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Falling down and getting back up

How one project started to go off the rails but saved itself... for the most part.

What is PMG

Pediatric Medical Group (PMG)

Billing Group owned by 200 MCH MDs

5.5 FTE Billing Analysts (BAs)

$32 Million in billing

400,000 billable acts/yr

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Why PMG needed a new approach

Manual data entry

Inadequate software

Inadequate communication with MDs

Opaque business processes

High MD and BA dissatisfaction

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Typical approach to improvement

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Tools used for Initial Analysis

Vision and Scope

Workflow and Risk analyses

Business objectives and success criteria

Scope Agreement and Budget

Development Roadmap

Market analysis and RFI

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Billing Analysts’ Self-Assessed Core Competencies

Accurate and fast data entry

Power Users of MediRam software

Knowledge of MCH and MDs

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Key Factors in Deciding to Build

Idiosyncratic Business Rules

Estimates for modification >= building

Pyxis Presentation

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Why Pyxis?

Leader in Agility

Respect for each other when speaking

Commitment to avoiding “us vs. them”

Strong references

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Agile at its core

Individuals and interactions over processes and tools

Working software over comprehensive documentation

Customer collaboration over contract negotiation

Responding to change over following a plan

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Expected Workflow

MD uses mobile device to enter billing

PMG Reviews, Fixes, Bills Ins. and Pays MD

MDs review all billing and pay info.

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How it would work out!

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When will heaven be here?

Lack of interface with MUHC

Data review ---> Data Entry

BAs feel under siege!

SMEs not so “E”

Change management is ALWAYS hard

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Heaven? What’s that?

BAs won’t take ownership

Users won’t test = bugs

Users ignore rules engine = bad billing

MDs see billing problems = complaints

I don’t say “no” enough

New functions over quality = bugs

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The Frantic Angry Phone Call Demanding Immediate Attention and how Josh felt

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My 2nd weirdest meeting ever

Pyxis’s President’s approach: Things are going bad, so let’s talk about how we

“feel” about the project.

Josh’s thoughts: WTF! Bugs! Too many Bugs! What about the BUGS!!!

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Why I trusted rather than screamed

“There can be no friendship without confidence, and no confidence without

integrity.”

---Samuel Johnson

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How we got “past” blocking emotions

Check ego… be present... REALLY listen

How do they feel?

Why do they feel that way?

Check ego… put myself in their shoes

Give them what they REALLY need

See “Everything is Workable” by Diane Hamilton

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Pyxis Team Building (weirdest meeting)

Why aren’t we doing what we think we want to do?

What do you think you want to do?

What are you doing that stops you?

What do you gain by NOT doing it?

Big assumptions at the root of your actions?

See “Immunity to Change” by Robert Kegan and Lisa Lahey

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Now what?

Transparency: Own our responsibility

Inspection: Find and fix the problems

Adaptation:

Developer and PO are more present

Pyxis pays to fix some bugs

PO changes his approach

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Key Lessons learned

Be present

Let anxiety be your guide not your master

The conversations will happen, when should they happen?

Ownership doesn’t just happen

Agile blindspot?- PO needs things developers don’t

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Tools that worked

Team maintenance meetings

Proving to Customer you get them

User led Demos

Taking responsibility minimizes blame game

Ultimately...The software!

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Not all peaches and cream

Over budget

Lack of full functionality

Ver.2 = 25% of $ but 40% of total value

Longer to complete than expected

Time to market never key constraint

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Software’s current status

6 month ROI to Partners (not partnership)

Cost overruns = political problems

Ver. 2 is coming?

Billing transparency lowers MD confidence in BAs

BAs own software

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How the PMG is doing now

BAs feel under siege & resistant to Ver. 2

2 new MD groups want to use software

Support costs expected under budget

Director of BAs believes system = “dramatic improvement!”

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Just between us

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Josh’s Contact Info.

If you need help with a project or have questions or thoughts you’d like to share:

jshcwn@gmail.com

or

514.816.8706

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