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Reinstall or Replace – Getting the most from tools

Lately, I’ve been visiting software tool evaluation sites. These sites collect, organize and evaluate personal feedback from current clients, providing data that can reassure, alarm or affirm contemporary points of view about software vendor capability, competence and value. As a former executive client of many of the reviewed vendors, I will admit to some sympathy for the vendor. For many vendors, their goal is to provide a tool that offers attractive features and performs reliably. How the tool is provisioned with content, configuration choices selected, workflow practices, user training program content and delivery rigor, are the primary responsibility of the purchaser. Vendors offer an array of services to support the users efforts, but the team making the crucial decisions is the buyer.

Maybe this is why vendor evaluation data looks like a bell curve. Some percentage of vendors end up liking the product, sharing success stories and outcomes. The majority of vendors in the middle has a mix of good, ok and not so good outcomes. There’s also a percentage in the dissatisfied group, offering a litany of feedback and complaints. One wonders how the vendor even comes to work each day!

What I find interesting is how often observations of satisfied clients conflict with feedback from the dissatisfied group. Many of these complaints do not seem to have much to do with the tool itself. Instead, the dissatisfied buyer’s comments discuss content (order sets, formularies, alert messages, and other “master file” content), configuration/workflow decisions, presentation choices, training practices – all elements typically under customer control.

If your hospital is struggling with current tools, an expensive tool change may be the answer.  However, don’t be shocked if history repeats itself and the new toolset fails in similar ways. The challenge may be more than the vendor – it might be closer to home.

A few tough questions should be answered before an expensive launch:

  • How are successful clients operating in ways that differ from the current local practice?
  • Is our system “provisioning” of master files as simple, clear, aligned with external standards as it can be?
  • Do we support adoption rigorously with training, metrics, outcome analysis, improvement, and feedback for our staff?
  • Has the performance experience been well supported and efficiently provisioned?
  • Are we using all the features and functions our tool provides, in a manner that optimizes utility and outcomes?
  • Did we fully exploit and conform to the new tools, or do we expect the tools to conform to us?

If the answer to any of the above questions is “no,” perhaps re-installation rather than replacement should be considered. For many decision makers, re-installation is not a natural course to follow, requiring a systemic overhaul of tool content, configuration, workflow, metrics, data flow/interfacing, support practices and infrastructure. A commitment to learn from, adapt, adopt and embrace the practices of facilities which are experiencing a sound operating performance by fully exploiting their tool investment is necessary to achieve improvement.

By making a commitment to maximizing your operational performance, either by replacing or re-installing old tools, your  hospital will become a healthier and sustainable provider of quality care. If, at the conclusion of a successful re-installation effort, it is determined that the current toolset is still not the best fit for facility operations, it is likely that a consensus on the need for a new tool is clear, sound and objectively derived.  At that time, the facility team will be prepared to drive value soundly from a new tool investment, having mastered the skills and mindset necessary to realizing its full potential.



Gary Seay is Principal of BrightWork Advisory, LLC., a practice focused on enabling innovative healthcare solution success.  Mr. Seay is an author, speaker and advisor possessing extensive executive experience with major healthcare provider systems, managed care organizations, venture capital firms, and academic programs.  He can be reached at josephgseay@BrightWorkAdvisory.com

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