“Do what you do best and outsource the rest,” says Peter Drucker, one of the great management consultants of the 20th century. But it’s not always so simple. When it comes to deciding whether a medical practice should maintain its own IT staff, I often answer with a quote of my own: “It’s complicated.”
It doesn’t really matter whether or not you have a large or small practice, everybody needs help with technology. Larger practices with lots of personnel in differing roles have a more complicated mix of hardware and software, workflows, needs, and expected outcomes. As a result, these practices often have advanced technology, such as virtualized servers, specialized networks, and multiple device types throughout their operation. They tend to have one or more staff members that are tasked with keeping the digital lights on, often spending their day working in break/fix or firefighting mode. They’re tactical players, getting the job done with no time (or maybe even the knowledge) to plan for the digital future of the practice. In this case, keeping a small cadre of in-house desktop “fixers” is warranted, albeit at the expense of long-term strategic thinking.
Smaller practices often have a simpler environment but still need technical support – passwords are forgotten, keyboards break, printers jam – but not with such frequency that it justifies a full-time technician. The job often falls to the person with the greatest aptitude or interest in technology which, of course, keeps them from “their day job.” Contracting with a managed service provider (MSP) is likely the prudent and economic solution in this instance.
As we wrote last month, MSPs are aggregators of knowledge and skill that can be shared and distributed across a broad client base in the appropriate quantity, and at the right time. Part of the value of a managed service provider is that we allow for scale, up or down, depending on demand while representing an opportunity for significant savings.
Digital Delegation (let’s be honest, that sounds better than “outsourcing”) allows you to focus on the operations of your practice while having confidence that your technology is being monitored and maintained by experts.
As with medicine, technology requires specialization and expert knowledge to be managed, diagnosed and treated correctly. I’m reminded of a conversation that I had with a surgeon friend of mine. We were discussing which specialties a health system should offer. Market dynamics of supply and demand come in to play as there is a need for a sufficient population to provide the necessary number of cases to justify a particular specialty. The example that he brought up was neurosurgery – a highly specialized, highly valued skillset, with a distinct shortage of surgeons.
There is a balance that is difficult to maintain between emergency and scheduled needs (the need is most urgent and acute when there is a trauma), but keeping a 24×7 rotation of qualified surgeons is extremely challenging. And then how do you justify the expense – are they going to be busy enough beyond the emergencies?
The modern practice environment works in much the same way – the more cutting edge the technology, the more specialized and concentrated the experts become. The key difference is that the expertise of technologists is much easier to distribute – they can come across the wire to assist and manage. The necessary aggregation of work to justify the expertise is significantly easier as the geographic limits are erased.
The outsourcing dilemma is not always easy to solve but noted economist (and former Prime Minister of Singapore) Lee Kuan Kew said it this way: “If you deprive yourself of outsourcing and your competitors do not, you’re putting yourself out of business.”