There's an old saying: "Culture trumps process." I'd like to amend this to say, "Culture trumps technology." While this is obviously a play on words, one does have to seriously consider the culture of organizations that are acquired today in the healthcare space.
This is particularly true if the goal is to standardize on technology platforms and drive operational efficiencies and savings early on in the acquisition process. Underestimating the impact of culture on your technology plans can lead to costly delays and unplanned outages.
We have developed what we call a 3 C’s Approach to managing Information Services that has become a mantra for us. It means: common systems, centrally managed and collaboratively implemented.
I will mainly focus on the common systems piece in this blog, but will also touch on centrally managed as that is one of the keys to achieving the most significant benefits of merging and integrating technology platforms.
This 3 C approach has been baked into our DNA now for some time and has delivered some significant benefits. As a result, we have top down organizational support around this methodology.
However, when you acquire a new hospital or a large practice, it’s important to begin to articulate this approach early and often. We typically work collaboratively with the new organization to help them see the rationale behind this approach and the associated financial and operational benefits. We publish a formal benefits realization white paper every two years and this report really helps us to articulate tangible results.
In any acquisition, technology is typically on the tip of the spear.
The first thing that we typically do is connect the organization from an infrastructure perspective. That begins to provide insight as to what vendors they use and how their infrastructure and information security is handled.
As we start to mature the relationship, we typically develop a side -by-side look at the technology platforms. We often overlay technology roadmaps to demonstrate commonality. This begins to provide a visual that we use to look for prioritization and expectation setting in terms of savings opportunities.
From there, we look at low hanging fruit. What are the technologies that can be retired to deliver earlier savings? Typically, these are platforms and technologies that are low on the complexity scale and low on the effort scale.
Then we begin to look at things opportunistically: things such as technology refresh cycles, when contracts are up, when technologies are not meeting an organization’s needs. From here, we typically craft a multi-year plan that identifies the opportunities with the final goal being completely supported on common systems.
I should note, that sometimes we find that a newly acquired organization has a “superior” technology and we eventually migrate towards that as a new enterprise standard.
Diligence and commitment
Developing and maintaining evolving enterprise standards requires diligence and a commitment to the process. We have found that having very good architects are key to this process. We have developed an architect job family and development program where we have matured several of our best engineers.
We run bi-weekly architecture review board meetings that are well attended and serve to review new proposals. This process allows us to avoid technology duplication in our several entities. Our filter for new systems typically includes tenets such as: Secure, Extensible, Supportable, Scalable, and Resilient.
This architecture review board and stringent change control process are the reason that we have been able to establish solid infrastructure resiliency and dramatically reduce enterprise outages.
All throughout this process, it’s very important to talk about your technology vision and make sure that the engineers and technicians understand it, as well as the Project Management Office and applications leaders.
Our vision includes stakes in the ground such as: Utility Uptime, Clinical Grade, Self-Healing, Self Service, Software Defined and Cloud Right. These handful of tenants allow us to make solid decisions around technology investments and continue to head down the direction outlined by the 3 C approach.
In summary, when you take this common systems approach to managing your enterprise, you set yourself up for running a lean and mean organization. You can work to develop a solid technology reference architecture that features key vendor and partner relationships that can be leveraged for economical and creative ways to improve your services while reducing your technology footprint.
John Donohue is associate vice president for enterprise infrastructure services at Penn Medicine.