Six Steps for Medical Practices When Implementing Major Projects

As healthcare reform evolves, many practices are embarking on major projects, such as participating in accountable care organizations, forming Patient-Centered Medical Homes, and implementing new technology.

But not all practices are, or will be successful when taking on major new initiatives.

Consider EHR implementations as one example. According to Physicians Practice's2013 Technology Survey, Sponsored by ZirMed, nearly 30 percent of respondents that had implemented an EHR said the transition was "more painful than it needed to be" and of those who had attempted to attest to the Stage 1 rules of the government's meaningful use requirements for EHR adoption, nearly 40 percent had failed.

At this year's Healthcare Information and Management Systems Society (HIMSS) Conference in Orlando, Fla., attendees heard from one health system that embarked on a major new technology initiative, and is now enjoying a significant return on investment.

Sarah Korf Dill, client service partner for business and technology consulting firm Slalom Consulting, and Rance Clouser, vice president of field services for Advocate Health Care, the largest integrated healthcare system in Illinois, shared some of the key lessons learned when implementing a unified communication and collaboration support system at the healthcare system. 

During their session, "Do You Have Hidden ROI," Dill and Clouser discussed Advocate’s four-year initiative, during which it deployed several new technologies  including a telepresence network, digital signage, a new Intranet, secure HD clinician-to-clinician communications (used for sharing text messages, patient notifications, lab results, and photos), e-mail upgrades, and web conferencing capabilities. As a result of the initiative, patient satisfaction scores increased, as well as physician and staff and staff productivity and collaboration, said Dill and Clouser.

Perhaps what's most relevant to Physicians Practice readers, however, is not what Advocate accomplished, but how it accomplished it.

During their presentation, Dill and Clouser identified six steps for project implementation that other practices embarking on large-scale projects (such as a major technology initiative) might consider.

Step 1: Focusing on the destination. At the outset of the project, it's critical to think through where you want to go, said Dill. Consider what problems you are trying to solve, what critical milestones you want to reach, and how you will define success. Also, clarify the benefits the project will bring to all of the key stakeholders (such as physicians and staff).

Step 2: Building a program.  At this point, it should be clear that you are building a sustainable program versus a project. "The structure piece is really, really important," said Dill. "When we think about the key success factors that helped us be successful at Advocate, it really was about thinking very long term not just very short term." Also, set up project teams and make sure responsibilities are clearly assigned, including who is going to sustain this change long term.

Step 3: Engaging your stakeholders. At Advocate, this meant forming a steering committee made up of technology experts and users and clinical users to discuss how changes would impact them. At your practice, it might mean asking physicians to meet with key project leaders (or vendors) to discuss the initiative. "You can have the best solution but if people don't understand what the value is and then they're not willing to go out and champion for you it's really going to hinder your success," said Dill.

Step 4: Creating a strategy. This is where you build your project roadmap, said Dill. While doing so, keep your vision and ROI in mind. Also, determine your key priorities and don't feel like you need to tackle every aspect of the project at once, said Clouser.

Step 5: Defining your solution. Pick your tools based on your vision, as opposed to letting your tools drive where you are going to go, said Dill. In other words, think about what you need to solve, and then go out and find the tools that will help you solve that problem.

Step 6: Managing the change. Train, engage, and support stakeholders throughout the change, said Dill. Also, make it clear how the change will impact staff members and be as specific as possible, said Clouser. "One things that we found quite helpful in managing the change was ensuring that we had developed the appropriate collateral for all of our stakeholder organizations … We had a core message and then we tailored it for each group."