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When do you Optimize? Tweak before or after an Install?

February 1, 2010
by Pete Rivera
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My son was very proud of his new car audio system. It even came with an iPhone adapter. My only question to him was; “Don’t you still have engine problems?”

It struck me that many organizations approach IT upgrades and installs much the same way. They take on an IT project before working on the Revenue Engine!

Software does not cure bad habits. Lack of proper training, poor policies and procedures all lead to bottlenecks in your process. Doing a Gap Analysis against your process compared to Best Practice is a sure way of doing a diagnostic test on your Revenue engine. The question is do you do it before or after an install?

Some will argue that you can leverage the IT project to tweak processes. The problem is that you don’t always get the skill sets that are able to do both the IT and revenue cycle improvement. So what are doing for optimization, before or after the IT project?



Thanks Pete.

I may have an overly superficial perspective but it seems that these are often accepted as the only available roads to progress, given budget and social constraints. About half of my clients are lucky and sophisticated enough to have clinical leaders that work well with the larger executive team and strategy. The other half have either no appetite to involve physicians or no physicians (physicians that are both interested and can afford the time.)

It's more fun for everyone in those former, healthier organizations.

Another way to ask that same question is "is go-live the end of the project or the beginning?"

A related question is, do you let (on insist that) stakeholders (business owners and end users) validate the system build prior to go live?

In both cases, if you're taking the long view, you need to create awareness, acceptance and commitment before the install. That process itself will always produce Tweaks.

Hi Pete - great question. My answer is both. First, I believe that hospitals should not look at as new system as an "IT project" but as a clinical or administrative project where IT supports the development of optimized process and maximized adoption with the new system.

Additionally, I strongly believe that IT needs to work with clinical and administrative users (and the vendor) to design the optimal process that can be facilitated by the IT application BEFORE deployment. And then they all need to work together to continually optimize their implementation.

Agreed. But I see far too many organizations that depend on the vendor Go-live to solve all the problems. Its a recipe for failure for any vendor.
To Joe's point, I call this "Wag the Dog" (See HCI Issue Date: May 2007-Wag the Dog). You need providers driving the clinical process decisions and operations driving the financials. IT is there to bring it all together and make sure it fits withing the infrastructure plan.