Managing a new electronic health record system can be a nerve-racking experience for hospital executives. Millions of dollars are on the line, and patients expect the quality of care to be maintained regardless of what's happening in the back office. A few health systems with large IT implementations on their résumés are looking to ease that process for their peers.

Missouri-based Mercy health system hopes to capitalize on its experience of implementing and operating EHRs at about 30 of its own hospitals by helping other hospitals or physician practices manage applications, and by consulting and assisting with the mechanics of EHR system implementation.

When converting its 800-bed hospital in St. Louis to a new EHR system a few years ago, Mercy relied on red shirt-wearing superusers to help on the go-live date. "It looked like an army of red invading the building," says President and CEO Lynn Britton. "The good news was that, when I would walk the floor, nobody was complaining or upset. If they had a question, there were so many red shirts, all they did was tap them on the shoulder."

Gil Hoffman, chief information officer of Mercy, says the ideal clients for the service are small- to mid-sized hospitals, typically with 400 beds or fewer.

Mercy is not alone. Other health systems also are adding IT consulting to their service lines for similar reasons. Kootenai Health in Coeur d'Alene, Idaho, pulled its IT functions in-house in recent years, and now offers its EHR expertise to other provider organizations.

The approach has been a success for Kootenai, which includes a 254-bed hospital. Revenues generated through the consulting department have expanded from a little more than $5,000 shortly after it started to $5.4 million last year.

Even so, CIO Steve Garske, encourages others to avoid thinking of such an endeavor as a moneymaker. "You have to have the right motives. If we were in this for the money and a large profit margin, then we would be just like any other outsourcer," he says. "But what distinguishes us from everyone else is that we're a nonprofit entity."

Along with the added revenue streams, experts say hospitals can reap other benefits — for example, forging partnerships with other hospitals and physician practices to coordinate care. Another possible benefit: Projects with partnering organizations can keep IT staff engaged and energized — and less likely to leave for another job.

Hospitals that serve as IT consultants are fairly uncommon, says Lorren Pettit, vice president of market research for the Healthcare Information and Management Systems Society, but it's likely to happen more frequently among advanced EHR adopters.

"Hospitals and health systems have invested a lot of money, time and energy in their IT staff, so I think it's part of the equation that they are really trying to look around and say, 'OK, we've made these investments, now what else can we do to increase our ROI?' " he says.