Corporate Culture. In the Health Information Technology World MedPractice Solutions, LLC Successful Outcomes for Healthcare

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1 Corporate Culture In the Health Information Technology World

2 What is Corporate Culture? Beliefs, values, & behaviors of leaders Beliefs Values Behaviors What do you believe? Who do you trust? Who are your partners? Who are your allies? Who are your customers? What motivates people? What do you want? What are you afraid of? What gets rewarded? What gets punished? What is your management style? What happens when things go wrong? What happens when someone makes a mistake? Corporate culture is the sum of the beliefs, values, & behaviors of everybody

3 Why is Culture Important? Culture eats strategy for breakfast and technology for lunch. Cultural pitfalls & barriers are the most common reason for project failures

4 Some Realities of Corporate Culture There are espoused values and de facto values 90% of culture is beneath the surface There are sub-cultures Departments = silos Management levels = silos de facto Values There can be conflict between sub-cultures

5 The HIT Sub-Culture Beliefs Values Behaviors HIT is the answer to healthcare delivery problems System performance is more important than userfriendliness Needy users are a problem Security Control Change management Training Standardization Speed / bandwidth Rigid adherence to the PMP Cookie-cutter implementation Reluctance to customize Poor communication with non- techies

6 The Physician Practice Sub-Culture Beliefs Values Behaviors The patient belongs to the doctor they are solely responsible for his/her health Bureaucracy & gov t regulation are impediments HIT comes between them and their patient Clinical quality Competence in all things Throughput / productivity Autonomy / individuality Time / money Resistance to change Arrogance (defense against feeling incompetent) Counting clicks complaining that EMR is slowing them down Truancy from or inattentive at training

7 Culture Clash Line Leaders dislike when IT IT leaders dislike when the business. Service or Control Is overly bureaucratic and Makes half-baked requests and control oriented is clueless about impact Results or respect Consists of condescending Treats IT professionals like techies who don t listen untrustworthy servant genies Tactics or Strategy Is reactive rather than proactive Develops plans without including IT Expense or Investment Proposes deluxe when good Focuses on costs and not on enough will do value Quickness or Quality Doesn t deliver on time Changes it s mind all the time Customization or standardization Doesn t understand the true needs of the business Wants it all right now. Regardless of ROI Innovation or Bureaucracy Doesn t support innovation Isn t IT smart and doesn t use or understand IT systems Greatness or Goodness Inhibits business change Is never satisfied with IT

8 Cultural Pitfalls Problems arise when de facto values conflict with espoused values Customer Service Quality Teamwork Integrity Excellence Compassion These conflicts engender a counter-culture of resentment, distrust and apathy, making any strategy or project more difficult to execute

9 Conflicting Values Espoused Values Quality Teamwork Integrity Excellence Compassion De Facto Values Poor quality (inefficiency, waste & error) tolerated from high producers Appraisal and incentive systems geared toward individuals Commitments not honored Mediocrity is tolerated Theory X management style

10 Cultural Barriers Misaligned interests or incentives Differing perceptions Territoriality Resistance to change Language or jargon Breaking through barriers is more difficult than avoiding pitfalls, because barriers have strong foundations beliefs & values

11 Perception can be a barrier People outside the HIT sub-culture probably don t see your project the same way you do Collaboration is the key to seeing eye-to-eye

12 Territoriality can be a barrier What gives you the right to come in here and tell me how to practice medicine? A strong dose of empathy can help you cross the border safely

13 Getting Things Done with Culture Be Collaborative Show some empathy Align values & incentives Care about their values Quality show them how the new way is better medicine Competence training Productivity reduce clicks Autonomy let them make some decisions Acknowledge the pain Get the staff on your side be a partner/ally

14 Changing Culture Slow, careful process Collaborate at all levels Incentivize the new values/behaviors Model the new values/behaviors Takes a LONG time & HUGE effort o Projects need to be on a much shorter time-line

15 Building a Bridge Faster Easier Allows sub-cultures to keep their beliefs & values intact However The bridge must be sturdy enough to carry the load

16 Building a Bridge P R O J E C T Common Ground Project Plan Communication Compromise Consensus I/T Dept Behaviors Values Beliefs History New Behaviors P L A N Goals Values Beliefs Common Ground Results Accountability Trust MD Office Behaviors Values Beliefs History

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18 James C. Larson, FACMPE is a board-certified medical practice executive and a Fellow in the American College of Medical Practice Executives with a 30-year track record of achievement in physician practice settings. Jim has owned a successful medical billing company and has held executive positions with numerous physician practices; from a solo practitioner to large, hospital-owned multi-specialty groups. He has also led free-standing diagnostic centers (MRI, CT, etc.) and large Management Services Organizations (MSOs). MedPractice Solutions compounds the power of people by building bridges between individuals, stakeholders, and silos creating a Culture of Quality. Analysis, Education & Training Process Design & Management Implementation & Execution Health Information Technology Business Operations Quality & Patient Experience