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1 Critical Access Hospital Workshop Affordable Information Technology For Smaller Health Care Organizations WIPFLI HEALTH CARE PRACTICE Title goes here February 4, :30 a.m. 10:15 a.m. Date or subtitle Janice Ahlstrom, RN, CPHIMS, Partner Wipfli Health Care Practice Wipfli LLP

2 Learning Objectives Understand the components of effective technology management Discuss common issues with selection, deployment, and support of technology in small organizations and strategies to address them Recognize industry resources to leverage in making technology decisions Learn how to leverage resources on a budget Wipfli LLP 1

3 Technology Performance What you are trying to achieve? Selection Implementation Acceptance Fulfillment Identify Investment Asset Use Improvement Performance Wipfli LLP 2

4 Factors to Evaluate Technology & Service Total Cost of Ownership Integration with Existing Technology Maturity of Technology or Service Relationships with Existing Vendors & Partners Internal Staff Capabilities & Ability to Support the New Technology Competitive Advantage Wipfli LLP 3

5 Total Cost of Ownership Direct Costs Researching Designing Sourcing Purchasing Delivering Installing Customizing Training Deploying License fees Indirect Costs Operations management Systems management Maintenance of hardware Maintenance of software Upgrade costs User support Environmental factors Wipfli LLP 4

6 Technology Assessment What questions are you trying to answer? Generally all questions or concerns are related to matters of compliance or performance Compliance Performance How well are we adhering to regulations? Are the current remediation efforts adequate? What is our risk if we are not compliant? What kind of value should we expect? Do we have the right types of skills and knowledge? Are we staffed at appropriate p levels? Are the current levels of service satisfactory? How much of an investment should we be making? How does our productivity compare? Are we properly aligned to the business? Wipfli LLP 5

7 Health Care Technology Management Wipfli LLP 6

8 Management of Health Care Technology Governance Identification, Evaluation, Prioritization, Approval, Funding, Scheduling, Staffing, and Monitoring Assets Work Technology Categories Security (Firewall, Policies, Anti-Virus) Infrastructure (Servers, Routers, Switches, Network) Collaboration ( , Voice Mail, Intranet) Personal Computing (Desktops, Printers, PDA s, Helpdesk) Applications (EMR, Financials, Payroll, External) Data (Databases, Repositories, Warehouse) Facilities/Equipment (Data Center, Buildings) People (Competencies) Platform Management Project Management Business Analysis Technical Analysis Software Engineering Network Engineering Leadership Service Delivery Strategy & Planning Research Vendor Management Procurement Learning & Development Recruitment & Retention Project Execution Platform Support (Preventative Maintenance, Upgrades, Break / Fix) Projects Assessment Decision Implementation Assets Work Return on Assets Productivity i Leverage Utilization Throughput Adoption Proficiencies Knowledge (Industry, Organization) Skills (Technical, Interpersonal) Abilities (Personal Development, Process Execution) Service Level Agreement Cost Quality Productivity Timeliness Return on Investment Strategic Advancement Performance Metric Improvement Keeping the Lights On (Cost of Doing Business) vs. Discretionary Investment (Continuous Improvement) Wipfli LLP 7

9 Common IT Deployment And Support Issues Wipfli LLP 8

10 Typical Project Risks Expectation: getting everyone on the same page What is the problem and why is it important to address? What solutions will be utilized and how will they be implemented? Who will be involved and how and over what time frame? What outcome are we seeking? Acceptance: getting proper utilization of the tools to achieve the desired outcome WIIFM? (What s in it for me?) Resource: getting the proper accounting of all money, time, and change required to achieve the desired outcome Wipfli LLP 9

11 Common Technology Deployment Issues No Strategic Technology Plan Success Strategy: Short- (1 year) and long-range (3-5 years) strategic IT plan to guide investments Wrong Technology or System Selected Success Strategy: Use a formal process to identify and prioritize requirements; objective vendor analysis; careful management of vendor contracts Integration with Existing or Future Systems Success Strategy: Make decisions with an eye on how a new technology will work with existing or planned implementations Wipfli LLP 10

12 Common Technology Deployment Issues Lack of Project Planning Success Strategy: Follow a standard method for managing projects that incorporates planning and analysis of risk, scope, time/deadlines, resources, budget, integration, and communication. Failing to Define Success Success Strategy: Clear definition of the primary objectives; project teams must define and document the criteria for a successful project before it starts. Wipfli LLP 11

13 Common Technology Support Issues Lack of Routine Maintenance (Reactive vs. Proactive) Success Strategy: Make time to change the oil and check the brakes. Issues found sooner and resolved quicker with less financial impact. Failure to Share Knowledge or Involve Clinicians Success Strategy: Imperative e for a well-managed aged IT department that the team shares information. Implement a knowledge base or procedure archive to make the entire team more efficient. Involve physicians and clinical users in selection and implementation efforts. Wipfli LLP 12

14 Common Technology Support Issues Lack of Formal Service/Help Desk Approach Success Strategy: A service desk promotes consistent service delivery, optimizes support resources, speeds resolution of issues, and increases user satisfaction. Define service level expectations. Failing to Set a Reasonable Pace Success Strategy: Consider the capabilities of your staff and infrastructure and the ability to grow. Moving too quickly often results in cutting corners and a failure to meet expectations. Wipfli LLP 13

15 Health Care Technology Cost Wipfli LLP 14

16 How to Maximize Your IT Dollars Governance Selection Implementation Maintenance and Support Wipfli LLP 15

17 Investment Governance Activities related to investment opportunities Identify Evaluate Prioritize Approve Fund Schedule Staff Manage Monitor Define for each activity Participants Procedures Tools Investment charters Status t reports Accountabilities Authorized Responsible Consulted Informed Timing Frequency Planning Intervals ROI should be measured in terms of the investment s ability to improve the organization s strategic t measures Wipfli LLP 16

18 Cost Considerations Vendor Software Selection Projects Limit vendor demonstrations No more than 3 vendors No RFP Yields marketing materials with no objective basis upon which to make a decision Be an effective negotiator with vendor contracts Seek contract review to provide advice Do not divulge too much information too soon Consider how many releases or patches the vendor distributes Impacts testing and training time for staff.tco Consider proposed vendor platform changes Wipfli LLP 17

19 Maximize Your IT Dollars - Selection System Selection Solution Fit Document requirements Develop demonstration scenarios Use objective scoring tool Facilitate vendor demonstration process Analyze vendor fit to requirements Implementation Plan and Budget Solution Feasibility Understand and document customizations & interface requirements Develop implementation project plan and budget Understand the total cost of ownership Staff training or transition planning Wipfli LLP 18

20 Maximize Your IT Dollars - Implementation Implementation Document a Project Charter Define scope how many providers, clinics, functionality, etc. Document project objectives define the measures of success Document deliverables process flows (current and future state), interface specifications, baseline measures for performance measurement, etc. Define the implementation timeline decide phases and sequencing Define project team members yours, vendors, and consultants t Define project governance define responsibility for sign-offs Define project risk management plan what are the perceived risks and develop/implement l plans to mitigate t Define project communications plan mediums, intended yield Document project costs in dollars and effort (your staff, vendor, consultants, t chart abstraction, ti etc.) Wipfli LLP 19

21 How to Engage Help on a Budget Do hire help to do the work Manage M hire help to manage the work with your staff doing the tasks Mentor hire help to mentor your staff Advisor, neutral, objective, experienced Should provide tools/templates to kick start the effort Consider a combination of these approaches Consultant mentor or shadow project manager Remember your organization needs to own the implemented software and have a leader Think WIN/WIN Wipfli LLP 20

22 Build Relationships to Save Costs What is the Basis for Customer relationship? Relationship Needs Your Approach Relationship Type Partner Value Problem Solving (Custom) Planned (Proactive) Collaborative Preferred Vendor Predictability Flexible (One-Off) Responsive Contractual Vendor Cost Solution Driven (Repetitive) Opportunistic (Reactive) Transactional Wipfli LLP 21

23 Cost Software Implementation ASP Model Application Service Provider Limits it staffing costs Understand Wide Area Network and Hosting Costs Consider forming a buying group SISU Medical Systems Wipfli LLP 22

24 Cost Considerations Maintenance/Support Consider hiring less experienced staff Lower salary Ability to train on best practices Hire a mentor for mid-level and junior staff Save travel and registration/tuition costs Keep staff longer, reduced costs from turnover Outsourcing All technology functions Infrastructure support Hardware monitoring Help Desk Increases available skills Wipfli LLP 23

25 Questions? Wipfli LLP 24

26 Wipfli LLP 25

27 Speaker Information Janice Ahlstrom, CPHIMS, RN, BSN Partner, Health Care Practice Wipfli LLP Innovation Drive, Suite 250 Milwaukee WI All presentations available for download at: Wipfli LLP 26

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