The EMR falls short. IT is preoccupied and cost constrained. Middle managers need access to software. And widespread experimentation is key to transformation.
Strategy Execution Platform: Enterprise healthcare technology designed-for-the-user, won’t-bust-the-budget, and especially-for-your-need.
This is the most exciting time to be effecting change in the history of healthcare delivery. Healthcare transformation is continuously creating new operational requirements for healthcare delivery firms. Executives respond to the shifting operational requirements within healthcare delivery — both problems and opportunities — with strategies.
This is the most exciting time to be effecting change in the history of healthcare delivery.
As they have always been, middle managers are tasked with executing identified strategies. And as they have always had, middle managers use three resources to implement and execute: people, process, and technology.
Middle managers use three resources to implement and execute: people, process, and technology.
Decisions of whom to hire and promote have long been the agency of middle managers. The same goes for determining how employees do the work and customers experience the service.
Historically, however, technology decisions have been left to the IT department. Continuing this paradigm will only impede progress by creating barriers and causing frustration.
While not every problem is solved with technology, nor does every opportunity require technology, increasingly solutions are dependent upon technology. This makes it imperative to empower middle managers with it.
The responsive healthcare delivery firm provides middle managers the capability to act by empowering them with agency over people, process, and technology decisions. Responsive healthcare delivery firms allow middle managers to quickly solve problems and take advantage of opportunities by piloting as many ideas as possible.
Empowered middle managers create responsive healthcare delivery firms. Responsive healthcare delivery firms empower middle managers.
The rigidity of the EMR and existing industry IT ideals are combining to prevent middle managers from being empowered with technology in the same fashion as they have been with people and process decisions. Fortunately, there is a solution.
The Strategy Execution Platform.
A Strategy Execution Platform provides diverse functionality, allows a sustainable support model, and is inexpensive to implement. It possesses the privacy and security features demanded by the healthcare industry. It allows IT to facilitate technology diffusion throughout an organization by focusing on governance rather than managing a project request queue. Instead of a single-record keeping system that promises everything to everyone with a single usability framework, it allows for many projects to be built upon a single framework promoting usability to match the workflow needs of the user.
Most important, a Strategy Execution Platform gives middle managers access to the technology necessary to promote widespread experimentation. Finally empowered with all three resources — people, process, and technology — middle managers are now truly enabled to implement the strategies of healthcare transformation.
A Strategy Execution Platform gives middle managers access to the technology necessary to promote widespread experimentation.
As continuing healthcare evolution has required us to inventory technology, question processes, and challenge our people, one thing has become clear: It will be the summation of many efforts that will allow healthcare to transform. With the aid of a Strategy Execution Platform, those middle managers able to pilot projects by marshaling their resources, innovating their processes, and taking advantage of new technology will be the leaders to get us there.
The Electronic Medical Record is a Brick Wall
The EMR is a necessary piece of technology. It’s the workhorse technology of healthcare delivery. It ensures stringent adherence to process. But the inherent rigidity and weight mean functionality, existing or promised, hasn’t adapted well to the requirements of an evolving operating environment. The EMR has not adapted to the flexible requirements of healthcare transformation.
Usability is terrible. It’s cumbersome for entering information and navigating existing information. The data is poorly organized. It doesn’t have a longitudinal view of information making it difficult to capture a snapshot of a patient’s context.
Speaking of data, it’s nearly impossible to get out for enterprise purposes. Creating or extracting reports, analytics, and dashboards requires an analyst, usually one that reports up through the IT function.
Customization of anything requires the consensus of a committee, is impossible at worst, and completed on a lengthy timeline at best.
The EMR controls workflow and process, rather than process and workflow being built into the technology. It offers no insight into productivity or performance. Automation, business logic, and workflow support are maddeningly absent. It recognizes no opportunities for process improvement.
Integrations are difficult or impossible. It lacks any effort to allow patients to enter information. And it doesn’t help market services, monitor health, or promote engagement.
Healthcare delivery requires a better way to become responsive to problem-solving and responding to opportunities brought about by transformation. It requires a flexible, complementary software solution that can be implemented anywhere, connect with anything, and is perpetually customizable.
The IT Department Has Become a Roadblock
The information technology department has been the most important department in healthcare delivery over the last forty years.
But IT has unintentionally become a roadblock. Technology now touches almost every aspect of healthcare delivery. Given this growth and new requests that come along with it, IT leaders have been forced to create a bureaucracy that allows only the most important and pressing needs to be addressed. This bottleneck prevents progress in an environment that is demanding more and more technology to support organizational initiatives.
The same cost-cutting and value-improving pressures facing operational departments are facing IT, too. With pressure to reduce headcount, a growing number of projects, and rising support requests, increasing needs from operational departments become more difficult to fulfill.
Technology needs of operational entities are viewed as a lower priority because IT’s focus is on other strategic priorities and enterprise initiatives like ICD-10, Meaningful Use, privacy and security, EMR replacements, technology issues related to mergers and acquisitions, clinical data integrations, etc.
Data analysis resides as a department, often within IT, instead of as a function embedded within each department. The necessary bureaucracy of the centrally managed IT function does not promote scope, scale, nor speed in new projects.
Given its support department status, IT is too far from the patient experience. Technology should be making it easier to use and consume healthcare services, not making it a more frustrating experience.
Creative technology solutions are viewed as a risk. No CIO has recently been fired for implementing Oracle or Cisco or IBM or Epic. This mentality leaves inexpensive and effective solutions to a wide variety of problems on the table.
IT must transition into a role as technology facilitator, helping to diffuse technology-supported solutions as quickly as possible. This mentality will allow organizations to take advantage of new competitive priorities and improvement opportunities. The IT department should be promoting care coordination, patient experience, team-based care, interoperability, and data sharing at every turn. IT must help other departments become more functional, not stand in the way of being functional.
This is the Golden Age of Middle Management
Where is healthcare transformation occurring?
The answer, clearly, is where healthcare is being delivered: in places like the clinic, the radiology department, the contact center, and the case management department.
Who is responsible for implementing healthcare transformation?
The answer, undoubtedly, is middle managers. The individuals charged with leading the clinics, the radiology departments, the contact centers, and the case management departments.
While executives have the enjoyable task of intellectualizing and philosophizing for the pursuit of creating strategy, it is middle management that has the responsibility to make the strategy happen. The ideas — yes, important — are the easy part. Bringing the ideas to life is difficult.
Peter Drucker, the famed management consultant, relayed it best when he wrote, “… the man who focuses on contributions and who takes responsibility for results, no matter how junior, is in the most literal sense of the phrase, ‘top management.’ He holds himself responsible for the performance of the whole.”
Perhaps a bit more succinctly but equally prescient, Herb Kelleher, the founder and CEO of Southwest Airlines put it this way: “We have a strategic plan, it’s called ‘doing things.’”
This is the golden age of middle management. An era when all the action of improving healthcare delivery is happening on the front lines under the supervision of the often maligned, but unnecessarily so, middle manager.
Middle managers are central to the success of healthcare transformation. As such, they are central to the success of healthcare delivery organizations. Maybe, just quite possibly, more important than the CEO.
But middle managers need to be empowered with the resources to make transformation happen. The job of the middle manager has become increasingly difficult: their plates are full, the velocity of industry change is increasing, and the constraints of the technology they and their staff are using are real.
Historically, with only supreme agency over people and process resources, it is time for healthcare organizations to empower middle managers with a third: technology.
Widespread Experimentation
As commonly held as the notion that organizations must innovate to continue to create value is, healthcare delivery organizations continue to struggle to ensure that innovation is systematically part of their culture, part of the day-to-day approach of solving problems or taking advantage of opportunities.
Charles Darwin had it right when he wrote about biology. It appears the same holds true for the modern-day business entity, too: Adaptation is key to survival. How to adapt but one step at a time?
Some ideas pontificated following the passage of the Affordable Care Act are beginning to appear. For many, though, we are still maddeningly far from knowing what is going to be the secret to success in population health, value-based reimbursement, or care coordination, among the many other elements known or unknown of healthcare reform.
Innovation is not a board room strategy, it’s a way of doing. A way of operating. Innovation only happens through experimentation with ideas. Many ideas.
While great headway has been made in finding new ways to deliver healthcare, there is truly only one way to continue to figure it out: try more ideas.
Tom Peters, the management consultant, puts it best: Whoever Tries the Most Stuff Wins.
Successful innovation is simple: widespread experimentation. That doesn’t make it easy.
Admirably, healthcare delivery has long been experimenting. It’s the essence of the scientific method, pilot projects, trial and error, Plan-Do-Check-Act cycles, Kaizen, process improvement, etc. Whatever the organization calls it, it’s imperative to do more of it.
As Malcolm Gladwell relays in his “Creation Myth” essay, psychologist Dean Simonton notes, “Quality is a probabilistic function of quantity. The more successes there are, the more failures there are as well.”
If innovation is the way into the future, and it most certainly seems to be, healthcare delivery firms must embrace widespread experimentation and make the tools, both tangible and intangible, acceptable, available, and accessible.
Strategy Execution Platform
Arthur C. Clarke, the acclaimed futurist, wrote: “Any sufficiently advanced technology is indistinguishable from magic.” That notion has been canonized as the third of Clarke’s Three Laws.
“Any sufficiently advanced technology is indistinguishable from magic.”
How does an organization empower middle managers with technology?
With the magic of a Strategy Execution Platform.
A Strategy Execution Platform provides diverse functionality, allows a sustainable support model, and is inexpensive to implement. It possesses the privacy and security features demanded by the healthcare industry. It allows IT to facilitate technology diffusion throughout an organization by focusing on governance rather than managing a project request queue. Instead of a single-record keeping system that promises everything to everyone with a single usability framework, it allows for many projects to be built upon a single framework promoting usability to match the workflow needs of the user.
Most important, a Strategy Execution Platform gives middle managers access to the technology necessary to promote widespread experimentation. Finally empowered with all three resources — people, process, and technology — middle managers are now truly enabled to implement the strategies of healthcare transformation. The ability to pilot ideas, as many as possible, in response to arising problems and opportunities and then iterating, expanding, or ending the idea is a paradigm changer for healthcare delivery.
As a flexible, complementary solution, a Strategy Execution Platform can be a standalone software system allowing software to be created for any need. It can be an overlay, a way to make existing technology more functional. It can be a way to connect technology with new or existing systems, making integrations the default and not an exception. And it can even be a solution that stands between two other solutions, drawing data from each and recombining to create something new for a related function.
A Strategy Execution Platform is the easiest answer to a problem facing more and more departments and cross-functional initiatives: information management. As organizational efforts take notice of the reality that what happens outside the hospital or clinic is as important as what happens inside, the patient journey continuum becomes a necessary concern. The four activities — acquire, connect, retain, and improve — some pursued collectively, others independently, become important considerations for a firm’s activities as a system of record.
As a platform strategy, a Strategy Execution Platform meets the goals of exponential distribution (scale), widespread experimentation (scope), and expedient implementation (speed). It can be programmed, tailored, and adapted to a department’s needs. It removes the need for IT to conduct a scoping exercise every time a technology request is made. Governance is possible but doesn’t stand in the way of progress. The system is dependable but doesn’t require excessive support. It is a multi-sided technology solution addressing the requirements of a diverse set of stakeholders.
The velocity of industry change requires an approach to solving problems and taking advantage of opportunities where there is a bias for action and an expectation of widespread experimentation. It requires a new commitment to speed and scale and scope. This notion becomes a reality only with empowered middle managers. Agency over people process, and technology decisions is their new domain.
A Strategy Execution Platform makes it possible.
Hi, I'm Drew Weilage. 