About
About Smith Mountain Advisors
Smith Mountain Advisors is an independent executive advisory firm for health systems. We help healthcare executives turn continuous technology change into measurable value—deciding what matters, aligning investment with organizational capacity, and putting the right changes to work.
The firm
We sit on your side of the table
SMA is independent of software-vendor, implementation-firm, and staffing economics: we don't resell software, we don't staff implementations, and no partner drives a recommendation. The firm is principal-led by an operator who has managed the consequences of these decisions, and it is organized around measurable value, not technology deployment. We work alongside your existing teams—not in place of them. How every engagement runs is described at How We Work.
Smith Mountain Advisors operates at the intersection of strategy, execution, and risk containment. We are most often brought in when execution risk is high and timelines are non-negotiable, when leadership needs a single aligned view of a program, when financial performance is under pressure, or when a program needs both credibility and course correction.
Principal
Noelle Brackett, Chief Executive Officer
Healthcare Technology · Strategic Advisor
Noelle Brackett is a healthcare technology advisor specializing in large-scale EHR implementations, post-go-live optimization, and complex merger and acquisition integrations. Her work spans full-lifecycle transformations across academic medical centers, children's hospitals, and multi-hospital systems, and she is known for stabilizing high-risk environments, aligning executive leadership, and building operating models that deliver measurable financial, clinical and operational performance.
She has led some of the most complex healthcare transformations in the country: enterprise Epic transitions from legacy platforms including Cerner, Meditech, and eClinicalWorks; migrations to cloud-hosted environments with a modernized security posture; large-scale clinical and operational workflow redesign; the rationalization of more than 900 applications to 160; post-acquisition IT due diligence, infrastructure redesign, and consolidation; and end-to-end hospital-acquisition integration covering infrastructure, data conversion, and restructuring.
Areas of expertise
- Pre-implementation strategy and preparation
- Enterprise EHR implementations (Epic and multi-platform)
- Application rationalization
- Mergers, acquisitions, and system integration
- Post-go-live optimization and performance improvement
- Governance design and management
- IT operating model and operational governance design
- Operational readiness
- Revenue cycle and patient access transformation
- Large-scale training and adoption (10,000 to 34,000+ users)
$276M+
Revenue improvement
$186.4M
Vendor cost savings
$139.2M
Budget savings
$47.4M
Project savings
125%
Ticket-aging improvement
Results from work led by SMA leadership across academic medical centers, children's hospitals, and multi-hospital systems.
What clients say
“Noelle went above and beyond to make our implementation a true success. I couldn't have done it without her leadership and partnership, and I value the trust and relationship we built along the way.”Tina Haskins Smith, Chief Applications Officer, Seattle Children's Hospital
“Noelle has a rare gift for helping healthcare leaders turn big-picture strategy into front-line systems that work. She brings order to complex implementations, strengthens workflows, and gives teams the clarity, confidence, and momentum they need to succeed.”Linda R. Potts, MSN, RNC-OB, BC-NI, ACNO, Tufts Medicine
Experience includes work with
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