BC Advantage (BCA): Can you tell us a little bit about yourself and why you started your own healthcare consulting company?
Amber Winkler (AW): After graduate school, I worked in healthcare for about 5 years before starting Clarify in 2011. During my work in and after grad school, I was fortunate to get some varied but complementary experience and exposure to the industry. It was 2009 and I was working in the PCMH, population health, and EHR optimization space-this was early compared to many other healthcare organizations and the industry as a whole. Many organizations are just now starting to tackle these projects, or haven't even started yet and it is 2016. This and my previous work allowed me to have certain experience, expertise, and exposure in a few areas, and laid the foundation for my ability to start a company and begin to help others. Looking back, I guess it was 2010 and into 2011 when I began feeling and thinking that I wanted to take the work I was doing and lessons learned and use that to work with more healthcare organizations, groups, and practices.

BCA: What does a typical work day normally entail for you?
AW: There really is no normal. That's one of the things I love about my life, but it's something that I know would drive other people crazy. Whether I'm in office or on the road, every day (or at least weekly), I spend time on client work, the business, networking, development, how to improve, follow-ups, and brainstorming. I also try to read or listen to a podcast, and get some form of exercise in daily.

There are definitely pros and cons to my "schedule." There are some early mornings or late nights involved, but on the opposite side, today I went to yoga at 9:30 a.m., and occasionally I'll play a round of golf in the late afternoon. I try to listen to my body, brain, and energy levels and give myself a break when it's needed. I find this is the best way I can ensure the time I spend working is effective and that I'm able to be creative and think critically.

BCA: Being a healthcare consultant, what challenges do you face on a day-to-day basis when helping practices achieve NCQA?
AW: Each practice or organization has strengths and weaknesses, but they are always different. One of the first challenges is understanding a client's culture. Asking the right questions and clear communication is also an ongoing emphasis and area that can make or break relationships. What resources, skills, or strengths does a client have that we need to capitalize on? What areas or processes need to be improved, put in place, or strengthened? Expectations and perception are also difficult to quickly understand and manage. As a consultant, I come in as an outsider, and there are always inner-organizational dynamics, relationships, protocols, processes, and history that we quickly need to understand, navigate, or ignore in order to be effective. That's right, I said ignore. Not always, but at times, the reason we're impactful is because we push through mental constructs, barriers, or patterns of behavior that are holding the group back from achieving the progress they desire.

BCA: In your opinion, is it important for every practice to have a healthcare consultant?
AW: I actually don't think every practice needs a consultant. I also don't think every organization and a particular consultant will be a good fit.
When an organization or leader understands the value of consulting, and invests in it to better their organization, save time, and do things right the first time, it is an ideal consultant-client relationship. 

What I will say is, many practices don't think they need a consultant, or believe they can't afford it without looking into it, and they are the ones who actually need a little help the most. Often the staff or teams at these organizations are the most extended or overworked, and people end up feeling they aren't doing anything well. This is terrible for morale and retaining staff. Turnover is costly. Often it is actually less expensive (direct and indirect costs) to subcontract us (Clarify) than to put the additional work on your staff or hire an additional person, and that person likely doesn't have expertise in certain areas, so they're trying to learn this from scratch. In the projects we take on, we've done that type of work before, so we can save people time, help them avoid or quickly solve problems, and even find ways to save money and make money in our work together.

Here's a quick story. We showed up for our first meeting with a new PCMH and Population Health client. They're a fantastic, very effective group. They were planning on hiring a registered nurse (RN) and assumed they needed this role immediately. This would be a very expensive addition to their team. In five minutes, we shared with them how to avoid or delay this new hire until they had a specific set of reasons or roles. The average RN salary in the U.S. is $67,930. When you consider salary plus benefits, we probably saved them nearly $100,000 in five minutes.

BCA: You're the CEO of Clarify. How hard/easy would you say it is to develop effective measurements and reporting systems that drive improvement for your clients?
AW: This is one of my favorite parts of what we do with clients. I wouldn't say that it's easy, but it's rewarding. What is easy and what is difficult varies by the size and capabilities of the organization. Sometimes, large health systems have almost unlimited capabilities, but it may take longer or be more complicated. And smaller organizations face different challenges. We almost always are able to find a way to utilize existing measurement systems, tools, or technologies for reporting and measurement, and using what we find to make improvements. Our goal is to make small changes that deliver big results. It is not our aim to make massive, disruptive, or heavy-handed changes.

BCA: What has been your biggest achievement so far in your career that means the most to you?
AW: This is tough. Along the way there have been both big and small wins for our clients and our company. Speaking at both the first and second annual NCQA PCMH Congress is a proud moment (2015 and 2016). NCQA is the market leader in PCMH Recognition and they are a PCMH "governing body" of sorts. It is an honor to speak on that type of national platform, particularly two years in a row. Another achievement is starting the company in 2011 just after my 28th birthday. Starting a company was a lifetime goal of mine.

BCA: If someone would like to obtain a career as a healthcare consultant or become a self-employed healthcare consultant, what kind of advice could you give them?
AW: It's a lot of fun, and always full of challenges and rewards, for me. But it's not for everyone. Your life and path will be very different if you pursue work at a large consulting firm, a small firm, or if you start your own firm. Every company is also unique. It will also vary based on your level of experience or expertise. If you're a student or in a position to intern, I'd recommend doing an internship to see how you react to the environment and preferably try a couple of environments. If you know or can connect with people who work in the industry or similar companies to those you seek, ask them questions about what it's like and see if that feels like a good fit for you. If you have an interview, ask good questions and find out as much about the company culture and job expectations as you can. Do some honest soul-searching about things like travel, your preferred work style, if you like project-based work, if you can handle change. Your research and answers will help inform your decisions. For example, I enjoy business-related travel, but a project helped me realize I do not like to travel four days per week every week. I know people who do this and love it-it's their "normal."

A friend from graduate school is an employee of a company, but serves as "internal consultant" of sorts, working with different departments and projects all the time-he worked at a large firm before landing his current role. Consulting means a lot of different things; there are many different types of consulting and consulting environments, so being honest with yourself will help you find a good fit. There's no point in being miserable at work-life is too precious and short, so do something you love.

Also visit www.getclarify.com for more information about Amber and her services.