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Even Small Planes Need Big Plans!

February 2, 2016
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Physician groups often overlook the need for strategic planning. They think that because they don’t have very many resources they don’t have the need to develop a five-year plan. Of course if all you wanted to do was go around in circles, then you really don’t need a plan.

When I became a private pilot I thought that I would not use a lot of the flight planning tools with small planes. I could just figure out where I wanted to go, set up my heading, and make sure that I had enough fuel to get there. Of course I found out that unless I was just going to be circling the airport doing “touch and go’s,” I really needed to factor in all the information to arrive safely.

We have seen some major changes that have radically transformed physician groups in just the last 10 years. Meaningful use and ICD 10 have been just a few of those changes. Unfortunately many physician groups have had to react to these changes and implement systems and processes without strategically planning their impact. Purchasing systems that fit their immediate goals, and budget today, with no regard for what’s around the corner.

In the case of meaningful use many organizations implemented an EMR without fully planning on all the tentacles that this system comes with. With each EMR capability comes technology challenges as well as opportunities for improved data gathering and patient outcomes. I have personally witnessed many of these implementations continue to be a cyclical reaction as more systems are added, additional interfaces have to be built, and physicians demand improved integration.

All of this contributes to a culture of frustration within the organization and a feeling that nobody is at the helm. ICD 10 will have an insidious effect on reimbursement. Understanding and planning for the inevitable change of payer models will enable you to get in front of the technology requirements and the potential for budgetary impacts.

Planning ahead takes time. Just like my flight experience in small planes, I still had to factor all the same things large airlines have to consider. Physician groups are no different than hospital groups when it comes to strategic planning. They all have to follow the same methodology:

  1. Build on your mission and vision. Don’t lose sight of this as you develop your plan.
  2. Avoid preconceived notions. There will be some within the senior leadership that has already decided where they want to go, and how they want to get there.
  3. Take the time to speak to each department. Collect the data in an objective way. Document, tabulate, and start identifying key themes that will surface during the interview process.
  4. The leadership needs to get away from the office and meet in a different environment with no cell phones. This may be a half day or full day evolution. But it essentially needs to be a commitment from each person.
  5. The meeting builds on the themes captured during the interview process and ranks order them. From a technology standpoint, you look at ways of how the existing systems could meet the objectives or how new systems would have to be added in order to accomplish those goals.
  6. Eventually you arrive at Goals with key Objectives for each goal. They have to be quantifiable, realistic, and with a set timeline.

How many organizations have you seen that:

  1. After a short amount of time they are already having to upgrade their EMR and financials?
  2. They purchased a massive amount of servers, but now are considering cloud based solutions?
  3. They feel really behind in capitalizing on the integration with IP phones.  
  4. Are just piggybacking onto whatever their hospital affiliate is doing.

All of the above examples are organizations that I have been involved with. To their credit, they realize that they should have developed a better plan but they tell me; who has time for that? The reality is that it is cheaper to plan your technology initiative than to rip something out and change systems every couple of years.

Arriving at an uncontrolled airport (without an air traffic control tower) I had already predetermined my runway based on the winds at the location (and double checking the windsock at the airport) and I knew how I was going to approach the traffic pattern. I announced over the radio frequency for that airport who I was, were I was, and what runway I was going to land. Then I heard a very anxious high pitched voice over the radio from someone in another plane that was approaching the runway in the opposite direction! After informing them of the correct wind direction, I circled around to make sure they were indeed going to land at the proper runway heading. Then I set up my approach.

Planning ahead allows you to anticipate the challenges, it also allows you to remain calm when you see other organizations going in the wrong direction.