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Barriers to Build – Fixing Systems Change

New systems investments are exciting.  The process of systems change is tough.  Amazingly, not much has improved in conversion practice, despite wave after wave of consistent experience.  The best we have come up with seems to be application of a methodology for ‘working the change process’ of discovery, build, validation, training, transition and launch and staffing change teams with highly skilled, experienced builder/change artists who “do it right”.

Professional service teams create value by moving from client to client, exploiting consistent process and deepening competence to move an operation from one tool infrastructure to another, leaving no capability or data behind.  This process includes discovering and rebuilding institutional content from old system to new, largely by hand.  Operation enabling content (order master, item master, charge description master, pharmacy formulary, order sets and others) are integrated and interdependent – changing one requires careful change of all.  System content is unique to each institution.  It is complex, fragile and often in poor condition.  It has grown up over lengthy periods between system tool investment under the stewardship of many different managers and administrators.  One key assumption and goal of systems conversion is an expectation that content will be transferred with integrity and fidelity from old system to new.  One of the key determinants of post go live experience is the degree to which content provisioning has been executed with rigor and integrity.

Client executives and their organizations want continuity in master file configuration to avoid problems.  Prior change experience provides lessons in operating risk, productivity impacts, patient safety challenges and other operating hurdles.

System conversion by hand, rebuilding the local version of master file content in the form of the new system, is an expensive, lengthy process, which will have flaws at go live – quality of rigor, attention to detail and builder competence/diligence will determine the degree of clean up required to return to sound performance.

It may be time for system conversion practices to offer client executives an alternative to traditional content provisioning practice.  Imagine hospital execs and staff being offered transition to a new tool infrastructure, supported by proven high quality/integrity master file provisioning supplied from the service’s library of reused, standard content.  The new tool, provisioned with master file content proven through experience with other clients, would require unique facility and staff content provisioning and conversion of historical operating data to be up and available for use.  Work flow configurations could be supplied by the service or built to client specification.  Custom work flow would require unique training programs, adding time and cost to system preparation.  Adoption of standard work flow leverages build, documentation and training artifacts, providing predicted performance experience demonstrated at earlier clients.

Such an alternative would require analytics tools to cross reference current, local content with standards.  This process would serve to validate to clients that standard content supports local clinical services seamlessly.  It provides a cross reference that enables conversion of historical data (patient records, billing, et cetera) to be transitioned to the context of new master file constructs.  Natural Language Processing and Artificial Intelligence offer technologies capable of tackling content provisioning and data conversion challenges in new ways.

Transition from local content provisioning to standard content reused at many facilities offers a second opportunity.  Conversion service companies could offer and client executives purchase ongoing content administration services to maintain content over time.  Such a service could reduce provider operations costs, assure timely compliance with regulation and clinical advances and help manage performance risks.  Conversion services or software vendors could add a recurring revenue stream to their product portfolio and improve market reputation/position by taking positive control of a key source of poor conversion outcomes or software performance challenges.

Conversion service providers can accelerate change projects, reduce costs, improve client outcomes and enhance their reputations and value, growing market share.  It is time to invest in tools and content to get results.

Contact BrightWork Advisory to develop your strategic plan to compete at the next level of quality and value.

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