OUR HEAD IS IN THE CLOUDS WHILE OUR FEET ARE STUCK IN THE MUD: THE NEED FOR APPLICATION CONSOLIDATION

Transcription

1 OUR HEAD IS IN THE CLOUDS WHILE OUR FEET ARE STUCK IN THE MUD: THE NEED FOR APPLICATION CONSOLIDATION John Kravitz, MHA, CHCIO, CIO, Geisinger Health System Todd Hatton, MHSA, CHCIO, ACIO, Saint Luke s Health System William Reed, FCHIME, LFHIMSS, Huntzinger Management Group

2 Agenda Topic and Panelist Introductions Learning Objectives The Geisinger Perspective The Saint Luke s Perspective Panel Q&A

3 Topic Introduction The ability to aggressively pursue cloudbased service is inhibited by the heterogeneity of most organizations application portfolios Question How can rigorous application consolidation address this issue, enabling the exploitation of the benefits cloud-based services offer?

4 Learning Objectives Identify the extent application heterogeneity exists within organizations Identify the economic benefit of consolidating applications Explore the potential impact application consolidation can have on cloud-based services Discuss approaches for an application assessment with the intent to consolidate

5 Panelists Introduction John Kravitz, MHA, CHCIO, CIO, Geisinger Health System Todd Hatton, MHSA, CHCIO, ACIO, Saint Luke s Health System

6 The Geisinger Perspective Established an IT Governance process which includes application rationalization. Governance process will provide a complete review of new system requests. Need to identify the problem to solve, not bring forward a solution. Rationalization of IT Application Portfolio is a critical component of this process.

7 IT Strategy for Application Consolidation Geisinger IT supports nearly 1,700 software assets. Need to eliminate our Best of Breed environment, moving to an integrated environment Reduces complexity of environment, reducing cost to support Simplify the infrastructure eliminate mainframes Simplifies the environment less support cost Reduces cost of supporting multiple disparate computer platforms

8 IT Strategy for Application Consolidation Example Epic Module License Implementation Maintenance Personnel Cost Removed Billing $6,220,039 $10,879,552 $611,845 $1,680,000 $3,785,896 Radiology $ 860,000 $ 2,488,575 $107,796 Same $ 651,141 Laboratory $3,112,000 $ 4,500,000 $303,000 $500,000 $1,050,000 Cardiology $ 551,570 $ 3,500,000 $ 53,000 Same staff $ 243,075 Bed Mgmt. $ 250,000 $ 30,000 $ 35,000 Same staff $ 531,322 Outpatient Pharmacy $ 573,825 $ 2,435,300 $ 55,087 $160,000 $ 684,400 Utilization Mgmt $ 539,777 $ 705,840 $134,795 Same staff $1,884,000* Summary $12,107,211 $24,439,267 $1,300,523 $2,340,000 $8,829,834 * 3.5 Year ROI

9 Application Rationalization Status Report - Example

10 Hosting in the Cloud Goal is to host 50% or more of our applications in the Cloud by Value of the Cloud: Cost transparency Requesting party will have full visibility and accountability for cost of their application(s) Security Cloud providers providing the highest level of security protection Opportunities: AWS, Google Cloud, Azure, etc.

11 SLHS Perspective Highlights from IT Guiding Principles: Pursue core vendors to support across enterprise Follow model build, avoiding customization Deploy generally available software IT Steering Committee to provide oversight / governance Execute on projects and IT Service Delivery

12 SLHS Consolidation Plan 5-year plan to consolidate to a single EMR platform 13 Ambulatory Clinical Inefficiencies in IT Variation in servers, client software, support staff Business continuity across all systems Security hardening and auditing Inefficiencies in Operations Growth limited by over burdened IT Patient safety due to variation of software in use Lack of adoption / optimization 12 Inpatient Clinical 7 Inpatient Rev Cycle 1 EMR 5 Ambulatory Rev Cycle 8 Critical Access Clinical 3 Critical Access Rev Cycle Analysis of patient populations increasingly complex Innovation vs. Scale Speed to market vs. Stability

13 Move to the Cloud is Not a Guiding Principle Resilience against loss of service Ability to pass the appropriate security audit Supports larger strategic goal of IT Infrastructure

14 Panel Q&A

15 IT Guiding Principles: Summary 1. IT Governance and Project Sponsorship 2. Overall Vendor Strategy 3. System Ownership and Support 4. Core System Design Strong, unified governance process for making IT decisions requires discipline and a consistent and ongoing commitment by SLHS executives. Technology change initiatives will be owned and driven by operational/clinical leadership. Clear and consistent prioritization process in place. Pursue integrated, core vendors (e.g., Epic, ERP solution) to support functions across the enterprise (vs. cluster of core vendors). Core vendor: integrated architecture and data base; cross continuum and all locations; includes physician, nursing and ancillary workflow. Consolidate systems where feasible. Structures in place to say no to local desires at the expense of the greater good. Assume the integrated vendor product will be the system of choice unless a business case demonstrates a clear and compelling reason to consider an alternative solution. Understand there will be requests to go outside core vendors product lines, including considerations for funding and supporting interim solutions until a core vendor is able to support a specialized need. In these instances, SLHS will implement processes to ensure justification, accountability and adjudication. Subsequent to initial implementation, system support responsibilities will be shared by the Information Services and User Departments. Focus on enterprise-wide process and system designs shared by all departmental/business/clinical units and service lines whenever possible. Leverage vendor-recommended model configurations and avoid customization wherever possible. 5. Resource Focus Shift the focus of our internal resources to designing and implementing new solutions from support and enhancement of applications that will be replaced. Explore discrete outsourcing opportunities to improve effectiveness, reduce cost sand/or enhance skills. 6. Risk Profile and Innovation 7. Reliability Standards Deploy generally available software. SLHS will be a fast follower in most areas and an innovator in very high value areas (without putting organization at risk). Appropriate financial investments will be made in reliable infrastructure and business recovery processes; these investments will be prioritized; (not all applications are equal).

16 Governance Committees Executive Sponsor meets monthly Steering Committee meet quarterly User Groups meet monthly or as needed