Part XIV: The Consultant’s Approach

Laura Kolkman, RN, MS, FHIMSS  
Bob Brown

By Laura Kolkman, RN, MS, FHIMSS, and Bob Brown

In this series of monthly articles, the authors, based in part on their recently published book, discuss current HIE-related events and leading practices within the context of forming an HIE initiative in your state, region or community. This is Part 14 of the series. You can access previous installments at the HIELights e-newsletter archives.

In this month’s column, we’ll give a brief overview of consulting competencies and practices typically associated with HIE formation engagements. If you’ll be working with consultants, it’s appropriate to understand a little about the art and science of consulting, especially as it relates to HIE formation

Working with a consulting firm on an HIE formation effort typically begins with some form of assessment of your team’s readiness to accomplish the objective.  Have you defined your objective in detail?  Do you know what’s required to get there?  What work has already been done – by you or your team – that can be leveraged?  Are the team’s skills and experience sufficient for the activities that must still be accomplished?

The result of the assessment phase is a plan of action that leverages the work that has been done to date, ensures any necessary corrections are made, closes the remaining gaps that exist, and defines the activities that must still be accomplished to reach your objective.  Given all the variables, it answers the question, “What’s the best way for us to reach our objective?”

Many consultants use a solutions-based consulting approach when the objective is, at least at a high level, understood and agreed upon.  To do so, they should have access to a body of knowledge that describes the objective and what it should look like (in this case a functional HIE).  Any consultants you’re thinking about engaging to help you with your HIE initiative should:

  • Be able to describe and clearly articulate the attributes of a successful HIE;
  • Understand and describe each of the essential HIE formation activities that must be accomplished in order to reach that objective;
  • Understand the multiple competencies (knowledge, experience, expertise) that must be present in the client’s team to accomplish those activities;
  • Understand the range of leading practices – based on the consultant’s own research and experience – that might be used to accomplish each of those activities;
  • Be able to provide constructs, templates, checklists and examples related to each of the activities to be performed;
  • Understand the specific criteria that must be met to constitute a successful completion of each of the essential activities; and
  • Have been down this path before; they should have previously done this type of work and have solid references.

On this type of engagement, the consultant’s job is to provide expert advice, clear guidance, and transfer the knowledge needed for the client to be successful.  In all the HIE formation efforts in which we have been involved, the clients understood that they had the primary responsibility for recruiting and managing a team of competent professionals (volunteers or paid staff) that would shoulder most of the day-to-day heavy lifting  Our approach is based on the fact that it’s the client’s HIE, not ours.  We understand that like politics, healthcare is local.  So, we provide them with:

  • An approach to identify and engage the key stakeholders they will serve;
  • Advice on forming an organizational entity that specializes in handling protected health information;
  • An understanding on how all the HIE formation activities relate to each other  – and the end objective;
  • Insights on the best order in which the required activities should be performed;
  • Suggestions on the best approaches to completing the activities;
  • Constructs, templates, checklists and examples related to each of the activities to be performed;
  • An understanding of the critical success factors that must be met or accomplished while completing each activity; and
  • Key performance indicators that can be used to measure their progress to reaching their objective.

Forming an HIE is a complex process with many moving – and sometimes conflicting – parts and priorities.  Having a trusted advisor by your side is an approach that many communities are realizing is worth investigating.

Next month, we’ll begin a discussion of specific activities that are typically undertaken as part of an HIE formation project.

Laura Kolkman, RN, MS, FHIMSS is the President of Mosaica Partners and Bob Brown is the VP of Professional Services. Their book—The Health Information Exchange Formation Guide—was published by HIMSS in February 2011, and was the winner of the 2012 Book of the Year Award. View the HIMSS’ companion web site to read chapter summaries and download select tables, figures, illustrations and checklists.