, and you don't really understand the decisions that went into it.

Whenever someone says, 'I don't know, that person built it,' they're not saying it in a good way. It's really a negative connotation. That's where I think a quality consultant's going to hand off that knowledge and make the client an owner of that information when they're done. Even if you built it, let them own it.

John: Yeah, I think that's critical. Something you started talking about was there's handing off the background on the build and the projects you finish, but there's also building the skills of the team around you, because that's one thing I've heard in conversations with clients and in consultants, that you can tell the difference from a consultant who comes in just to get a job done and a consultant who comes in to leave the team in a better place. There's a huge difference there. Clients want, and they expect and deserve, with the rates that they're paying for consultants, somebody who makes the team better, who makes the whole project better, other than, 'I accomplished X, Y, or Z in the system. This is live, and it's transitioned.' It's, 'Well, you taught my team some new skills that made them better.'

It should be happening throughout the contract, but especially as you're looking to close out, that's a really good time to, 'Hey, it turns out I built this new thing and I used some cool import tools and some exporting and that sort of thing, and this person that sits next to me that's going to end up supporting it, they can support it without knowing that, but if I teach them a couple other things, they'll be even better off when I'm gone.'

Dan: Agreed 100 percent. That's where the idea of leaving the client better off than when you came there, not just from a system build standpoint ... Because you're right, you could come there, you could add some new features in the system, stabilize it a little bit, and then in some way the system is better off, but a quality consultant ... Like you said, the clients are paying a decent rate. We call ourselves consultants because we're there to consult, to transfer a lot of knowledge. We carry a lot of knowledge with us too from those former clients that we've worked with.

This is really something that you should be doing, in my opinion, from day one, is mentoring your team. You're there because you're an expert. You've done this before. You've probably done this a lot of times before. Chances are the FTEs at your client site, this is the only time they've done it, and for a lot of them this is a comfortable career and this will be the only place that they work. You're there that, as you're doing this build, as you're maintaining, not only are you building this, but you want to show them how you built it. That has a couple of benefits. Obviously, the team gets better, but it helps you. If you shoulder all the work but don't allow anyone else to learn from you, then you will just continue to shoulder all that work and the team will never really be able to take it over. Mentoring should be an ongoing activity from day one.

Some other things to consider too. You're going to be mentoring them, but there's going to be other certain areas that maybe you take over. A common thing that I'll see. You go to a client that's been live for a while. Epic always says, 'Make sure you're monitoring those interface error queues. Make sure somebody's monitoring the failed results routing pools.' A lot of clients maybe do that for a few weeks, and then their Epic ACs and AMs roll off and then some of that stuff ends up getting brushed under the rug. You, maybe as a consultant as an example, come in, you find one of those areas, and you take it over. That's another area where you want to mentor them. As you transition onto a new contract, if there are specific areas that you ended up taking on yourself, you want to make sure that there's somebody identified to own that going forward.

That's certainly a conversation to have with a team leader and manager, because you might not be in a position to authorize or require someone to do that, but by bringing that information to the team lead and the manager, that's your expertise. You've seen as a best practice we should be doing x and y. You might want to assign owners to that to make sure that it continues after we leave, so transitioning ownership of those areas and assigning people to it.

John: One thing I've seen from consultants who have done this transition really well is it's better to lean towards being too thorough or too formal with those transitions than not, to start setting up time 45 days out with your manager, like, 'Hey, here's my whole plan of what I plan on transitioning. Here's the documentation.' Not a couple e-mails here and there. Making it a really thorough, solid plan, so that there is no gray space. One of our Nordic maxims is 'embrace the gray,' but this is not a time to do that. This is a time where you want to leave things black and white for the team so that they know exactly what's going on, so leaning towards formal meetings, whatever you need to do.

Dan: It's a good point. I've run through what I like to do, but different clients are different. Some clients might be more mature. Some clients might have an expectation for what they want you to do. I'm laying out some of my best practices, but what I will typically do is, I know I'm transitioning on and moving on, I'll have that conversation with the manager to make sure that I know what they expect. I'll lay out what I'm going to do, 'Here's what I do,' maybe show them some examples of what I've done in the past, but is there anything in particular that the manager or the team lead might want you to do? There might be a few things on the table that you didn't get around to doing, like, 'Hey, if you had a few minutes or a day to sit down with x member of the team to show them a couple of these skills that I feel like they've been lacking on a little bit.'

Chances are either the manager or the team lead's got a few things in the back of their head that they'd like to see wrapped up, things that maybe you hadn't thought about. Having the conversation about what the client's expectation is for a transition is key. Then, obviously, once you know their expectations, you can either exceed them, and that will only make them happier.

John: I've also seen that's a good time to start, if you are moving on, or even if not, those formal transition meetings or those conversations with your manager to say, 'How happy are you with me and the product I've produced?' Assuming it's good, if you're a high-quality consultant, it shouldn't be a surprise if there's question marks there, but assuming it went well, starting to ask for a letter of recommendation or connecting with that person on LinkedIn. Because if you provided a great service, you should be able to use that to your advantage in the future and be able to say, 'This is the work I did and these are some examples, some letters of people who I've worked with in the past.' As we were talking about before, you never know when that orders manager that you worked with briefly for a couple weeks ends up the director at a client a couple years from now. Building those networks, it's a good time to do that too as you're wrapping up.

Dan: Yeah. I really like that. When we were talking about transitioning toward the end of the contract, there were a couple of buckets. We talked about transitioning the team, and you just hit the other one on the head, and that's your personal preparation now and that networking. That's definitely a key thing, is we're already having these conversations with the managers. It's a good time to get in front of them. Don't be timid about it. Networking is always good in the professional world, but particularly in the consulting world it's critical. We're constantly moving around. A lot of the value that you derive as a consultant comes from those experiences that you have at lots of different clients. You're able to more rapidly build skills, I believe, in a contract world than maybe as an FTE.

Along those lines, don't be afraid to have that conversation. I think consultants are going to come with different personalities, but don't be afraid to have the conversation with your manager to get that honest feedback. Even getting negative feedback is not bad either, because unless you're absolutely perfect, in which case I'd like to meet you because I could learn a lot, there's probably some things that you could work on a little bit, and by learning that from your manager, then you can improve on that in your next contract. Having the conversation with your manager, finding out what went well, seeing if they have any things for you to work on, but simple things like letter of recommendation ...

It's funny, in this digital world and LinkedIn and all that, people just don't even think about ... Like, 'Letter of recommendation? What is that?' I've actually personally asked for them at every site, and I swear half the time the response is, 'How should I give it to you? Do you want me to write it?' 'Just type it up in an e-mail.' It doesn't need to be formal. Just any sort of written recommendation is great, because I can put that in a file, I can show that to future clients. I can put that in my résumé for the day that I'm done consulting and I want to get off the road. You're constantly in front of a lot of people, in front of a lot of managers, in front of a lot of directors as a consultant, and you would be selling yourself short not to get those recommendations so that you have a nice handful of them for the future.

Along the lines of networking, I think its also really critical to make sure that you're networking with other consultants, even consultants from other firms. I would say consulting now for four years, Nordic does a phenomenal job of always finding contracts, but I probably get more text messages and leads from either former consultants or former clients that I've worked with. You made a comment about you never know when that FTE leaves and moves to another client. It literally just happened recently where the team lead of one of my former clients left, became a manager at another client that I'd never worked with. She messages me for an opportunity. It's all about timing. Rarely can you necessarily take those opportunities, but it's still good to know that they're thinking of you, they're thinking of you first because you left a lasting impression.

Maybe you might not be able to take that contract, but they're also going to look for you for a recommendation of someone else. That's what pretty much always happened, like, 'You know what? I got three months. I'm not going to be able to in the time you need,' and they'll be like, 'Well, do you know anyone else? Do you have any other colleagues who you've worked with?' 'Of course I do.' I'll always have some names and can always kick that back to Nordic or the firm because I know that we're going to have someone that can meet that. I'd rather see people that I know and the firm that I know fill that position than having the client have to go to another firm that might not do as well.

John: I think what you bring up as far as working through other firms or not ... Evaluating the firm that you're currently at for how well they also match your career, your path that you want to go on, that's important too. I obviously see the world through green-colored glasses. I love working at Nordic. I'm really proud of what we've put together, and I think with all the clients that we work with and the growing business lines, you will not have any more opportunities than you will at Nordic, but knowing what you as a consultant are looking for and the types of projects and taking a real hard look and saying, 'Is this the firm, not just for my next contract?' Because it's always tempting to take that one contract that seems really appealing, it's in a cool location, but how is that firm going to match and build you as a consultant, that contract, the one after? Because if you're looking to make a career out of this, the firm is a huge part of that.

Dan: Yeah. That's another interesting thing about networking, is networking, again, goes both ways. I have worked with consultants, I've even seen it happen with Nordic consultants, where they get towards the end of a contract and maybe Nordic didn't have the exact unicorn contract that they want and then they get this LinkedIn e-mail and then they start fishing around. The problem is, if you start doing something like that, you can really only end up doing that once or twice, because, again, networking can also go negative. If you end up burning your bridges with one firm, it is a surprisingly small world and you might get that one next contract that you got, but now you've moved to this other firm who you might not be as familiar with, who you might not have done your research on. Okay, so we got one contract that we're really excited about, but what comes after that? What's the next contract after that?

Evaluating the firm that you're with is absolutely critical. I think the most important thing about any career, whether we're in consulting or a full-time analyst somewhere, really your career happiness is going to come down to your employer, your manager, who you work for and if they've got the work that you enjoy doing. It can be tough. There's a lot of noise right now in the consulting world. As soon as you make a LinkedIn profile and you put the word Epic on there, you're going to start to get blown up. There's a lot of firms out there. There's a lot of recruiters. Wading through those can be difficult.

I think there's a couple probably good at least easy ways that you can try to weed some of that out. The first is, if you've been in the field for a while, this goes back to networking, talk to people who maybe have worked for them before. Before I chose Nordic and started consulting, I knew some former colleagues that had gotten into the consulting world, I knew some of the different firms that they had worked with, and I had some conversations. I just got on the phone and I sent some text messages and I said, 'Hey, you're working for x. What's it been like?' 'Hey, you're working for there ... ' you're going to get some of that feedback. Hopefully, they're honest with you. Leveraging your networking to find out about the certain firms is important.

Another good thing that you can do. I know firms in Nordic and Epic and everyone talks about class, but class I think is a really good indicator of the quality of that firm, because how the clients are talking about the firms, well, it's the clients that are giving the firms work, and if that firm is doing well and the clients think highly of them, then there's obviously going to be a greater chance that that firm is going to have more opportunities and is going to be thought of better, which is going to ultimately reflect better on you in the long run to say, 'Hey, I was at Nordic for five years,' versus, 'Hey, I was at XYZ Consulting.' You definitely want to do the research on that firm from the long-term standpoint.

John: A lot of it does come down to the right contract being available at the right time. Hopefully, it's through the firm you want, but sometimes you've got to be flexible on that.

Not the most fun conversation, but you should be prepared financially. It's good basic advice for anybody, but especially in a contract-based sort of thing. How do you financially ... We try to minimize downtime as much as we can, but it's an inevitable part of it that a week, two, is not uncommon, and sometimes longer. How do you get ready for that?

Dan: We in a contract-based world, we do it because it's exciting. You gain a lot of experience. It can be financially rewarding. Of course, the greater the rewards of anything, the greater the risk. The risk that we carry as contract employees is always that risk of moving onto the next contract. I have a couple of answers to that. My first answer, actually, dials back to when I was talking about, what are you looking for in your next contract? Ultimately, you need to make sure you have realistic expectations.

I mentioned the unicorn contract. Every consultant wants the unicorn contract. They want the one that's in Hawaii where they only have to go there once a month and they want the perfect rate and they'd ideally like to be in this perfect role, or, 'I'm just always going to work remote. I'm going to be a 100 percent remote consultant.' Well, those are not realistic expectations. It's not that you won't land one of those contracts, but the likelihood that you'll get that perfect contract will only extend the length of time it will take you to find it.

It's going to come down to how important it is for you to line everything up perfectly. If you have extremely high expectations, you should also have the expectation that you might have to wait a little bit longer to find that perfect contract. Either way, you've always got to assume that there could be some kind of downtime. Again, I'm saying I'm looking two months out to the end of the contract. Hopefully we find something before the end of this contract, but maybe the start date is a few weeks or a month after this first contract. Even if you found something, there could be some unplanned downtime.

When it comes to financially preparing, that's a pretty personal thing for a lot of people, but there are some pretty standardly agreed on metrics that you really want to try to maintain. I've heard anywhere from like three to six months up to a year of all expenses in reserves. I try to shoot a little bit higher. You want to make sure that you have some reserves set aside so that you're not in a pinch, so that you're not being forced to take that contract that you don't want, so that you're not putting maybe your family or anyone else in a bind. Always having a plan and always having appropriate expectations and just knowing that it could happen, so make sure you've got something set aside.

John: I definitely agree. I've talked to a lot of consultants who their, if not their primary ... Consultants make a good living, and one of their biggest things, they want to maximize their earning potential. They think that by doing that ... Take-home rate has a huge part of that, but so does downtime. If you're holding out for a rate that's a couple bucks more per hour but you're willing to take a week off, think about what that actually mean ... That week off, at the rates that we're talking about, how long do you need to work that three dollars more per hour rate in order to offset that week off is something that people should think about too as far as knowing your drivers.

Dan: Yeah. That's just it. It comes down to what's important to you in all those attributes and understanding then when those dates and what it actually means for finding that right contract.

John: One other thing we haven't really gone into much is what else you can do. We've talked about the things that you can do within a client to prepare yourself for your career path. There's stuff you can do outside of that too. If you're interested in becoming a project manager, going to get your PMP. If you were in Radiant and are looking to expand into Cupid, going to Epic certification. This time between contracts can be a good time, especially if you're going to have some downtime, to go ahead and make use of that and prepare yourself professionally as well.

Dan: Those are good questions. Part of that is knowing where you want to be. Again, this consulting industry that we're in, it's very competitive, and it gets more competitive by the day as more people enter the field. It's important to make sure you stand out. That's not exclusive to consulting. You want to make sure that in a professional environment you're always trying to improve your skills. For me, I'm on the road a lot with the travel. It's not glamorous, as everyone will soon find out. I really try to leverage that downtime in the hotels to try to improve myself professionally. I can either choose to hang out ... Of course, I watch plenty of Netflix and other TV, but if that's all I do then I know that I'm not growing.

There's a couple different things you can look at. Obviously, we're in the Epic world. I think it's important to always try to keep the gauge on the different applications and where things are going. Those are definitely things you should be able to learn from your firm. Hopefully, you're with a firm that will share that information and the amount of opportunities you have.

Your point about Cupid. When I started at Epic, I was Radiant at a time when Radiant had just started to explode. It really exploded in the few years that I started in it. At the time that Radiant was exploding, we had Cardiant. Cardiant was not even yet Cupid. A lot of people might not even know that. There was maybe like two people at Epic that implemented it. It was a little hodgepodge app and there weren't a lot of customers taking it. Lo and behold, a few years later you could really see Cupid start to trend the same way that Radiant was doing. I picked up that Cupid certification knowing or at least believing that it was going to grow like Radiant, and it really has. Now, four years later, or seven years later in my Epic career, I think we're probably at a point, I'd be really curious to see some graphs, where I think the Cupid opportunities have started to overtake the Radiant opportunities.

That's an area where for having a vision of maybe other applications and other skills so that you don't find yourself outmoded by the rest of the field, keeping an eye on Epic certifications, getting other certifications. Other big ones are now like Cogito, the Population Health. Another good place, too, is keeping an eye on industry news, so like HIStalk or Healthcare IT News. Just periodically reading those headlines you'll get an idea for what's important to the different clients and seeing then what types of applications or skills might meet that. That's one way.

Those are some Epic skills. There's of course a lot of other more industry agnostic type of certifications and skills that are definitely worth building. I think some big ones that I highlight that I see pretty prevalent in the health care IT world ... You mentioned project management. PMP, or, for the folks that don't yet have the experience, the CAPM, both of these are project management certifications through the PMI. These are globally recognized certifications. They're good to have not only in the health care IT world but they definitely transfer outside of health care IT. Those are good ones to pursue in your downtime.

Another certification that's pretty exclusive to health care IT is the CPHIMS, the Certified Professional Healthcare Information Management Systems. That's a mouthful. That's offered by HIMS, interestingly enough. It recognizes individuals with experience in health care IT systems, so it should be something that's right up a lot of people's alley. I wouldn't even say it's terribly difficult. That's one that's always good to fill the résumé with.

A couple of other interesting ones that I think I've definitely seen start to grow in popularity over the last few years. ITIL, which is a broad service management framework, is something that a lot of clients are adopting. You might not be aware of it, but pretty much any change management or ticketing system is going to employ some kind of ITIL practices. That certification is an interesting one. It has a lot of different levels. You start like a foundation and you can branch into different specific areas. Either way, familiarizing yourself with the basics is something that will translate and resonates well with clients because they're used to working in that.

Then I think the last one that I've seen grow a little bit too is Six Sigma or some of the Lean certifications. That's one that I personally haven't done yet but I think I'm probably going to tackle next. This is one that tends to be a little bit more important to post-live customers. Six Sigma and Lean focuses on maintaining system and monitoring errors and how can we slowly improve to a very minimal margin of issues. A lot of clients are starting to adopt in the health care IT world the Six Sigma and the Lean practices. That's another one that I think is worth taking a look at.

John: I think a point that you made there that's really important is you can do a lot of this prep and research yourself, but this absolutely should be an expectation you have of your firm, too, is that they're preparing you, that they're telling you what they're seeing. A couple years ago we know we saw it was the big implementation boom, and we're still seeing a lot of implementations, but we're seeing more move to, the customers that have been live for a couple years moving into optimization or they're tackling data and analytics or they're moving into population health.

Those are all trends that your firms should be ... First of all, if they don't have a take on that, that's something to ask about. If they do, and they should, how do you fit? How does your skills and what they know about you match with what they see the evolution of health care IT becoming? What best positions you for where things will be a couple years from now?

Dan: I really like that you brought that up. I was hoping we'd chat a little bit about that. First, some of that goes to your evaluation of the firm, so asking the firm what their vision is. If you're in that process of evaluating firms, having those conversations about how they understand the industry, where they see it in a few years, and just, do they even have an answer? Does it sound strong? Does it sound like it's something that's going to fit? One thing, and I'll be a Nordic spokesperson here for a minute, but one thing that I really love about Nordic and I think where Nordic is really hitting it out of the park is having an eye on the future. Still, I think the largest majority of our business comes in the implementation and the staffing, but as we know, the landscape is shifting. What Nordic has done a great job is focusing on some of those areas that they see growing, and so far Nordic has predicted it extremely well.

Does your firm offer other types ... We've been talking a lot about standard types of contracts like staff aug or new implementation, but one thing that's really awesome about Nordic is having some of these other opportunities and business lines to get in, move in more of a lateral direction, and have the opportunity to work on some different types of projects, so things like very focused optimization. Optimization gets thrown out very loosely, like, 'We're going to go in, we're going to make the system a little bit better,' but a focused optimization is going to bring in experts. We're going to evaluate it, we're going to have quantitative metrics on what the outcome of this project is going to be, and then we're going to go in there and execute on this and, again, then truly optimize the system based on what the most experienced consultants have seen across a hundred different clients. Optimization has been a big one.

Probably the biggest and most exciting one that I really like is the different affiliate, the community connect, the mergers and acquisitions. This is really exciting to see, not just from the Epic side, but I think this has really become a natural progression of the health care world. We've got these huge system, hundreds of millions of dollars. It really is pretty crazy how much money goes into this. A lot of people and particularly providers end up questioning, 'Well, what do we get for this money that we spent?' Now what we're finally seeing is we're seeing those big organizations, the big hospital, being able to leverage their Epic systems and see a return by reaching out to those smaller hospitals that Epic, as we know, just doesn't really work with the smaller hospitals, the smaller clinics.

Now you've got the clients with their system becoming almost the seller of the software, and so there's become a huge demand with helping clients roll out their existing Epic systems to these new either connect customers or mergers and acquisitions. That's a really exciting area, and I think Nordic had that spot on when they focused on that business line a few years back.

John: Yeah. As you mentioned, implementation support is still the majority of what we see, but it is shifting quickly to the amount of stuff that we see from affiliate, that we see from optimization, data analytics is going. Managed services, which is a new concept to Epic customers.

Dan: That one's really exciting.

John: That one's really exciting.

Dan: I want to fast forward 10 years and see where that's at.

John: Yeah. It's something that Cerner and other EHRs we know have done well. It's just a new thing within Epic and we're starting to see there's definitely a need for it out there. Knowing what your firm's take is on those things is really important, how that fits with you.

Dan: Yeah. I think when we're talking about evaluation, obviously I know that Nordic has knocked this one out of the park, but if you're looking at any firm, just knowing that they have a good vision for the future, because, again, there's a lot of firms, and I would say the vast majority of them are just in it for a cash grab right now and all they're doing is just trying to sell bodies to clients. Then, when that shores up, they'll probably move on to the next. They'll move on to the next technology they can get consultants for.

John: This is not the best segue I've ever had in my life, but we're just going to go with it. The under-appreciation I've seen some consultants give to their résumé as far as ... That speaks to who you are. It's the first impression that a client's going to have of you, for the most part, unless you've got a connection or a network or a reference or something like that. Making sure that that document is really as strong as you can make, because that's what you're going to get an interview based on. That really is you on a piece of paper.

You mentioned the OneNote that you use to keep up to date with, to keep a list of the things that you've done at a project. That seems like a useful thing that you could also go back to as you're getting towards that contract then and say, 'Hey, what does my résumé need to reflect based on what I've done at this place?'

Dan: Yeah, that's a good point. I think in general, again, this isn't just in consulting, I think most people don't enjoy updating their résumé. Most people don't look forward to interviews. This is, again, one of those things that just comes with the territory of being a consultant. You're going to be interviewing more often than if you were a full-time person. Again, knowing that the industry is becoming more and more competitive, you're probably not going to be the only application on the table. You're not going to be the only person that ends up interviewing for that position. Keeping that résumé up to date in that sense becomes very obvious. In my opinion, I think you should put as much care for your résumé for your next contract as you would if you were applying for a management or a director level position at some kind of a full-time opportunity.

Then, along with that, so you've got your résumé updates, and then you want to make sure that you're prepared for that interview as well. Some things that I do for that. You alluded to it a little bit. Again, you're doing a lot of things on a project. Maybe you've been there for a year. Maybe you've been there for two years. You do a lot of different things and so things change. If you're keeping that running list of the different types of build, that's helpful. A thing that I'll do is I'll just keep a little tab, and if there's certain maybe achievements that I made on a client or things that I was particularly proud of, I'll just run a bullet list so that I have those in the back of my mind, so that when it comes to updating that résumé I'm not putting it off and thinking, 'Oh, I've got to ... ' Everyone does put it off. Then I've got this pick list that I can just pull some items out. Usually that list ends up being longer than what you can fit on that. Then you've got the best things that you're the most proud of to add to that résumé and you're ready to go.

Definitely take care of your résumé. With that, too, even things like LinkedIn. I'm always amazed at how many consultants don't keep up their LinkedIn, or even little things like having a LinkedIn profile picture. Again, being in a competitive industry, there's a lot of other consultants out there, and your firm might not even be the only firm passing résumés to a client. There's a good chance that a client is going to go on LinkedIn, maybe look you up, and it makes a difference. They haven't met you. They usually don't even meet you in person till the first day you're on site. They're going to start looking. They're going to go, 'Well, this client takes care of his LinkedIn page.'

It might seem like a little thing, but it stands out. It sends a message, versus the person who doesn't even have, like, 'Why doesn't this person have a LinkedIn profile? Is this really not that important? Are they not really that professional? Maybe it's not the person I want here,' versus someone who's very proud of the work that they've done and wants to show it off. Don't skimp on LinkedIn. I'd say it's very prevalent in the health care IT field, and most FTEs and clients use it as well.

John: Dan, this has been great. I really appreciate you taking the time to sit down. Hopefully, everybody who listened learned something. This is an important time. You should treat it as a professional. You should treat is as your career, give it its due weight. I know you have, so I'll let you say a couple final thoughts.

Dan: If it's something that you've picked up on, hopefully can tell that consulting is something that I am very passionate about. I think that it's something ... The industry is changing, and I think a lot of people maybe think of consulting as this bridge or this temporary space, but if you treat it correctly, consulting really can become a permanent full-time position. For me, it's been some of the most rewarding if not the most rewarding experiences that I've had being able to work with so many different clients. Give it the nurture that you would of a full-time position, and it will certainly reward you back.

Topics: Epic Consulting

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