News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

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Becker’s Health IT Releases Lists of Providers That Paid the Most for Their EHRs

New EHR installations may require new laboratory information system upgrades and interfaces

Electronic health record (EHR) systems continue to be one of the costliest investments healthcare providers can make. And the company that holds the largest portion of the EHR market is Epic, with anywhere from 36% to 44%, according to various published reports and research briefs.

Healthcare executives remorseful about the cost of their hospital’s EHR may take solace in Becker’s Health IT’s recent list of the “most expensive” Epic EHR installations. It is common for the largest projects to cross the $1 billion mark.

Clinical laboratory leaders tasked with interfacing their hospital’s laboratory information system (LIS) with their healthcare system’s EHR may find the following information useful. The investment in time begins months before the actual EHR implementation.

One example is Lake Charles Memorial Health System (LCMHS) Lake Charles, La. In a blog post, the health system reported that it took 18 months for its physicians, clinicians, and staff to prepare for the installation of their new Epic MyChart EHR.

“There are lots of things we wish our customers would do to make sure their system runs well. Making sure every user is trained, for example. Putting in upgrades quickly. Making sure that the hardware runs fast enough,” wrote Judy Faulkner, Epic founder and CEO, in an Epic blog post.

“The LCMHS staff and physicians have championed this project from the beginning, and I have them to thank for the success of this EMR transition and look forward to seeing the positive impacts as we settle into the operational changes and new experiences Epic brings Lake Charles Memorial Health System and those we serve,” said Devon Hyde (above), President and CEO of Lake Charles Memorial Health System, about the provider’s transition to a new Epic MyChart EHR. (Photo copyright: Lake Charles Memorial Health System.)

Top 10 Most Expensive Epic EHR Installs of 2024

While Becker’s noted that the following compilation is “not an exhaustive list,” here’s its list of the top 10 most expensive Epic EHR projects based on publicly available sources.

  1. Northwell Health, New Hyde Park, N.Y.:                                          $1.2 billion
  2. Trinity Health, Livonia, Mich.:                                                          $800 million
  3. AdventHealth, Altamonte Springs, Fla.:                                            $660 million
  4. Memorial Hermann Health System, Houston:                                   $500 million
  5. UAB Health System, Birmingham, Ala.:                                           $380 million
  6. Broward Health, Fort Lauderdale, Fla.:                                             $250 million
  7. Wellstar Health System, Marietta, Ga.:                                              $175 million
  8. Health First, Rockledge, Fla.:                                                             $160 million
  9. Sarasota Memorial Health Care System, Sarasota, Fla.:                    $160 million
  10. MultiCare Health System, Tacoma, Wash.:                                       $50 million

Largest Epic EHR Projects Ever

Beyond 2024, here are the “largest Epic EHR projects of all time,” Becker’s Health IT reported separately based on publicly available sources:

  1. Kaiser Permanente, Oakland, Calif:                                                   $4 billion
  2. Mayo Clinic, Rochester, Minn.:                                                         $1.5 billion
  3. Mass General Brigham, Somerville, Mass.:                                       $1.2 billion
  4. Northwell Health, New Hyde Park, N.Y.:                                          $1.2 billion
  5. NYC Health and Hospitals, New York, N.Y.:                                   $1 billion
  6. Sutter Health, Sacramento, Calif.:                                                      $1 billion
  7. New York-Presbyterian, New York, N.Y.:                                        $964 million
  8. Providence, Renton, Wash.:                                                               $800 million   
  9. Trinity Health, Livonia, Mich.:                                                          $800 million
  10. Duke University Health, Durham, N.C.:                                            $700 million
  11. UMass Memorial Health, Worcester, Mass.:                                     $700 million   

Training Key for New EHR: Report

According to a report by research firm KLAS titled, “EHR Implementations 2025: Investing in People to Avoid Pitfalls and Ensure Clinical Success,” in addition to the “tremendous financial undertaking,” healthcare organizations also face implementation challenges following EHR installations.

KLAS reported that among the healthcare leaders KLAS interviewed:

  • 27% had “an above-average EHR post-implementation” likely due to “providing technological foundation needed” at go-live, while,
  • 40% said implementation of the EHR “had significant misses” and,
  • 22% reported “average satisfaction with room for improvement.”

Providing staff with adequate training may smooth the way for new EHRs, according to the KLAS report. “Often, leaders wish they had invested in more training time and workflow-specific training in the context of patient care,” the authors wrote.

New EHR May Mean New LIS

Pathologists and clinical laboratory leaders may need to transition the laboratory information system (LIS) when the healthcare organization moves to a new EHR. At the very least, new interfaces will be required.

While a new EHR and LIS requires significant investments, they also provide opportunities for needed upgrades, competitive advantage, and security.           

—Donna Marie Pocius

New Trend in Hospital Administration: On-Demand Management Assignments

Pathology groups and clinical laboratories experiencing shortages in management positions may want to consider on-demand healthcare leaders

Are “on-demand” leaders the answer to clinical laboratory and pathology group staff shortages? Perhaps. A new twist on management philosophies is gaining steam in hospitals: Hiring on-demand managers and executives to fill gaps in high-level staff. The practice is growing quickly and making its mark.

“[On-demand leadership] is really taking off,” said Adam Burns, Principal, Interim Leadership, at international executive search/leadership consulting firm WittKieffer, in a Newsweek article. “I think it’s something that’s going to be permanent in the industry. Once [health systems] start to think about all the different ways they could use somebody—when you take the org chart out of it and just think about the lists of challenges and projects and opportunities they have—it’s endless.”

Clinical lab administrators and pathologists should note that the trend of on-demand management assignments is distinctly different from the traditional locum tenens and temporary staffing that have been common in healthcare for decades. These arrangements are typically used to engage physicians and laboratory scientists to handle the daily delivery of clinical services. The on-demand management model engages individuals with proven management skills to address specific initiatives and projects that the institution would not otherwise be able to achieve.

Tight finances in many hospitals make hiring on-demand managers for short-term assignments versus long-term permanent positions a cost-effective way to deal with projects that need specific skills to be implemented. Another factor is experienced hospital administrators who retire but then want to return on a limited basis. They have desirable skills, knowledge, and energy worth retaining and on-demand positions may make that possible and affordable.

As hospitals warm up to on-demand engagements, clinical laboratories may also see benefits as the trend widens and gains more acceptance.

“The business challenges in healthcare are getting bigger every year. They’re very high stakes, because people’s lives are at stake,” Sandra Pinnavaia (above), Partner, Global Head, On-Demand Talent Strategy and Innovation at Heidrick and Struggles, told Becker’s Hospital Review. The Chicago-based global executive search and consulting firm has seen a strong increase in hospital placements and notes that healthcare is the “eighth most served industry sector in the US.” Pinnavaia says this growth helps hospitals keep up with “an evolving industry,” of leaning on temporary help. Might clinical laboratories benefit from filling empty leadership positions with on-demand leaders? (Photo copyright: Heidrick and Struggles.)

Who Are On-Demand Executives, What Positions Do They Fill?

According to Becker’s Hospital Review, an on-demand executive is “an independent and established business professional—ranging from the C-suite to the director level, or a management consultant,” who is often brought in to help with specific projects or fill gaps within an organization as needed during transitional times. Most provide temporary support without seeking full-time stability.

Top on-demand positions, Becker’s reported, include:

  • Financial controls,
  • Accounting and auditing,
  • Organizational design and workforce planning, and
  • Technology and systems implementation.

There has been a steady two-year increase of health systems “looking for senior leaders to solve specific problems rather than to hold specific titles,” Burns told Newsweek.

Occasionally, a “specialized eye” is needed for specific challenges, such as hiring a former Chief Information Security Officer (CISO) to establish an infrastructure that lasts beyond his or her stay, Newsweek noted.

“[Hiring an on-demand leader is] the most cost-effective option,” Burns said. “Organizations compare it to the cost of consulting firms, and when you compare hiring a senior leader in an on-demand capacity to hiring a consulting firm, many times it’s a third or half of the expense.”

Additionally, many hospital systems are still regrouping after the fallout from the COVID-19 pandemic. With all the consolidation that occurred to leadership teams as cost-savings efforts, many “systems lack the bench strength to source special projects from within,” Newsweek added.

Plusses for Hospitals

The benefits are numerous for hospitals according to Burns. “When health systems reflexively look inward for new projects, they can unconsciously build their tolerance for the status quo. On the other hand, a fresh, unbiased perspective can open new doors for the organization. On-demand leaders can make honest recommendations about what is best for the health system, free from internal politics or preexisting expectations,” he told Newsweek.

“The right on-demand leader can create momentum [on a project] without a long-term engagement with our system when there is no definitive construct of what an organization wants a function or role to look like,” Feby Abraham, PhD, Executive Vice President and Chief Strategy Officer at Memorial Hermann Health System in Houston, told Becker’s Hospital Review.

Further, “these roles provide opportunities for leaders with extensive healthcare experience, allow for a faster track to build momentum, and allow for developing a clearer vision for the long-term, full-time version of roles,” he added.

Plusses for On-Demanders

Pinnavaia told Becker’s Hospital Review, “[On-demand executives] are free agents, independent, and available to jump in and out of the organizations they serve, either by providing a proper coverage to a gap, like being an interim leader sitting in a gap, or to the augmentation of injecting skills and experience around a particular topic or movement in the business cycle.”

Burns notes that “numerous factors [are] fueling demand” for on-demand positions, Newsweek reported, adding that “Baby boomers are aging out of senior leadership roles and into retirement, leaving experience gaps in their wake. But after a year of vacationing and pursuing hobbies, many healthcare executives start itching for a new challenge. They become strong candidates for on-demand roles, which allow them to contribute their extensive knowledge without committing to an indefinite seat.”

It’s Not Magic

“This is a growing category, but it’s not magic,” Pinnavaia told Becker’s Hospital Review. “It takes an intermediary that advises both sides of the equation about how to make the project successful, how to structure the project, how to onboard someone, how to really make sure it’s going well. Secondly, it takes talent that has really done this before … it is a learning muscle,” she added.

Abraham agreed. “Many of the challenges revolved around crafting the role description up front, finding the right candidate, and then getting feedback to maximize the impact of that on-demand role itself,” he told Becker’s Hospital Review.

While hospitals warm to the notion of on-demand engagements, this trend may make its way into many clinical laboratories. Readers who work within hospital and healthcare settings should pay close attention. Understanding how these services are being used can provide a proper heads-up of what may come.

Do you have a story to share of your own experience? Hospital and health system laboratories using on-demand management assignments are invited to contact us to share their successes with this approach and the lessons learned.

—Kristin Althea O’Connor

Related Information:

Healthcare ‘Free Agents:’ Hospitals Embrace On-demand Leadership

Hospital in Crisis? Call an On-Demand Health Care Exec

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