Do You Have The Right Tech Strategy? An Executive Seminar On Technology Selection & Budgeting

Do You Have The Right Tech Strategy? An Executive Seminar On Technology Selection & Budgeting Monday, November 6, 2017 ⅼ 1:00pm 4:00pm #OMTechnology Matt Chamberlain, Senior Associate, OPEN MINDS 1 www.openminds.com 15 Lincoln Square, Gettysburg, Pennsylvania 17325 Phone: 717-334-1329 - Email: info@openminds.com

Agenda I. The Importance Of Strategic Planning For Technology Strategy II. III. IV. Why Scenario-Based Planning May Be The Best Option In A Changing Market The OPEN MINDS Approach To Developing An Effective Strategic Plan Sample Analysis Data V. Developing the Right Technology Strategy & Budget VI. Technology Planning Case Study #1 VII. Technology Planning Case Study #2 VIII. IX. Technology Planning Case Study #3 - Workgroup Technology Planning Discussion Questions 2

The Importance Of Strategic Planning For Tech Strategy

Perspectives Our goals can only be reached through a vehicle of a plan, in which we must fervently believe, and upon which we must vigorously act. There is no other route to success. - Pablo Picasso 4

Technology Investments Must Be In Sync With Strategy & Strategic ROI Your tech strategy can t be successful without having an overall organizational strategy "If you don't know where you are going, any road will get you there." - Lewis Carroll 5

What Is Strategic Planning? Strategic planning is your organization s process of continually assessing its internal capabilities and the external environment (payers, consumers, and competitors) in order to determine how best to use its limited resources to meet your strategic objectives. 6

The Strategic Part Of Technology Planning The Strategic Technology plan identifies technological infrastructure needed for organization to reach its strategic objectives Should demonstrate (and quantify) that proposed technology investments deliver return in: a. Increased revenues b. Improved performance c. Reduced operating costs d. Improved stakeholder preference or market position 7

Strategy In An Uncertain Landscape Need three plans 1. The strategic plan for the current market should focus on optimizing the performance of current operations (market positioning, market share, revenue, margins, etc.) 2. The strategic plan for the future market should have a vision for your organization in its next generation and determine the time and resource required to make that change 3. The transition plan to the future market the framework for moving from current market to future market 8

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Value Of Planning For CEO & Management Team Provides clarity from the board regarding organizational priorities and performance expectations Serves as the basis for development of organizational infrastructure and operating plans Serves as the basis for departmental and program plans 10

Value Of Planning For Your Organization Interprets the mission and vision, providing clear direction for the short-term and for the future Serves as a formal process to allocate limited resources Establishes strategic priorities Ensures organizational alignment Establishes the basis for on-going performance reporting on organizational status provided by the chief executive officer to the board 11

What Emerging Science Will Have The Greatest Impact On Behavioral Health? New Understanding Of Central Nervous System & Brain Chemistry Technology To Optimize the Value of Consumer Care 12 Technology To Support System Performance Improvement

Technology Infrastructure To Optimize Value Of Consumer Care Engaging Consumers Patient portals, websites, and web-based consumer tools Automated consumer outreach Reducing Service Cost Tech improving admin efficiencies Telehealth and telemedicine Tech-enabled treatment Remote monitoring 13

Treatment-Enabling Technologies Available All Along The Service Continuum Diagnostics Telepsychiatr y using IronWork s M3 (My Mood Monitor ) Brain scanning tech Consumer E ducation / Decision Support Video Doctor Common Ground Virtual Handheld Clinic PTSD Coach True Colours ChronoRecor d Health Steps for Bipolar Biomarker: BDNF levels mystrength Clinical T reatmen t TMS Therapy Beating the Blues SilverCloud Cognitive F unction Restoration My Mood Map ecbt Mood MyBrain Solutions E arly D e tection of Relapse Automatic Trail Making Tests fmri ITAREPS MONARCA Actiwatch Health Buddy OPTIMI Relapse Preventio n Technology Enhanced Recovery REAC-CRM (REAClithium) PSYCHE Personalise d Ambient Monitoring (PAM) MoodMappin g Remote Monitorin g of Patient Health ViTelCare T400 SenseWear Armband System MagneTrace ID-Cap Electronic Medication Management Assistant (EMMA) Implantable RF Transceiver ZL70102 Motionlogge r Actigraph Helius MOBUS 14

Technology Infrastructure To Support Performance Management Getting The Necessary Data Electronic health records Patient registries Health information exchange and data aggregation Consumer referral tracking Optimizing Organizational Performance, Care Coordination & Population Health Management Performance monitoring and management tools Care coordination platforms Consumer segmentation and health risk stratification Advanced population analytics and clinical decision support 15

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So Where Does Technology Fit In This Equation? Necessary To Manage Risk & Compete On Value Analytics technology to support performance measurement capability For analytics technologies, use of the data for decision making is key to ROI Treatment technology into increase value of consumer care For treatment technologies, increasing treatment value is key to ROI 21

Technology Has Changed The Expectations Of Payers & Consumers New treatment technologies have changed the options for consumers Health information exchange provides data exchange and creates big data for consumer service planning 1. Personalization of consumer treatment through analyticsinformed decision support 2. More efficient and effective coordination of consumer services across the service system 3. The measurement of value of services Smartphone and other technologies for inexpensive consumerdirected disease management Telehealth and virtual consultation changing geographic market boundaries for services 22

New Genetics, Pharma, & Neurotech: The What of Service Telehealth & Remote Services: The Where of Service Web-Enabled Admin Tools: The How of Service A New Market Model Is Emerging New Service Delivery Paradigm Analytics & Decision Support: The Right Service 23

Technology Adoption in Health & Human Services Is Slow Conflict between the technical capabilities of HIEs and HIPAA Lack of best practice models and expertise to reengineer service delivery Slow change in reimbursement models to support (require) new tech adoption 24

Adoption Of Technology Innovations By Specialty Provider Organizations, 2017, % Currently implemented Implementation in process Considering implementing in future 80.0% 60.0% 31.1% 30.6% 33.2% 38.3% 40.0% 13.3% 13.8% 15.8% 20.0% 0.0% 34.7% Text messaging/email communication with consumer 30.6% 25.5% 18.4% 16.8% Telehealth/telepsychiatry Consumer portal Patient engagement apps/tools 3.6% 22.4% 4.1% ecbt 25

Strategic Success Requires New Management Practices & Discipline 1. Develop vision of future competitive advantage and market positioning 2. Scenario-based strategic plan incorporating alternate future positioning options 3. Detailed plans marketing, financial, operational, capital, HR, etc. to implement strategy and future vision 4. Key performance metrics and metrics-based management to track strategy implementation (and allow mid-course adjustments) 5. Optimization of current operations to keep current programs as competitive (and profitable) as possible as long as possible 6. New service model development to support future vision 7. Collaborations as needed to facilitate new market vision 26

Where Does Technology Fit In? 1. Develop vision of future competitive advantage and market positioning 2. Scenario-based strategic plan incorporating alternate future positioning options 3. Detailed plans marketing, financial, operational, capital, HR, etc. to implement strategy and future vision 4. Key performance metrics and metrics-based management to track strategy implementation (and allow mid-course adjustments) 5. Optimization of current operations to keep current programs as competitive (and profitable) as possible as long as possible 6. New service model development to support future vision 7. Collaborations as needed to facilitate new market vision 27

Shifting Role of Technology In Health & Human Services Administrative Tool Compliance Requirement Platform For Competitive Advantage 28

The Shift From The Functional To The Strategic The result of compliance focus of the past ten years less focus on usability and clinical effectiveness From cost to investment From administrative management to imbedded in service lines Essential for competitive advantage and market positioning - over the next five years 29

Why Scenario-Based Planning May Be The Best Option In A Changing Market

Scenario-Based Planning Is A Tool For Planning In A Chaotic Market 1. Most organizations need to move forward with implementation without final information 2. Most practical option is concurrent scenario building and planning 1. A Most Scenario organizations Is... need to move forward with An outline of an hypothesized implementation chain of events without final information Depictions of a future that are useful to clarify thinking not 2. Most predictions practical or forecasts option of is what will happen; rather, a suggestion concurrent of what might scenario happen building and planning Several (usually 3-5) descriptions of hypothetical situations interspersed with extrapolations of trends; more useful for understanding options and dealing with uncertainty than in predicting specific events 31

Scenario-Based Planning Process 1. Build scenarios of likely future situations and high-level implementation plans for each 2. Determine the common elements in the scenario implementation plans common organizational capabilities, resource investments, partnerships, etc. 3. Select the most likely scenario to occur as the basis for the strategic plan 4. When building the operational implementation plan, implement the common elements to all scenarios first 5. Monitor events to update scenarios and action plans 6. Continuously update both the scenarios and the implementation plans based on new developments 32

Strategy Development - Common Strategic Options For Consideration Closure of services/service lines that are not profitable and/or affordable and/or good fit Strategies to improve margins of existing service line Building value added products to increase margins Expansion of successful service lines (expansion of geography, new customer base, etc.) Diversification of revenue sources Reconfiguration of services within value chain Strategies to address shifting economy of scale issues 33

Factors Contributing To Failed Plan Implementation Poor preparation of line managers Inadequate linkage of strategic plan with other control systems Definitions of service lines and operating units not precise Badly handled reviews of business unit plans Vaguely formulated goals Inadequate information for action planning 34

The OPEN MINDS Approach To Developing An Effective Strategic Plan

Recommended Phased Business Strategy Development Process Phase One Scenario-based strategy development Phase Two Modification of business unit plans to support strategy implementation Phase Three Development of executive team performance dashboard 36

Phase One: Scenario-Based Strategy Development Confirm short-term and long-term organizational objectives Analyze external and internal factors that affect strategy Identify likely environmental scenarios and related strategic issues and priorities Develop strategic priorities and related tactics Develop a strategic action plan with a high-level implementation plan 37

Phase Two: Modification Of Business Unit Plans To Support Strategy Implementation Marketing and development plan Organizational and program budgets Financial management organizational strategies Technology and communications plan Financial management plan Recommendations regarding organizational structure Operations management plan Human resource and talent management plan 38

Phase Three: Development Of Executive Team Performance Dashboard Determine critical performance outcomes for success of strategy Identify leading indicators and metrics that track these performance outcomes Develop key performance indicator metrics and related specifications Create an executive team performance dashboard based on these strategy key performance indicators 39

Overview Of Strategic Planning Process Review/Establish Mission/Vision/Objectives Gather External Information/External Analysis Trends & Competitors Gather Internal Information/Internal Analysis Service Portfolio Analysis Identify Options for Achieving Objectives - Strategies, Tactics, Markets & Services Develop Operational Plans Marketing & Business Development, HR & IT Develop Budget & Financing Plan Develop Detailed Implementation Action Plan Develop Key Performance Indicators 40

Typical Strategic Plan Outline Executive Summary Statement of Annual Goals & Objectives (3 Year) Summary of Internal Organizational Analysis Summary of External Market Research Possible Environmental Market Scenarios Organizational Strategies & Tactics for the Most Likely Strategic Scenario Strategic Issues & Objectives Strategic Initiatives Key Tactical Elements of Each Strategic Initiative Implications of Proposed Strategy & Tactics on Operations Marketing & Development Implications of Organizational Strategies Operational & Technology Implications of Organizational Strategies Financial Management Implications of Organizational Strategies Strategic Action Plan: High-Level Implementation Plan for Each Strategic Initiative 41

Sample Analysis Data

Analysis Data Points State Trends Consumer Data Population / Demographics Payor Coverage Medicaid, Medicare, Commercial, other Competitors Size, Population, Service Lines, Branding 43

Internal Analysis Revenue By service line Payer mix Profit and loss Number of consumers served by service line Unit cost data SWOT Analysis 44

Revenue Mix By Service Line Partial Care Services Other Services Adult Intensive Case Mangement Services Adult Supported Employment Adult Residential Supported Housing Adult PACT PATH 50% 47% 46% 28% 28% 28% 15% 15% 12% 4% 3% 3% 3% 3% 3% 1% 2% 2% 2% 2% 3% 2015 2010 2016 2011 2017 2012 45

Revenues Profit and Loss by Service Line, 2017 Allocated & Direct Expenses Percentage of Revenue by Service Line Profit/Loss (Margin) Margin (Percentage) Funding Mix Other state funds/ grants Other local funds/ grants Medicaid Partial Care Services $2,387,697 $2,583,957 12.5% ($196,260) -8.22% 43% 55% 2% Adult Residential Supported Housing $5,400,241 $5,298,334 28.2% $101,907 1.89% 13% 86% 1% Other Services $419,493 $451,558 2.2% ($32,065) -7.64% 99% 1% Adult PACT $9,589,380 $9,370,374 50.0% $219,006 2.28% 42% 58% Adult Intensive Case Management Services $364,118 $428,828 1.9% ($64,710) -0.67% 31% 69% PATH $410,177 $401,618 2.1% $8,559 0.09% 21% 79% Adult Supported Employment $600,715 $576,691 3.1% $24,024 6.60% 100% Total $19,171,821 100.0% 46

47 2017 Unit Cost of Services Unit of Length Unit Cost Statewide Median, 2010 Partial Care Services A County - Adult Only - Partial Care Services hour $38.35 $22.03 B County - Adult Only - Partial Care Services hour $16.51 $22.03 Adult Residential Supported Housing A County - Adult Only - Supported Housing 15 min $42.07 $43.14 B County - Adult Only - RIST 15 min $74.94 $50.05 B County - Adult Only - RIST 2 hour $22.49 C - Adult Only - RIST Tri-County 15 min $90.65 $50.05 C - Adult Only - At Risk 15 min D County - Adult Only - Supported Housing 15 min $54.70 $43.14 E County - Adult Only - Supported Housing 15 min $39.04 $43.14 UnEion County - Adult Only - Enhanced Support 15 min $48.28 $43.14 Other Services Regional - Adult Only - Supported Education hour $66.22 Statewide - PACT TTA Adult PACT E County - Adult Only - PACT 9 hour $261.81 D County - Adult Only - PACT 5 hour $274.71 B County - Adult Only - PACT 7 hour $237.53 B County - Adult Only - PACT 8 hour $250.76 A County - Adult Only - PACT 6 hour $223.41 C County - Adult Only - PACT 1 15 min $205.85 C County - Adult Only - PACT 2 15 min $278.10 C County - Adult Only - PACT 3 15 min $254.32 Z County - Adult Only - PACT 4 15 min $274.57 Adult Intensive Case Management Services F County - Adult Only ICMS 15 min $82.23 $58.85 PATH F County - Adult Only PATH 15 min $92.63 $56.63 F County - Child & Adult - PATH 15 min $53.53

Unit Cost Data 48

Developing The Right Technology Strategy

Overview The planning process can represent a significant challenge. It takes time and resources in an already taxed environment Planning Remove obstacles Look for process improvements Define best practices Consider new technologies (Broaden the scope of technology don t see what you have now as all you ll ever need) 50

The Strategic Part Of Technology Planning Are you a small or large business? What is your current technology investment? How far is it from where you need to be? (Timeline & Budgeting Effects) In-House or Cloud-Based It s not just EHRs! Moving to the Cloud? Internet bandwidth could be an issue Current and future needs hardware, software and support Staffing - Less or More? 51

The Strategic Part Of Technology Planning Continued Organizational Impact How will it affect: People IT Management Clinical Billing Time Processes Training It is easy to underestimate The most important question is WHY? 52

The Strategic Part Of Technology Planning Continued The Strategic Technology plan identifies technological infrastructure needed for organization to reach its strategic objectives Should demonstrate (and quantify) that proposed technology investments deliver return in: Increased revenues Improved performance Reduced operating costs Improved stakeholder preference or market position 53

Broad Categories Of Technology Use In Behavioral Health Care The Basics: Electronic Health Records Operations Software Applications HR / Payroll; GL / Accounting Telehealth Technologies Consumer-Focused Technologies Informatics, Analytics & Decision Support Technologies Website & Social Media Usage 54

. Three-Phase Review Of Technologies Strategic review phase Clinical review phase Business model review phase 55

Start With Strategy & Positioning Of Each Service Line Strategy should set the context for tech selection what markets and what service lines? Key question is competitive advantage of each service line in the selected markets What are the competitive threats to keeping targeted customer and consumer markets? 56

Technology Investment Should Serve Strategic Purpose Reduce cost of service per unit Reduce cost of service per case Improve payer preference Improve consumer preference Improve operating performance Improve consumer outcome or functioning Facilitate new consumer service Facilitate new payer relationship Strategic review Short list of technologies for each service line Clinical review 57

. Phase 2: Clinical Review Phase The technologies that meet the strategic review criteria form a short list for clinical review. Review of clinical leadership of proposed technology Clinical methodology and operational use of technology Scientific development and research data Outcomes and performance data Customer/consumer acceptance Does the new technology meet your organization s clinical standards? Select treatment technologies to build into service process 58

Phase 3: Business Model Review Phase Define the revised service line business model with embedded technology Determine financing model and reimbursement for service Process mapping of revised service line Develop a financial sustainability plan for the business model breakeven and P/L Establish key performance metrics for tracking performance 59

Step 1 & Step 2. Define The Business Model & The Financing Model For The Service Line Structural Financing Model Service Delivery Model 60

Step 3. Creating Process Map Of Revised Service Line 61

Step 4. Develop Financial Sustainability Plan For Business Model Conduct a breakeven analysis Develop profit/loss projections Business model to imbed in organizational strategic plan, operating plans, and final budget 62

Conduct Breakeven Analysis Breakeven analysis answers question: At what level of revenue (how many consumers) will the program break even? Breakeven analysis is a supply side (i.e., costs only) analysis does not address revenue side of the equation Construct breakeven analysis for the specific coordinated care business model both with and without organizational overhead Key breakeven analysis factors: 1. Annual yield/productivity of service units (by type) per direct service (billable) clinical team member 2. Average annual total compensation cost per direct service (billable) clinical team member Assumptions in breakeven analysis: 1. Constant fixed costs 2. Average variable costs with assumptions 3. Relationship of revenue to variable expense in assumptions 4. Factors affecting assumption of yield/productivity of team members 63

Develop Profit/Loss Projections 1. P/L determines the margin of service line based on revenue projections and operating cost model 2. Financial statement summarizing revenues (with associated costs and expenses) incurred during a specific period of time 3. Illustrate the ability of the program to generate a margin by increasing revenue and reducing costs 4. Revenue projections and assumptions are key element of P/L projections 5. Typically, revenue projections in health and human services are created by payer/contract Key Variables In Profit/Loss Projections 1. All services provided 2. Number of annual unique consumers by payer 3. Number of annual service units (by type) per consumer by payer 4. Negotiated contract rate for each service unit, case, or population, by type and by payer 5. Billing and collections yield (% of total units billed that are collected) by payer 6. If P4P bonuses or penalties, the projected performance on each P4P performance measure 64

Analysis Of Program Business Model 1. Does the investment in technology achieve objectives and improve the performance of the service line? 2. Improve margin and sustainability? 3. Reduce costs to customers (payer or consumer)? 4. Improve performance or outcome in metrics that are of interest to customers? If no demonstrable improvement in cost reduction, margin improvement, or revenue no reason to invest in technology 65

Step 5: Establish Key Performance Metrics To Track Clinical & Financial Performance If you don t measure it, you can t manage it Having a plan is not enough tracking and managing performance of plan is key Whatever gets measured... Gets attention Gets done 66

The Budget Issue Can You Afford The Technology You Need? 1. Capitalization of the initial purchase is smaller issue 2. The big question on-going costs of technology and systems to support it 3. Part of financial analysis breakeven points and on-going P&L 4. It s all about ROI "Price is what you pay. Value is what you get. Warren Buffet 67

From Technology Planning To Budgeting Organizational Strategy & Vision For IT Current IT Environment: Gap Analysis & Assessment Future IT Environment: What It Will Look Like & Performance Expectations Detailed Plan Budget & Other Resource Requirements 68

A Review: Budgeting 101 A balanced financial plan that promotes the efficient allocation and use of resources and ensures that all funds received and disbursed are accounted for in accordance with current laws, regulations, and policies A plan Identifies receipts and expenditures in specific amounts Specific cost categories Set period of time Monitoring mechanisms 69

Three Key Components Of Technology Budget Technology Plan Budget Ensuring that technology aids in your objectives Basic Expenses Covering all the basics to support infrastructure, applications, and staff Routine Capital Budget Maintaining and enhancing technology infrastructure 70

1. Technology Plan Budget Components This one is easy it s the current budget year costs as laid out in your detailed technology plan 71

2. Basic Technology Budget Expenses This is the bigger list of items: Information technology staff and benefits Telecommunication/connectivity costs Internet access costs Software maintenance and help desk fees Training costs Consulting/customization costs Must-Have Basic IT Budget Expenses Infrastructure support and maintenance Application support and maintenance User support (Help Desk) Outsourced IT service costs Other? 72

3. Technology Capital Budget Expenses This includes your typical capital budget expenses Hardware, networks, and upgrade costs Software and software upgrade costs Other capital expenses and related depreciation Use both strategies in your IT budgeting process: Top Down IT initiatives are pushed from the top executive level on down to the masses, based on strategic objectives and initiatives Bottom Up Where they start at the department level and roll upward for approval 73

Common Questions Related To Technology Planning & Budgeting What percentage of your overall budget should the technology budget be? How many FTEs should you have in your technology department and who does it report to? What are the key initiatives and objectives of your organization s technology plan for the next 3-5 years? What major expenses are you anticipating in your technology budget and how are you funding them? How is your technology staffing changing (if at all) to meet your organization s needs over the coming years? How are you building in mechanisms to support your staff s increased use of technology? 74

Major Data Systems Analysis: EHR Inventory your current use of your electronic health record software solution Using all major modules and components? Keeping abreast of updates and new functionality? Ensuring data quality? Good end user training materials and documentation? Routine reporting set-up with documentation on use? Other? 75

Major Data Systems Analysis: GL/Accounting Systems Inventory your current use of your GL/accounting software solution Using all major modules and components? Keeping abreast of updates and new functionality? Fully integrated with human resource and payroll applications? Broad areas of functionality Budgeting and financial reporting Contract & grant management Unit cost reporting and management Forecasting Fixed asset management Electronic banking 76

Major Data Systems Analysis: Integrated HR System Inventory your current use of human resource software solution Using all major modules and components? Keeping abreast of updates and new functionality? Broad areas of functionality Basic employee information Position control Education and certification tracking Electronic timesheets Employee self-service (demographic information, benefits, etc.) Manager self-service (position changes, evaluations, etc.) 77

Video & Telehealth Technologies Do you use video technologies for staff meetings and staff contracts to reduce travel time and costs? Have you implemented the use of video technologies for service delivery and consumer contacts? 78

Research & Plan for Use of Other Consumer- Focused Technologies Which categories of consumer-technologies make sense for your organization? How to you decide which to use? Diagnostics Consumer education Treatment technologies Cognitive function restoration Early detection of relapse Relapse prevention Remote monitoring 79

Data Analytics Plan What reporting do you want from your various software systems and databases? Define reporting and dashboard needs. Identify data points and locations. Identify tools (data warehouse, data exports, business intelligence tools, etc.) to aggregate and analyze data. Train staff in using the reports, dashboards, and data analysis tools 80

Resources To Support Your Technology Use Application support Do you have staff members who are the expert users as well as those that support your key software applications? Are the basics documented so that you are not dependent on individuals? Technology infrastructure support and maintenance What is your plan for maintaining and upgrading your technology infrastructure? Help Desk Do you have formal help desk functions, require response times, and reporting to support all technologies? 81

Six Simple Rules For Tech Investment 1. Buy technological functionality like you buy anything else 2. Don't be swayed into buying new technology simply for the sake of the technology 3. Don't immediately reject technology that re-engineers your work processes 4. Assess potential technology vendors like you would potential business partners 5. If a reasonable person can't understand it, don't buy it 6. Choose wisely, plan carefully, and monitor progress 82

Sample Technology Plan Outline Executive Summary a. The executive summary is a snapshot of the entire plan, highlighting the key areas of the plan, which include goals, vision, needs, priorities, and proposed solutions. It conveys how you will use technology to achieve your strategic and operational goals in alignment with your agency's mission. Organization Profile a. Include a short description of the organization to set the context, including a summary of the current state of technology use in comparison with the rest of the industry Goals & Technology Vision a. Describe the vision of how you see your organization using technology in light of its strategic and operational objectives. Current Technology & Resources a. Describe your current technology use and staff resources. 83

Sample Technology Plan Outline Priority Needs a. Develop a bullet list of priority technology needs for the next 3-5 years, referencing how they support the strategic and operational goals. Focus on what you want to do with technology, not simply what you want to purchase. Technology Solutions a. Detail the proposed technology solutions as a discreet list of items Timeline a. Develop a reasonable timeline to complete all phases of the technology plan. Set deadlines for phases and milestones. Budget a. Develop a budget for all of the items detailed in the technology solutions section. Supporting Documentation a. Include an appendix at the end of the plan for any support documentation. 84

Technology Planning Case Study #1

The Situation County-based provider $15 million in annual revenue Medicaid; Medicare; Commercial; DHHS 230 Employees 3 Locations Key state trends: Privatization of the management of some of the behavioral health services One million more individuals expected to obtain coverage through the Medicaid expansion provisions of the health care reform legislation The state has added or restored funding to improve the system of care for individuals with intellectual and developmental disabilities due to assorted court decrees Service Lines Adult services (adult outpatient, community support) Child, adolescent & families services Senior services Emergency services Housing services Medical (medication) services 86

Strategic Objectives #1 Continue to develop the administrative systems and service array necessary to maintain and further ABC Organization s reputation as a premier service provider in the context of the changing state human service market. #2 Pursue further revenue diversification and expansion of services, supports, and prevention activities so that ABC Organization can expand its impact on individuals, families, and communities. #3 Celebrate and communicate ABC Organization s performance and reputation as a center of excellence, center of influence, and employer of choice. 87

Strategic Initiatives Initiate a formal process for enhancing or developing relationships with MBHOs or other parties who are likely to win the contract for privatization Enhance the unit cost reporting and management and financial reporting systems to ensure the ability of the ABC Organization to set target costs and prices and manage them for all lines of service as well as provide all managers with up-to-date financial reports with analysis and trend reporting Implement a comprehensive technology infrastructure that: Supports the organization s administrative, management, and compliance functions Creates new revenue and market opportunities Ensures successful implementation of electronic health records and meets all federal requirements of meaningful use 88

Strategic Initiatives Develop and expand the business development office to include marketing, public relations, grant writing, and advocacy functions at ABC Organization. Marketing and business development Referral generation and management Grant and contract writing and management Market research and service line development Partner selection and management Public relations Advocacy and lobbying efforts with communities and government stakeholders 89

Strategic Initiatives Implement a formal balanced scorecard performance measurement system and performance dashboard at ABC organization. Develop a key stakeholder reporting and communication system to communicate ABC organization s performance and reputation as a center of excellence, center of influence, and employer of choice. 90

Technology Planning Case Study #2

The Situation Multi-County Provider Annual Budget $130 million 97 county contracts, the majority are line-item cost reimbursement contracts with performance reporting The organization put together a seven component plan to be implemented over an 18-month period 92

Strategic Objectives #1 Ensure the organization maximizes reimbursement by spending exactly the budgeted amount on each line item of each cost-reimbursement contract #2 Provide better data and reporting to financial and clinical staff to manage report financial and performance data on each contract 93

Strategic Initiatives Implementing an electronic health record (EHR) to provide: Data on consumer demographics and service delivery Management reporting for operations Restructuring the general ledger chart of accounts to: Enhance financial reporting and projections Allow the system to be used for reporting actual versus budgeted expenses for each contract Implementing new A/P process to: To coach program managers in using management reporting To aid programs in managing expenses to hit budgeted numbers and service delivery to hit targets 94

Strategic Initiatives Designating financial analysts for each clinical program: To coach program managers in using management reporting To aid programs in managing expenses to hit budgeted numbers and service delivery to hit targets Designing and implementing CRM-based software solution to: Manage all RFP opportunities and proposal development and submission Manage all current payer contracts, including contact information, billing and reporting, and summary actual versus budget expenses 95

Strategic Initiatives Implement an overarching business intelligence tool on top of the EHR, GL, and CRM systems to: Address the complexity of the contract financial performance reporting Simplify the process of allocating shared expenses each month across contracts and programs Generate required service and demographic reporting Address executive and management metrics dashboard needs Involving quality assurance and clinical leadership in providing oversight to ensure performance targets are achieved 96

Technology Planning Case Study #3 - Workgroup

The Situation Mental Health/IDD Authority in the State of Texas 600 employees $60 million operating budget 16 locations 25 combined program / service lines Key Issues: Clinician Shortage Lack of local contribution to service delivery system Low per capita income; provide services to some the poorest zip codes in the country Historical reliance on State contracting and general revenue Staff in the field complain about documentation (want mobile) Difficulty keeping OP in the black Need to grow caseloads and do more with less Staff pushback Management complains about poor data and reporting capabilities 98

Strategic Objectives #1 #2 #3 99

Strategic Initiatives: Discussion Where does Technology fit in? How will it affect the budget? 100

Technology Planning Discussion Questions

Case Model Discussion Questions Organizational Situation What is your assessment of the Center s current situation? What questions would you want to ask the CEO? Developing A Plan What options do you see as available to the Center at this point? What are the advantages and disadvantages of pursuing each of them? If you were to replace the current CEO, what tactics would you include in your plan for the next 90 days? 102

Review Of Technology Planning Process Review/Establish Mission/Vision/Objectives Gather External Information/External Analysis Trends & Competitors Gather Internal Information/Internal Analysis Service Portfolio Analysis Identify Options for Achieving Objectives - Strategies, Tactics, Markets & Services Develop Operational Plans Marketing & Business Development, HR & IT Develop Budget & Financing Plan Develop Detailed Implementation Action Plan Develop Key Performance Indicators 103

Review - Technology Planning To Budgeting Organizational Strategy & Vision For IT Current IT Environment: Gap Analysis & Assessment Future IT Environment: What It Will Look Like & Performance Expectations Detailed Plan Budget & Other Resource Requirements 104

Finally, strategy must have continuity. It can't be constantly reinvented. -Michael Porter

Questions & Discussion

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