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The EHR Dress Rehearsal: Because Practice Makes Perfect

Posted on July 14, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Over the past year I have been leading the implementation of Epic for University Medical Center of Southern Nevada (UMC). On July 1st, we went live at our primary care and urgent care clinics. The go-live was a great success. While no go-live is flawless, we encountered minimal issues that could not be quickly resolved and user adoption was excellent despite the majority of the users using an EHR for the first time.

Today is July 8th, and I’m spending a quiet day in our command center just one week after go-live and reflecting on the factors that made this transition exceed even our optimistic projections. By Day 3, users were comfortable with basic workflows and bills were going out the door. One week into go-live, we are scaling back our on-site support and discussing closing down the command center earlier then expected. Our team universally agrees that the most significant factor in our success was a last minute addition to the methodology – what I refer to as the Workflow Dress Rehearsal.

In my experience regardless of the quality of training that is provided, the classroom is not enough to prepare the staff for what happens when the patients start to walk in the door. Learning in your actual environment helps staff to gain comfort and uncovers challenges in technology and workflow that even the best testing will not reveal.

The concept of doing a true dress rehearsal that mirrors the real experience as closely as possible is one that dates back to retail point of sale and inventory implementations that I did 20 years ago. During those projects, we would shut the doors of the operation and have the staff go through a “day in the life” on the new system – doing everything as they would do it on go-live day – using their actual workstations and logging into the production system. We decided to apply this same concept to an EHR implementation and provide a full-day experience for the entire clinic staff as the final component of their training.

The logistics of making this happen across 8 physical locations and 15 busy clinics required extensive planning and execution. We created a full-day experience starting with scripted patients who would be represented by a clipboard that moved from the front desk and to triage before being roomed. Nurses and physicians went in and out of rooms as they would with real patients, completing the appropriate steps in each room. Later as they gained more comfort, we substituted the clip boards with actual people who represented patients – making up symptoms to help the staff learn how to navigate the EMR and be prepared for what would happen with a real person answering questions, such as providing information out of order of the screens. By the end of the day, the staff was gaining confidence in the application and in themselves. They were also learning how to work as a team in an EMR environment. Most of all, they found the experience more fun, and more directly beneficial then their classroom experience.

The benefits to this process were numerous, and the key contributor to the reduction in our support needs at go-live. Here are just a few examples of the benefits it provided:

1) Security was validated – Every user had the chance to log into production and do actual work just as they would on go-live day. As a result, security issues were resolved during the rehearsal and we had less then a dozen security calls during the first week.
2) Hardware was tested – Taking the previously completed technical dress rehearsal one step further, every workstation and ancillary hardware device was used just as it would be on go-live day. The result was we identified gaps in available hardware, incorrectly mapped printers, and configuration issues that could be resolved the same day, eliminating issues during the actual go-live.
3) End to End Workflow Validation – Nurses, Front Desk, and Physicians had received training individually as each had different content to learn, but didn’t fully appreciate how it all came together. The Workflow Dress Rehearsal allowed them to understand the full life cycle of the patient in the clinic and how their documentation impacts others later in the process. Through this process, they gained an appreciation for each of their respective roles in the EHR experience.
4) Practice, Comfort, and Speed – Working on the system in their actual work environment helped them to gain confidence and get faster using the application. While our mock patient experience is not the same as having a real sick patient in front of them – it was the closest experience that we could create so when the actual patients walked in the door, they knew what to do.
5) Content – We encouraged physicians and nurses to try common orders and medications that they use on a regular basis to make sure they were available and setup properly. Inevitably, we uncovered missing or incorrect information and were able to correct them well before go-live. The result was minimal missing content at go-live as we had already worked out those issues.

The Workflow Dress Rehearsal process allowed us to uncover many of the issues that would have happened at go-live while also allowing the staff to gain comfort with the new solution in a lower-pressure environment. The result? A quiet go-live with minimal complications and a happier staff. Encounters were all being closed the same day, and staff were going home on schedule. These rehearsals also created an educational experience that was fun and motivating to the staff and was of more value to them then another day in the classroom would have been.

I believe that this process can be applied to the implementation of any software solution in any environment. Its not always easy, and we realize that it will be much more complicated to create this experience as part of our hospital go-live later this year. However, the time invested paid off as it saved us so much time in the support of the system during go-live, and created a better experience for our patients during our first week on Epic.

Consider how you can create a Workflow Dress Rehearsal experience for your ERP, EHR, and other solution deployments and you may find that it is a critical success factor to your go-live as well.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Rumor Control: These are the Facts

Posted on January 16, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Why is it that one of the largest challenges on any project is miscommunication and out of control rumors? While many projects need and would benefit from more communication, even with the best of communication plans, project teams can spend more time dispelling false information than proactively communicating.

I believe in strong communication plans for EHR and ERP projects that include a wide range of communication including town halls, newsletters, emails, signage, internet sites, and other methods of sharing correct information. But on every project, no matter how much we communicate, certain hospital staff will find other sources of information.

I can see the rumor coming when an email or conversation starts with “I heard that…” or “Is it true that…”. These are telltale signs that I am about to hear a rumor. Rumors can range from minor details to far-reaching implications such as a perceived change in project scope or even the live date. While most rumors are just annoyances, responding to them and controlling them can be a significant strain on the project team’s time.

I believe that hospitals have a unique challenge in that proactive communication is more challenging than in many traditional businesses because it is common for a large portion of the staff, including nurses and physicians, to rarely check email. As a result, they are often in a position where “hallway conversation” is how they first hear information and are more likely to give it credibility.

While I admit that I have personally never been able to fully eliminate the rumor challenge, I’d like to share several ideas about what I have seen as an effective way to keep the rumor mill under control:

1) Establish a clear Source of Truth – From the very beginning of the project, communicate to every possible audience how decision and communications will be distributed and who they should contact with questions and information. If it doesn’t come from one of the accepted Sources of Truth, its not true. When I lead a project, I prefer to be the Source of Truth – if it doesn’t come from me verbally or in writing, it isn’t true.

2) Encourage questions and respond to all of them timely – When I am running a project, my motto is “Ask me anything, anytime”. At times, I will get dozens or even hundreds of questions a day through meetings, phone calls, texts, and emails. I respond to every question, providing the truth if I have it, or getting them to the person who can provide the truth. Rumors often start because staff members are not getting answers or don’t feel their questions are welcomed. How do I respond to so many requests? I do it immediately so they can’t accumulate – which also helps inspire confidence and a feeling that they can ask rather than assume.

3) Town Halls – I strongly believe that a change management and communication strategy must include town halls. During town halls, project teams should provide an overview of what is occurring that is relevant to the staff, do occasional software demonstrations, and most importantly – field questions. Creating those proactive communication channels is a powerful way to avoid people creating their own truths.

4) Provide the complete truth – Sometimes the answer to a question is not known because it has not been determined, or has not been considered. Sometimes it is not what the person wants to hear. Regardless, provide the truth – and the complete truth. There is nothing wrong with saying that you don’t know – but can find out. Or that a decision has not been made, but now that they have raised the concern we will make it and get back to them. Responding immediately doesn’t always mean providing an answer immediately, as long as the follow-up is done once the answer is available.

5) Communicate Everywhere – A communication plan must be extensive and include many different points of contact. Intranet sites can look impressive and have lots of great information on them – but usually only a small percentage of the staff will check them. Consideration must be given as to how to communicate with contracted employees, physicians, and traveling nurses. This is particularly challenging during an EHR roll-out when all of these parties must be enrolled in training classes and kept up-to-date on the go-live. Find and use every possible communication challenge. There are always questions about how much communication is too much – but they apply to the volume of communication you push through a particular communication channel – not the number of different communication channels you use.

Finally, accept that no matter what you do, rumors will form and will need to be dispelled. Its part of project management and change management that always had existed, and always will. Properly controlled, the rumors can be a minor distraction at worst – entertainment at best.

Please share any ideas you have found to be successful in keeping rumors under control.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

McKesson and Infor Go-To-Market Partnership – What Happens Now?

Posted on January 9, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

A couple weeks ago, McKesson and Infor announced a partnership that will have McKesson EIS (Enterprise Information Solutions) offering Infor Cloudsuite as their cloud-based ERP (Enterprise Resource Planning) solution for human resources, supply chain, and financials. What does each party have to gain from this partnership and what does this mean for existing customers of McKesson ERP solutions?

Infor continues to be the dominant player in the ERP space for healthcare providers. Its healthcare applications, previously known as Lawson (and probably always known as Lawson to many of us), have the largest market share with the majority of larger hospitals and healthcare systems. Its closest competitor in the past, Peoplesoft, is now owned by Oracle which is focused on developing and promoting its Fusion product and has released the final version of the Peoplesoft product. Workday, the cloud-only solution that is publicly traded and making significant strives in many industries, has won deals in human resources and financials implementations but lacks a supply chain solution, critical to any integrated ERP deployment. SAP, the largest ERP provider in the world, has a strong presence in healthcare manufacturers but does not provide a supply chain solution well suited for the unique needs of healthcare providers, and therefore has a very small market share.

McKesson, once a strong player in this space, has faded over the years in ERP as they have with EHR solutions. The majority of the McKesson ERP customer base, using the products commonly referred to as Pathways, have been long-time legacy customers. Pathways has not been kept up with modern ERP needs, and it has been many years since I have seen a hospital consider Pathways as a potential solution, but rather it is typically the solution being replaced.

Infor has invested significantly in creating a cloud-based solution, referred to as CloudSuite. However, the existing healthcare customer base typically has an on-premise installation and therefore cloud adoption has been focused on new customers as well as those that are specifically looking to transition away from on-premise. McKesson has not had a cloud offering, therefore it would make sense for them to partner with someone to offer it as an alternative to Pathways.

Infor will gain access to the Mckesson customer base, many of whom are likely considering leaving Pathways for other solutions anyway. In addition, Infor will be able to provide Mckesson’s Strategic Sourcing solution for their customers.

However, it is unclear what that means for Pathways. While McKesson press releases state that CloudSuite is an alternative to Pathways, one has to wonder why Infor would want to expose their solution to someone who is actively selling a competitive solution, and why McKesson would continue to invest in Pathways when it has access to a much more mature and robust solution as a go-forward path for its Pathways customers.

Therefore while it is likely that McKesson will keep Pathways supported and up-to-date with regulatory improvements for the time being, it seems very unlikely that they would continue to enhance it – and inevitable that it will eventually be sunset in favor of transitioning those customers to Infor Cloudsuite. If history is indeed an appropriate predictor of the future, consider that McKesson announced its BetterHealth 2020 plan – in which they announced a focus on Paragon as their EHR but continued support of the older Horizon EHR product. Shortly after that they went back on that commitment and announced they would sunset Horizon in 2018.

Meaningful Use has led to a focus of resources on Electronic Health Records implementations which have led many customers to hold onto their older ERP solutions past their useful life. I suspect that the next two years will see a re-focus to ERP solutions with customers with more modern solutions focusing on upgrades and new feature deployment while customers with older solutions making a change.

Those customers who stayed on Horizon for too long are currently in a rush to implement replacements before the March 2018 sunset date.Customers on Pathways products should likely start the conversation now about their long-term ERP plans and consider if they want to get ahead of any sunset announcement.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

The Millennial Paradox and My New Year’s Resolution

Posted on January 2, 2017 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Simon Sinek always has some incredible insights. My wife pointed out this interview, the Millennial Paradox – it tackles the question of what Millennials are looking for in the workplace and also addresses issues with technology overload and our increased need for constant communication.

He speaks quite extensively about how technology is preventing us from establishing meaningful relationships. Its discussed in relationship to why Millennials have workplace challenges but while I am a generation removed from them I see that I share in these challenges and would likely find that many readers of this article do as well.

I suspect I’m not alone, but I have to admit that I’m allowing my phone to dominate my daily life and priorities. In the video, Simon describes how people take their phones to meetings and as a result, are not spending time building relationships with those they work with. I’ve been doing that lately – I put my phone on the table and feel the constant pull to check it. I need to check my email. I feel the siren call of the the vibrating phone and must see what it is.

I don’t generally do New Year’s resolutions. But this year, I’m making an exception. 2017 is the year I don’t carry my phone at every moment, the year that I might not respond to every text or email regardless of the hour, and overall the year that I reclaim control of my life from my iphone.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Getting the Team in an EHR State of Mind

Posted on September 23, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Recently I had the opportunity to do something different, fun, and unexpected – I opened a team meeting with a music video.

I am currently leading an EHR implementation. Each month, I hold a meeting of the nearly 80 hospital staff members who are part of the project. The meetings combine sharing information about the project with each other, team building activities, and teaching them about change management, process improvement, and team dynamics techniques. I am always looking for a way to make each meeting interesting and memorable.

This month I wanted to initiate a good dialog in the meeting about a topic I wanted to address head-on: Why do Physicians Hate EHRs? And what are we, as a team, going to do about it to make our physicians love their EHR?

It reminded me of a great video crated by a physician right here in Las Vegas, ZDoggMD, whose videos I found through Healthcarescene.com. Viewing it again, it was indeed the perfect way to set the stage for this discussion. Fun, entertaining and such an accurate representation of how physicians feel about these applications.

The video itself got the team excited, motivated, and laughing – and led to one of the most engaging, productive, and thought-provoking conversations we have had on the project.

For the project leaders out there – I would recommend trying this type of technique with your teams.

For any physician or anyone else who has used an EHR and has not seen this music video, enjoy and share if it represents your point of view about EHR applications:

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Bad Handwriting Could Cost a Doctor His License

Posted on September 16, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

I admit that I don’t have very good handwriting. My signature is no better, and often leads people to ask if I am a doctor. Because it is commonly known that doctors don’t excel at handwriting skills. Thankfully, I rarely hand-write anything anymore. With computers, I can write quickly while still producing a result that is easy to read.

One benefit of an EHR solution is that we don’t have to worry about deciphering handwritting! But for one Nevada doctor, poor penmanship may lead to the loss of his medical license!

Read this story in the Review Journal for more information or this excerpt of the situation below:

The Nevada State Medical Board has formally threatened to revoke the medical license of Dr. James Gabroy, a 69-year-old Henderson internist who has never had malpractice or professional incompetence problems, nor has he ever had sexual misconduct, patient abandonment or fraudulent billing issues.

why is the board taking action against Gabroy — punishment ranges from a $5,000 fine to license revocation — with a Sept. 28 hearing scheduled in Reno?

His handwriting.

Citing confidentiality, Ed Cousineau, the board’s executive director, won’t stray far from the Oct. 23, 2015, board complaint that alleges the medical records of three unnamed patients were illegible, inaccurate and incomplete.

Are we heading for an environment where you’ll have to have an EHR in order to have a medical license?

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Software Selection Done Right Part 2: Presenting a Vision through an RFI

Posted on August 22, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Be sure to check out part 1 in the series.

The primary driving document of a software selection is often the RFI or RFP, the invitation to vendors to participate in the process.. In future articles in this series, we will discuss the process of software selection and obtaining buy-in from stakeholders after the RFI has been received. For this week, we will focus on that centerpiece document, the RFI. This document sets the stage for the process, creating the tone and establishing the way that the hospital will work with the vendor during the selection.

However, far too often creating this document becomes the focus of the process rather then the actual selection. Creating an RFI should not be a large effort and done properly, can be one of the easier steps, allowing the journey to begin much faster.

The purpose of an RFI should not be to provide a laundry list of needs and wants to the software vendors. An RFI that includes pages of checklists of features can take a considerable effort to create and an even more considerable effort for the vendor, and actually adds little value. When it comes to mature software solutions, such as ERP and EHR solutions, it is very likely that the vendor understands your needs better than you do. They demonstrate software to hospitals every day, and have numerous customers who have been through the same changes and challenges that you have.

Several years ago I was working alongside an ERP software sales team and joined a meeting in which a potential customer had allowed them to present their solutions following completion of an extensive, laundry list style RFI. During the discussion the potential customer’s CIO was present and was looking through the response to the RFI carefully, with a frown on his face.

Then he looked up and asked a question. “I am reviewing your response to our RFI”, he said, “and I see that you answered no to many of the items in our requirements. Why should we choose you over another vendor who met more of those needs.” The salesperson from the ERP team was not only a seasoned salesperson, but also well versed in the business processes of ERP and was well prepared with an answer that I often reference to this day.

“Do you know what a Japanese auction is?”, he asked the CIO. “Actually”, he continued, “does anyone here know what a Japanese auction is?.” Everyone looked confused, but no one spoke.

“I don’t, but why would you ask that?” inquired the CIO.

“Because it is a requirement of the software in your RFP”, the salesperson responded, “and one of the examples where we said no”. He then went on to explain what a Japanese auction was to the hospital team, and asked if they would ever use that functionality. They all agreed that they would never have a use for it. In closing the salesperson asked what consulting firm wrote the RFI for them and if they were advised that they needed to include it, or if the consultant simply forgot to remove it from the template they were using.

This story highlights that the software vendor is well aware of the features and functionality that a hospital would typically use, and does not need a list of those features. It also demonstrates that paying a third party to develop an RFP does not always lead to a more effective document – and in some cases leads to a less effective document.

Rather than a laundry list of features, an RFP should tell a story. The story of who you are, where you are now, and where you want to go. It should explain the vision and objectives of your project, the organization’s current challenges, and your future vision for the hospital with the new software. The RFP should invite the vendor to participate and present how they will help you to achieve those goals. Each vendor can then present why their solution is the best to get you to your desired destination.

Specific features and functions are much less of a key difference between software solutions today. Feature lists have actually led many vendors to write and acquire software for the purpose of being able to check boxes in an RFP rather than reacting to actual customer needs or with the intent of producing a quality product. It is increasingly unlikely that a “smoking gun” will be found with a specific absolutely necessary feature existing in one vendor option but not the other. Rather, it is the design and the quality of the solution that is important, as well as confidence in the vendor and their ability to partner with you effectively and capability to deliver on their promises.

Indeed there is more to an RFP – and in a future article we will discuss how to define the rules of the road of the selection process and to make sure those rules are reflected in the RFP and that the vendors and staff follow those rules. However, the core content of an RFP is expressing that vision to your potential software partners.

Therefore rather than spending months of creating lists of checkboxes of features that you may or may not need, just tell your story. Explain the vision of where you want to go and invite the potential solution providers to explain to you how they will help you to achieve that vision. The result will not only be a significantly faster selection process, but also a better relationship with your vendor partners during the selection and beyond.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Is It a Hot or Cold Hospital EHR Buying Market? – Response

Posted on August 15, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

This article is in response to John Lynn’s recent posting, Is It a Hot or Cold Hospital EHR Buying Market?

In his recent posting, John Lynn asked the question “Is it a Hot or Cold Hospital EHR Buying Market?”. In it he highlights a recent KLAS report that over 490 hospitals, a staggering 10% of the entire market, were involved in an EHR decision in 2015. After reading his posting, I wanted to take a moment to share my observations.

2015 was indeed an amazing year for EHR sales, partly driven by the pending sunset date of Mckesson Horizon forcing many customers to switch EHR solutions. Some of those customers are going to Paragon, but many more purchased or are evaluating other solutions. During a recent trip to Epic University, I was surprised to find that nearly half of the attendees of the classes were hospitals switching from Mckesson Horizon to Epic – and all had just recently completed their purchases (late 2015/early 2016) and were facing the same live dates of late 2017/early 2018.

Hospitals who have purchased and implemented Epic or Cerner are very unlikely to make a change. Regardless of which solution is preferred, the investment in these solutions and the level of effort required to switch from one to another is so high, that it would take a significant triggering event for a hospital to make that change. Therefore it is likely that customers on these solutions will not be making a change in the near future.

However, KLAS reports that nearly 40% of MEDITECH customers would change EMR’s if they could, and that Paragon customers also report unrest. Therefore in addition to the shrinking number of those that have not implemented a viable EHR solution, the possibility that there will be a wave of customers switching from one of these solutions to Epic or Cerner remains a consideration. There is also the question of how the recent spin-off of Mckesson’s software division will impact the future of Paragon. If Paragon were discontinued or sold, it could lead to another explosion of EHR decisions. If instead there was a significant investment in the solution, it could become a more viable alternative as customers look to switch from one EHR to another.

I suspect that 2016 will be another strong year from EHR sales in general and for Epic and Cerner in particular. Beyond that, much will depend on the strength of the other solutions and which ones break out into the top tier. Regardless, the recent explosion of EHR sales and the rush to replace Horizon will in many cases lead to minimized installs – where the bare minimum work was completed and there is significant opportunity to improve business processes, implement new modules, and roll out advanced functionality within those solutions. As a result I believe that within a few years, the market will be more stabilized with fewer customers switching solutions, and instead focusing on maximizing what they have.

Unless another player comes in and disrupts the marketplace or a significant shift in the industry creates a reason to make a change yet again…

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

Hospital Software Selection Done Right – Part 1: Introduction

Posted on August 1, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Making a decision on which new EHR, ERP, or other major software solution is a process that must be taken seriously. The right decision can lead the hospital to the next level of automation, efficiency, and patient safety. The wrong decision can lead to a disaster, and therefore be a career-limiting move for those that make it. In addition, the right decision is subjective. Those that did not participate in the selection process may have their own opinions. At best, they could exhibit behaviors of frustration with the decision or passive resistance. At worst, they could actively look for opportunities to challenge the project decisions and increase risk of failure.

Over the course of several articles I will be analyzing the software selection process piece-by-piece and share the key components of a successful software selection. We will be looking at the process from a variety of goals and perspectives. This will include making sure that the result is the best possible solution, ensuring the process is run effectively, and getting engagement from the right members of the hospital staff to obtain buy-in and excitement, or at least acceptance, of the end decision.

An effective software selection starts with assembling the right team which must be a good representation of the user base while also being nimble enough to make effective decisions. In the first article of the series, I will share suggestions and lessons learned about how to structure and staff software selection teams including engaging physician and clinical staff in the process.

Additional articles will look at the RFI/RFP process and how to create an effective RFP with minimal effort, including critical aspects of content and how to complete the RFP process with minimal or no third party assistance. Often healthcare organizations spend significant amounts of money and time creating RFP documents that provide minimal value and slow down the selection process.

I will also look at the process of narrowing down vendors and actual selection logistics. That includes what to look out for in vendor demonstrations, how to maximize the time of your staff, surveying, reference checks, and driving to final decisions.

I hope that readers enjoy the articles and find that it helps you as you plan future software selections. Please share where you agree and disagree as well as comments and suggestions along the way.

If you’d like to receive future posts by Brian in your inbox, you can subscribe to future Healthcare Optimization Scene posts here. Be sure to also read the archive of previous Healthcare Optimization Scene posts.

HIMSS: The View from the Other Side of the Booth

Posted on February 29, 2016 I Written By

For the past twenty years, I have been working with healthcare organizations to implement technologies and improve business processes. During that time, I have had the opportunity to lead major transformation initiatives including implementation of EHR and ERP systems as well as design and build of shared service centers. I have worked with many of the largest healthcare providers in the United States as well as many academic and children's hospitals. In this blog, I will be discussing my experiences and ideas and encourage everyone to share your own as well in the comments.

Today is the first day of the largest IT conference in our industry. Chief Information Officers and other technology leaders from hospitals across the country have started to arrive in Las Vegas for a week of presentations, networking, and entertainment. I have participated in HIMSS and other conferences in the past in many capacities – as a speaker, as media, as someone doing research on products, and in many circumstances as a vendor using the show to promote our products and services. As our readers are primarily hospital staff, I thought perhaps it would be beneficial to share what it is like attending a conference from the other side of the booth.

As the owner of a consulting firm that attended many different events, what I will always remember about them is the amount of work that goes into having a booth at a large trade show. The week begins with excitement about meeting with current and potential customers and ends with physical and mental exhaustion as the long hours and fast pace begin to take its toll.

Vendors make a huge investment into trade shows. For many vendors attending HIMSS, their presence at the show may be the largest marketing investment that they make each year. There are so many factors of cost to consider. There is the booth itself, both creating an effective and interesting booth display as well as paying for the space on the convention floor. Getting the booth setup and broken down is often also a costly affair as shipping costs can be substantial and most convention centers require use of expensive union labor to move your booth to its location and to complete setup or breakdown. Brochures and other takeaways must be printed, various booth loot for people who stop by must be created and shipped. The cost for travel of staff to the show, hotels, and meals can often exceed the costs for displaying at the event. Then there is the often substantial investment in sponsoring events or providing entertainment and meals to current, and hopefully future clients.

HIMSS is such a big event, with 40,000 people expected to attend and 1,300 vendors, that it can be very challenging for each vendor to stand out and get attention. A large booth in an area with heavy traffic will be a major investment and require significant number of staff to participate. A small booth in a slower area will be a smaller investment, but risks providing minimal return as such as small percentage of potential customers will pass through. Each vendor must decide how to balance the costs with the potential benefits and make sure that their significant investment is maximized and worthwhile.

Tracking success of shows often is also complicated. Large IT decisions are rarely made at trade shows. More often, these shows represent the beginning of the decision making process that could take months or years as CIO’s explore options. These shows are also about connecting with existing customers to show them that you value their business – while every other vendor tries to take that business away from you. Often its not only new business that drives vendors to participate in these events – but also the cost of not attending is considered and the message that it may send to your existing customer base. A booth at a show is a demonstration of a vendor’s commitment to the industry and to be where there customers are going to learn about the changes in the industry.

Vendors will invest significantly in entertainment events – liberally inviting any CIO they can find to dinners or drinks in the hopes of building a new relationship or reinforcing an existing one. These can range from simple dinners to something more elaborate and unique. At one trade show in San Diego, another firm rented a deck on the Midway so that their customers could attend a party on an aircraft carrier. Personally I never valued these events much as a potential customer nor as a vendor, but for many attendees it is a highlight of attending trade shows and for many vendors their largest investment.

I recall at one event my company decided to get branded stress balls. We got the highest quality stress balls we could find – not wanting to give out something cheap but rather something that people would keep on their desk and actually use. They cost us $4 each. I remember being at the booth and having many people stop by because they saw the stress balls from someone else – which was great because it brought more people to the booth. But then people starting coming by and taking handfuls of them without even looking at our booth or talking to us. They made comments about how they could make great chew toys for their dogs or they were getting extra for their kids. As these thousands of stress balls disappeared, it occurred to me that our huge marketing budget was going to, literally, end up in the dog house.

Perhaps the purpose in writing this posting is to send a message to all of you that are attending HIMSS to respect the substantial investment that those on the other side of the booth make into these events. These vendors are directly responsible for most of the entertainment events and meals that you enjoy during the show. Indirectly they are a substantial portion of the show revenue that makes all the education events possible. Take the time to wander through the vendor halls and see what they are offering. You can’t stop at all of them, but choose the ones that you have a genuine interest in rather then those that offer the best chotskis. Choose to attend events for companies that are your business partners to help to support them, or companies with which you have a genuine interest in a business partnership. The best long term friendships and business relationships can come from these events if they are approached properly.

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