When opportunity knocks, it sometimes takes the guise of free time. In the case of Zachary Fridirici, M.D., recognizing that led to a brainstorm that is offering mutual benefit to health systems as they go live with EHR systems and a growing cadre of medical students and residents who are helping that process while earning some welcome income at the same time.

Fridirici, currently a resident in otolaryngology at Loyola University Health System in Chicago, is also the founder of MedDocLive, which uses medical students and resident physicians to help nurse practitioners, physician assistants, and physicians, learn some of the intricacies of EHR systems at the time of deployment. Fridirici says he originally got the idea in 2009 while he was a project manager for Epic Systems, when he noticed medical students at a customer site were incredibly quick to pick up the system.

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"They were young, they were tech-savvy, and they picked up the system even though they hadn't really seen it and had done about two hours of computer-based training," Fridirici told Health Data Management. "They were probably using the system twice as fluently as I was even though I could program the system and could make changes behind the scenes."

Before he made the career switch to the clinical side of medicine, Fridirici said he didn't thoroughly understand the workflow of hospitals; he also had a perception that medical students would be overwhelmed with work and would not be able to take the time to moonlight as EHR trainers. By the time he reached his own fourth year as a medical student, however, he realized his brainstorm might be viable – that not only could fourth-year students and residents offer clinical staff virtual peer-to-peer advice on a new EHR, they could also earn some much-needed income in the process.

"To be honest, when I was a medical student I remember trying to find a way to pay down my debt, to find a way to make some side cash so I could go out to dinner and not think about that," Fridirici said. "This is a fantastic way where you can take a week of vacation and make $2,000 or $3,000 so you can go on a trip, or go out to dinner, or buy that engagement ring. I think those are the best stories we get from medical students when we reach out to them to see how things went."

Things so far seem to be going quite well for the fledgling company, which officially launched in 2013. Fridirici said MedDocLive grossed about $1.4 million in 2014 and expects to earn about the same this year. The roster of potential trainers has also grown quickly, from 700 to 1,000 in the past few months alone.

The company's customers have included Henry Ford Health System in Detroit, St. Luke's Health System in Kansas City, Unity Point Health in Iowa, and Rockford Health System in Illinois, which Fridirici said was the proof-of-concept site for his idea, prior to the formal creation of the company.

"If I hadthe opportunity to do it again, I would do it in a heartbeat," said Denis L'Heureux, Rockford's senior vice president for IT planing and CIO. Not only did Fridirici quote him an extremely attractive price, allowing him to bring on all of the students available, but L'Heureux said the staff physicians also accepted the students' advice without hesitation.

"If I had sent IT people to the doctors, they would have spent five minutes yelling at my guys," L'Heureux said. "When I sent two medical students, the doctors didn't yell at them – the doctors wanted to show them they were already doctors and they wanted to encourage these kids to become doctors. So instead of yelling at anybody, they were open, they had a conversation with them. The students were able to calmly show the doctors what to do and the doctors were listening."

Thus far, Fridirici said, all of MedDocLive's customers have been installing Epic systems; he is open and welcoming of working with hospitals on other platforms, but said perhaps his own background at Epic may be a factor.

When a customer signs MedDocLive on, Fridirici and his partner – they are the only members of the company's staff – send out an email blast to their roster and fill out the ranks of available trainers. The current structure of the company, he said, allows the partners to be hands-on with every project, "so we know what's going on, we know who's going to be there, so we don't have the issues some of the other staffing companies have where people aren't showing up or are showing up late to shifts."

MedDocLive is not formally aligned with Epic or any other training entity; his students and residents are not on-site to replace any sort of corporate EHR education, but rather as an adjunct resource.

"We're specialized for the mid-level clinicians – the nurse practitioners, the physician's assistants, and then the physicians themselves," he said. "Because those roles are the same within Epic in terms of signing orders and writing notes, that's when we actually become valuable to these hospitals. We come in and are able to get them the shortcuts. We're able to take something that takes six clicks and make it two clicks once you know the shortcut."

As the first big wave of EHR deployments abates, Fridirici realizes his business model may prove expendable, but he is sanguine about its prospects in any event.

"When I started the company, I told my business partner it may be a four- or five-year company, and he was OK with that," Fridirici said. "The more we've been in this and the more we've learned about the industry, it will probably have a little more longevity. I don't know if it's something I'll be doing for the rest of my life, but it's definitely something in the meantime that I love and enjoy, and as long as I can provide a service for the medical students and residents with us, that's what I'm doing."

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