[Editor’s Note: This is part 2 of 2. To read part 1, click here.]
Change management is a very important topic today in the health IT sector as more and more new and amazing technologies are introduced into healthcare delivery. (Hello, artificial intelligence.)
Robert Slepin knows quite a bit about change management. He is an honorary CIO advisor at EHR kingpin Epic. There, he continually helps CIOs across the country transform their health IT setups.
There are only about a dozen of these contractors, available at the request of Epic supplier customers who need strategic consulting or temporary operational support from someone with deep experience on planning, implementing, and maintaining the Epic EHR system.
Slepin – who has served as chief information officer or held other top IT roles at many of the nation’s leading health systems – enjoys helping other healthcare leaders manage the challenges in EHR operations and optimization. And how to manage change – which he is there to do.
Yesterday we featured part one of his comprehensive exploration of change management. Here’s some more he had to say on that important topic.
Ask. In your opinion, what are the important components of a change management initiative? What should CIOs do?
ONE. There are several key areas to consider, starting with:
Sociotechnical connectivity. There’s a mantra of “people-process-technology” alignment that CIOs have been talking about for a long time. Any major IT-enabled business transformation needs to bring these pieces together to be effective. Talking and talking is one thing; talking is another matter.
To align human and technical factors in a way that achieves the best possible results, CIOs must have knowledge not only of information and technology but also of complex, adaptive systems, program/project management, risk management and change management theory, frameworks and practices. and approach change projects accordingly.
By understanding and applying an evidence-based approach, CIOs will be more capable of managing change. Adopting or adapting established frameworks to direct large-scale, complex change programs helps reduce risk and improve engagement and adoption.
Change the framework. An extremely important component is the change management framework. No need to reinvent the wheel; there are many “best practice” frameworks to choose from, and arguably any of them could do the job.
If the healthcare organization already has a standards framework in place that is used across the enterprise and/or for IT department purposes, then adopting or adapting that standards framework to all initiatives Anticipating major changes may be reasonable. If there isn’t an internal approach, choose one with guidance from colleagues or mentors. In my experience, a proven framework and toolset will significantly contribute to a more effective and efficient change management process.
Supplier alignment. CIOs must be careful to align their preferred change management framework with the standard approach of their software and system integration vendors. In my experience, it is unwise to blindly adopt a vendor’s approach or rely solely on that vendor’s change management team; nor is it smart to reject the vendor’s methods or fire the vendor’s change team.
“Find ways to align and align frameworks, processes and tools, and shift team members in a way that is culturally compatible and positions the organization to lead change, while respecting important and incorporates essential elements in the supplier’s approach.”
Robert Slepin, Epic CIO advisor emeritus
Instead, look to align and adapt frameworks, processes and tools, and shift team members in a way that is culturally compatible and puts the organization in a position to lead change , while respecting and incorporating essential elements of the supplier’s approach.
Being rigid and insisting on only using a supplier’s “best practice” methodology or only following the organization’s internal “this is how we’ve always done it” practices is a risk to the process. implementation, engagement and adoption and ultimately to business and project outcomes.
For example, if a hospital has widely adopted SBAR as the standard template for key decision summary notes, reuse or adapt the hospital’s template for the change project; don’t force people to spend more effort and time – which they may not have in abundance – to use.
Change teams. The CIO should appoint a dedicated change management team leader (and additional team members depending on project scope), as well as communications and training leads and team members. Change, communication and training/education are important functions and they need to work closely together – and they need to work well with others involved in the project.
Form follows function and ideally, in my experience, the change team should be organizationally aligned with the technical and project management functions within a change project/programme organization Unique social engineering change, cohesive reporting to the CIO. It is possible to organize the team differently, but this unified organization is the best structure for a complex IT-based healthcare change initiative, from what I have observed in the industry and based on my own experience at many hospitals and healthcare organizations.
Alternative approaches to organizational change management are recommended by some consultants and vendors, especially companies serving other industries. For example, separate the program management office, a technical project management function, from the change transformation management office, a people/organizational change management function.
While separation of these structures is possible and has been used successfully in healthcare and other industries, in my experience most hospitals and large health systems choose how to seamlessly integrate technology-process-people functional areas. The advantage of structural integration is its ability to simplify, clarify, and streamline coordination, accountability, and implementation.
Working together as a unified team is easier on a project when these functions are organized into one large group, while further division into logical subgroups is necessary for the scope. control and specialization, such as engineering, applications. , training, integration and other functional areas.
Q. What are examples of successful change management initiatives from your extensive experience? What did you do and how did it go?
ONE. An example of a successful change management initiative is JCL Connect, a program to transform the complex business, electronic health records and technology infrastructure at John C. Lincoln Health Network. , in the period 2011-2012. Before merging into a larger health system, JCL was an independent local integrated delivery system consisting of two community hospitals, a level 1 trauma center, and a medical group in Phoenix, Arizona.
Despite the bumps and bruises common to such an ambitious endeavor, the JCL Connect is still considered a success. Fortunately, the hospital network achieved all and exceeded some of the program’s business goals.
This program integrated and executed several major related projects: activation and migration to the company’s new data center; modernize enterprise networks, servers and storage; standardize outpatient clinic operations; create one of the first 100 Medicare Shared Savings Program accountable care organizations; and last, but not least in complexity and effort, the Epic enterprise implementation includes most of the clinical and revenue cycle modules.
My CIO role is as the technical sponsor of the program, partnering with the hospital SVP, ambulance SVP, and SVP/CFO, who together serve as business co-sponsors. Each sponsor, along with other senior leaders, plays a key role in the transformation process.
“The quality and safety team closely monitored post-implementation performance and collaborated with clinical teams to create significant improvement across many key performance areas, improving the care environment and patient safety.”
Robert Slepin, CIO emeritus advisor at Epic
A key part of my job is recruiting the right team to complete this ambitious undertaking, on time, within budget and putting quality and patient safety first. My job was made easier because I was fortunate to inherit an exceptional IT team, including a project manager with previous experience implementing EHRs at university health systems, as well as talented and highly capable application, infrastructure, integration and operations directors, managers, leaders and employees.
The results were amazing. Within the first two years after the program’s final launch, JCL earned its first position in the Top 100 Hospitals for Excellence in Cardiology and was recognized as one of seven health systems in the United States. Ky received the “MAP Award for High Performance” from the Healthcare Financial Management Association for excellence in revenue cycle.
The IT and EHR platform supported the physician network’s 2x growth and the addition of a freestanding emergency department. JCL’s IT department improved many performance metrics, including employee engagement increasing from 64% to 85%. Most importantly, the quality and safety team followed the activity post-implementation and collaborated with clinical teams to create significant improvement across many key performance areas, improving the care environment and safe for patients.
The JCL Connect program, as its name suggests, has a lot of moving parts, making it very complex and risky, and the timeframe is compressed to achieve meaningful use requirements. Centers for Medicaid and Medicare Services in a timely manner. The critical success factor in managing complexity and minimizing risk is an extremely strong commitment from the hospital network’s executive sponsors and indeed the entire C-Suite, which is one of important factors leading to our success.
Funding is another key success factor. The SVP of emergency medicine oversees and advocates for standardization of outpatient clinical practice. CFO and VP revenue cycles have similar impacts on finances and revenue. SVP for facilities that partner with IT to build and migrate data centers and refresh hardware.
The SVP of public relations provides communications resources and strategic guidance. VP Quality is a close partner to lead clinical change management, while the CMO/CMIO takes the lead role in leading physician change management. The 100% commitment, passion, dedication and hands-on role of every senior executive in the organization is critical in leading change.
While the importance of senior executive sponsorship cannot be underestimated, leadership at all levels across the organization is another key factor in our success . JCL has a special EHR project manager with previous experience at another organization; Her contribution is immense, as is the strong support and leadership of other talented directors, managers and IT team leaders. Leadership also came from the many champions and subject matter experts who volunteered to participate in the project part-time from start to finish.
They have led and participated in dozens of workgroups and hundreds of design sessions and readiness activities, pouring in countless hours, enormous amounts of energy, bringing enthusiasm, and making thousands of decisions. determined along the way.
To read an in-depth interview with Epic CIO Advisor Emeritus Robert Slepin on EHR optimization, click here.
