Business owner involvement from very beginning (system selection and vetting) and throughout the entire process is imperative to a successful implementation. This includes significant involvement in planning and system design, being kept abreast with reviews and checkpoints throughout build, and engaged in test scenario creation and testing. Also necessary for success is a formal communication plan and business review teams. It is important that individuals from all levels of the business are included, not just governance and managers.
Generally, most organizations go in with a good plan. They include business owners in the system selection phase and kick off the project with strong involvement and good intentions. However, as time goes by and the build process wears on, business involvement often wanes. It takes strong project management, communication and diligent governance to sustain this critical aspect of healthcare system implementation.
Without business input throughout the project, serious issues can arise. System design may not match the business need. This “miss” results in redesign and rework that can actually double the implementation time—and the costs. The “redo” can be avoided if business owners are involved stakeholders from the start.
For example, I recently served as a project manager for a large implementation after the original project manager and other staff left. During the turnover, the build team had been making decisions unilaterally due to the void in project management and communication. It resulted in the need for a total redesign.
To keep this from happening to you, here are some strategies I have used to keep business owners involved throughout all the phases of a healthcare system implementation:
1. System selection and purchasing: Include business owners in the earliest stages of the vendor selection process by involving them in the selection committee. After all, the system will have the largest impact on the business units. If owners can all agree that a specific system will work with their business, it is probably a good candidate for the organization.
2. Planning and design: Expectations are built in this phase. Therefore it is critical to gain business owner support when developing the project plan. Put meeting times, deadlines, etc. directly on to calendars and develop your project teams. Every large implementation should have an executive steering or governance committee/team. Each functional area should have, if applicable, operational, clinical and regulatory/quality people, end users, and an executive from the steering committee. Depending on the size of the organization, some of these roles may be the same person or rolled into a “super user” role. It is important to identify these individuals early, include them in the right meetings and design sessions, and ensure decision-making empowerment and communication responsibilities are clear.
Within the project statement of work (SOW) or charter, include statements and commitments outlining responsibilities, overall involvement and team outlines. This can help set the foundation for a successful and complete system implementation.
3. Build: Once the design has been completed and signed off by the appropriate teams and the build begins, it is important to have a communications plan that includes a way to keep business owners in the loop. For example, you may want to have a weekly or bi-weekly meeting or call where progress is reported, status is reviewed, issues are brought up, and tasks are delivered. These meetings also act as natural escalation paths. Although an official escalation path for issues and decisions needs to be included in the SOW, issues can be headed off at the pass with good communication. “No surprises” is the objective.
4. Testing: Testing is also a collaborative endeavor that cannot be accurately completed without the input of the people who perform the tasks being tested. Include users from various functional areas within each business unit so that scenarios can be representative of all functions and tested by the people who will do them.
I have experienced exhaustive testing phases with seemingly accurate testing scenarios that had to be completely redone due to the fact that business and process owners were not included in the scenario and script creation. The processes and workflow in the original testing were not completely in sync with the business owners’ vision. This resulted in angst, re-work and extra cost.
5. Go-live: If the business owners have been engaged and the teams have collaborated on design, build, testing and training, go-live should be a successful and celebratory event. System and workflow issues will undoubtedly arise, but they should be tweaks and general improvements. Ask business owners to keep a list of potential improvements. Create a forum for these improvements to be vetted and prioritized during the 30- to 90-day post-go-live optimization period.
Overall, maintaining an environment of openness and communication does wonders. It takes work to build in the communication infrastructure, but the effort is worth it. In addition to all the formal meetings, don’t forget to pick up the phone, send an e-mail or walk down the hall to talk to people. Buy-in has a lot to do with sustaining relationships.
Communication helps overcome another barrier to a good implementation—resistance to change. One organization reduced the impact of change by optimizing the workflows before the implementation. This way, users can’t blame the technology for the new workflow. They also get to familiarize themselves with the workflow changes before they have to learn the new technology. Lastly, this approach takes the burden of designing workflow out of the system implementation.
Implementing a new practice management system or any other large software system is a huge undertaking that requires collaboration across an organization. A long-term, successful system cannot be implemented along department lines and without cross-functional involvement. You can help ensure the long-term success of your implementation from the very beginning by developing business ownership and engagement, which will turn into cultural ownership of the system.
Luis Abila is a senior healthcare consultant at Hayes Management Consulting, Newton Center, Mass.