the healthcare cio boot camp - aventri · social media, big data, mobility) identify metrics and...
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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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We’ve come a long way!
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How to Be a CEO for the Information Age
Harvard Management Review, Winter 2000, Volume 41 Number 2
“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.”
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The Black Hole of IT Value
“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
“I estimate that about half of our IT investment generates value . . . I just can’t figure out which half.”
- Healthcare CEO
“Some healthcare CEOs refer to IT as that black hole you pour money into… never seeing results.”
- Healthcare CEO
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From “Good to Great” by Jim Collins
“…technology by itself is never a primary root cause of either
greatness or decline.”
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Care Improvement Process
Status Quo – Fee for Service
Wellness Care
Quality Care
Managed Care
Value Care
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“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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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
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“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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Using a business case cycle that produces VALUE.
3. Baseline
Existing
Performance
4. Describe the
Capabilities
of the Solution
5. Negotiate the Targeted Improvements
7. Develop
the TCO
6. Convert
the Targeted
Improvements
to Financial
Results
8. Calculate the
Hard-Dollar ROI
2. Select
the Metrics
1. Organize Stakeholders and
Focus on Benefits
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Business Value in Healthcare
Healthcare
Value ˭ Dollars Spent
Patient Outcomes
&
Revenue
Enhancement
Adapted from Value Measurement for Healthcare, Harvard Business School Executive Education
˭ IT/Informatics
Value
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Value Realization Requires a Structured Approach
Current State – Start the journey
Execute Roadmap
Manage Change
Capture Value Realization Opportunities
Future State – Define the ideal
Change Readiness
Assessment
Envision the Ideal State
Innovate & Optimize Costs
with Disruptive
Technologies (Cloud,
Social Media, Big Data,
Mobility)
Identify Metrics and
Develop the Business
Case
Implement PMO &
Governance Model Measure Benefits
1
6
4
7
2
Develop Implementation
Roadmap
5
3
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
Program Management and Governance
1.0 Enterprise Services Transformation – Change Management1.1 Org Design
& Process/Role
Change Mgmt
1.2 Communic.
Planning
1.3 Business Case
Development
1.4 Readiness
Assessment
2.0 Rationalize/Standardize/Define
2.2 Knowledge Mgmt Processes &
Tools
2.5 Reporting Processes & Tools
2.1 On-Boarding
& PD/Accred.
Processes
6.0 Service Support &
Enhancement
3.0 Enabling Capabilities – Service Detailed Design/Build
4.0 Monitoring & Assurance – Service Detailed Design/Build
5.0 Business Area Service Deployment
Quarterly Formal
Communications Releases
Quarterly Formal
Communications Releases
Quarterly Formal
Communications Releases
Quarterly Formal
Communications Releases
Quarterly Formal Business
Case Updates
Quarterly Formal Business
Case Updates
Quarterly Formal Business
Case Updates
Quarterly Formal Business
Case Updates
2.6 Assurance Processes & Tools
2.3 Sourcing
Processes &
Tools
2.9 Demand Fcstg, Resource
Planning, and Scheduling Processes
& Tools
2.7 Financial Mgmt Processes &
Tools
2.10
Requirements
Gathering Tool
2.11 Test Planning & Execution Tool
2.4 Functional Capabilities Demand/
Supply Assessment
3.2 Knowledge Mgmt Processes &
Tools
3.3 Sourcing
Processes &
Tools3.5 Transition to Desired Functional
Capabilities Capacity
4.1 PRT
Enhancements
4.4 Assurance Processes & Tools
3.6 Demand Fcstg, Resource
Planning, and Scheduling Selection
3.8 Requirements
Gathering Tool 3.9 Test Planning & Execution Tool
4.2 PRT Replacement Selection
3.7 Demand Fcstg, Resource
Planning, and Scheduling Design &
Build
4.3 PRT Replacement Design/Build
Wave 1 (All)
5.1 On-Boarding
5.2 Personnel
Development &
Accreditation
5.3 Sourcing
Wave 2 (All)
5.4 Know. Mgmt
5.5 Funct. Capab.
5.6 Assurance
5.7 Governance
5.8 Rqmnts
Gathering Tool
Wave 3 (All)
5.9 Financial
Mgmt
5.10 Test Plan &
Execution Tool
Wave 4 (By Business Areal)
5.11 PRT Replacement
5.12 Demand Fcstg, Resource
Planning, Scheduling Tool / Demand
Mgmt
2.8 Governance
Processes
6.1 Wave 1
Support Begins
6.2 Wave 2
Support Begins
6.3 Wave 3
Support Begins
6.4 Wave 4
Support Begins
6.5 Enterprise Services
Continuous Improvement
4.5 Financial Mgmt Processes & Tools
3.4 Governance
Processes
Quick Wins
Month 3 6 9 12 15 18 21 24 27 30 33 36 39
Re-
Calibrate
Iterative Definition to
allow for Quick Wins
Delivery
Iterative Design to
allow for Quick Wins
Delivery
3.1 On-Boarding & Personnel Development/
Accreditation Processes
Transformation
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William Bridges
“The three phases of transition”
Time
Acc
epta
nce
The phases are not separate stages with clear boundaries….
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The eight-stage process of
creating major change
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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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-79.5
-45.6
-29.9
-18.1-8.7
0.08.7
18.1
29.1
44.1
78.7
-100
-80
-60
-40
-20
0
20
40
60
80
100
Engagement Percentile
Av
er
ag
e %
Ga
in/L
os
s i
n P
ro
fita
bil
ity
Engagement Drives Profitability
Copyright © 2007 Gallup, Inc. All rights reserved.
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Why is ‘change’… and
change management’…
so important to us?
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Medication Error Rates
2007-2012
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VTE Incidence Per Year
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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.
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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 2011-2013
35 additional VTE/PE avoidance= $529,000 *Extended initial savings over years 2010-2011
**Estimates extrapolated from VTE reporting and CI DAM
*** Mid-range cost used from AHRQ inpatient DVT/PE estimates
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Thank You