Successful Change Survive and Thrive

Transcription

1 Successful Change Survive and Thrive Russ Branzell, FCHIME, CHCIO, FHIMSS CEO and President, CHIME CHIME Foundation CHIME Education Foundation July 1, 2015

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3 We ve come a long way!

4 The implications for existing and aspiring CEOs are equally clear. Information technology is now a survival issue more and more frequently IT issues are now wrapped inside wider questions of business strategy. How to Be a CEO for the Information Age Harvard Management Review, Winter 2000, Volume 41 Number 2

5 The Black Hole of IT Value Some healthcare CEOs refer to IT as that black hole you pour money into never seeing results. - Healthcare CEO I estimate that about half of our IT investment generates value... I just can t figure out which half. - Healthcare CEO While [the system] has helped [us] boost patient safety and medication administration processes, [we have] put quality of care and improving safety ahead of ROI and time savings. - VP of Quality and Care Management

6 technology by itself is never a primary root cause of either greatness or decline. From Good to Great by Jim Collins

7 Care Improvement Process Status Quo Fee for Service Managed Care Quality Care Value Care Wellness Care

8 The job of the leader isn t just to make decisions, it s to make sense. The Big MOO, The Group of 33, Quote by John Brown

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10 Building Blocks of HIT 2.0 Healthcare Information Exchange Certified Electronic Health Record Patient Portals Data Warehouse Business Intelligence Complete Data Integration Data Analytics World-class IT Team Unified Communications ACO System Population Health System Document Management

11 Making IT work demands the same things that other parts of the business do - inspired leadership, superb execution, motivated people, and the thoughtful attention and high expectations of senior management. Getting IT Right Harvard Business Review, February 2004

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13 Using a business case cycle that produces VALUE. 8. Calculate the Hard-Dollar ROI 1. Organize Stakeholders and Focus on Benefits 2. Select the Metrics 7. Develop the TCO 3. Baseline Existing Performance 6. Convert the Targeted Improvements to Financial Results 5. Negotiate the Targeted Improvements 4. Describe the Capabilities of the Solution

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15 Business Value in Healthcare Healthcare Value Patient Outcomes & Revenue Enhancement Dollars Spent IT/Informatics Value Adapted from Value Measurement for Healthcare, Harvard Business School Executive Education

16 Q4 12 Q1 13 Q2 13 Q3 13 Q4 13 Q1 14 Q2 14 Q3 14 Q4 14 Q1 15 Q2 15 Q3 15 Q4 15 Month Re- 1.1 Org Design 1.0 Enterprise Services Transformation Change Management & Process/Role Calibrate Quarterly Formal Quarterly Formal Quarterly Formal Quarterly Formal Change Mgmt Communications Releases Communications Releases Communications Releases Communications Releases 1.2 Communic. Planning 1.3 Business Case Development 1.4 Readiness Assessment 2.1 On-Boarding & PD/Accred. Processes 2.0 Rationalize/Standardize/Define 2.2 Knowledge Mgmt Processes & Tools 2.3 Sourcing Processes & Tools 2.8 Governance Processes 2.4 Functional Capabilities Demand/ Supply Assessment 2.5 Reporting Processes & Tools 2.6 Assurance Processes & Tools 3.3 Sourcing Processes & Tools Quarterly Formal Business Case Updates 2.9 Demand Fcstg, Resource Planning, and Scheduling Processes 2.10 Requirements Gathering Tool & Tools 2.11 Test Planning & Execution Tool 2.7 Financial Mgmt Processes & Tools Quick Wins 3.0 Enabling Capabilities Service Detailed Design/Build 3.1 On-Boarding & Personnel Development/ Accreditation Processes 3.2 Knowledge Mgmt Processes & Tools 3.4 Governance Processes 3.5 Transition to Desired Functional Capabilities Capacity Quarterly Formal Business Case Updates 4.0 Monitoring & Assurance Service Detailed Design/Build 4.1 PRT Enhancements 4.2 PRT Replacement Selection 4.3 PRT Replacement Design/Build 4.4 Assurance Processes & Tools Wave 1 (All) 5.1 On-Boarding 5.2 Personnel Development & Accreditation 5.3 Sourcing 3.8 Requirements Gathering Tool 6.1 Wave 1 Support Begins Iterative Definition to allow for Quick Wins 3.6 Demand Fcstg, Resource Planning, and Scheduling Selection 3.9 Test Planning & Execution Tool 5.0 Business Area Service Deployment Wave 2 (All) 5.4 Know. Mgmt 5.5 Funct. Capab. 5.6 Assurance 5.7 Governance 5.8 Rqmnts Gathering Tool Delivery 4.5 Financial Mgmt Processes & Tools Iterative Design to allow for Quick Wins 6.2 Wave 2 Support Begins Delivery 3.7 Demand Fcstg, Resource Planning, and Scheduling Design & Wave 3 (All) 5.9 Financial Mgmt 5.10 Test Plan & Execution Tool Build 6.3 Wave 3 Support Begins Program Management and Governance Wave 4 (By Business Areal) 5.11 PRT Replacement Quarterly Formal Business Case Updates 5.12 Demand Fcstg, Resource Planning, Scheduling Tool / Demand Mgmt 6.4 Wave 4 Support Begins 6.0 Service Support & Enhancement Quarterly Formal Business Case Updates 6.5 Enterprise Services Continuous Improvement Value Realization Requires a Structured Approach 3 1 Envision the Ideal State 2 Innovate & Optimize Costs with Disruptive Technologies (Cloud, Social Media, Big Data, Mobility) 4 Change Readiness Assessment Execute Roadmap Future State Define the ideal Current State Start the journey Manage Change Transformation 7 Capture Value Realization Opportunities 6 Identify Metrics and Develop the Business Case 5 Develop Implementation Roadmap Measure Benefits Implement PMO & Governance Model

17 Acceptance William Bridges The three phases of transition Time The phases are not separate stages with clear boundaries.

18 The eight-stage process of creating major change

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20 Employee Engagement Groups 28% 55% 17% Engaged Not Engaged Actively Disengaged These employees are loyal and psychologically committed to the organization. They are more productive and more likely to stay with their company for at least a year. These employees may be productive, but they are not psychologically connected to their company. They are more likely to miss workdays and more likely to leave. These employees are physically present but psychologically absent. They are unhappy with their work situation and insist on sharing this unhappiness with their colleagues.

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22 Average % Gain/Loss in Profitability Engagement Drives Profitability Engagement Percentile Copyright 2007 Gallup, Inc. All rights reserved.

23 Why is change and change management so important to us?

24 Medication Error Rates

25 VTE Incidence Per Year

26 Return on Investment Hard ROI: $5,000,000 in HIM staff reductions and efficiencies $1,900,000 in reduced forms cost $63,800,000 in Meaningful Use Stage 1 incentives 100% of eligible dollars Soft ROI: $23,000,000 in Clinical Value and Cost Avoidance $17,000,000 was recognized from decreased adverse drug events and incidence of VTE.

27 Estimated Cost Savings from Preventable DVT and PE $6,060,000 (404* preventable events x $15,000) Estimated System VTE/PE 2006 = 420** Estimated System VTE/PE 2010 = 218** Estimated cost per incidence $15,000*** Continued decrease additional VTE/PE avoidance= $529,000 *Extended initial savings over years **Estimates extrapolated from VTE reporting and CI DAM *** Mid-range cost used from AHRQ inpatient DVT/PE estimates

28 Thank You