Digital Transformation – The OPEN MINDS Guide To Getting The Most Value From Your Technology Investments
While health and human services has been decades behind other industries such as finance, retail, and entertainment in digital transformation, the COVID-19 pandemic accelerated the shift, especially with the increase in the delivery and acceptance of virtual care. However, as OPEN MINDS Chief Executive Officer Monica E. Oss said, “Telehealth is not the next big thing, it’s just the new service modality. Pandemic or not, what specialty health and human service provider organizations need, as we head into a disruptive market, is a strategy for complete digital transformation. And virtual care is just one element of that transformation. Digital transformation is more than a buzzword. It’s about integrating technology into all areas of business and operations—customer service, marketing, clinical interventions, staff interactions, data management—to deliver greater value to all the customers and stakeholders your provider organization works with.”
A flood of investments in digital tools, a relaxation of rules to use digital therapeutics, and continued growth of value-based reimbursement arrangements have increased the adoption of a wide range of technologies. The result? Consumer expectations, payer expectations, and price points are changing.
And in today’s digital age, every specialty health care provider organization—regardless of size, scope and scale of operations, budgets and revenue, consumer mix, and payer mix—must think about the technologies they need to remain in business in a competitive market driven by consumerism. But how to identify, prioritize, budget, select, and implement the right technologies at the right time? Our team at OPEN MINDS has developed an approach to optimizing technology investments. The approach has five sequential phases—evaluation of new technologies, determining return on investments, vendor selection, best practice implementation, and ongoing optimization of functionality—that are based on supporting organizational strategy.
Phase 1: Strategic Needs Assessment & Evaluation Of Available Technologies
The number one rule is to tie your technology planning back to your business objectives and strategic plan. Executives teams need to ask three key questions as they embark on their digital transformation journey. First, what is the new competency we need to operationalize our strategic plan? Second, who will use this technology product, platform, or tool and how will they use it? And third, how will this technology create value for the customer (either consumer or payer) and for the organization?
Available technologies fall in five broad categories—administrative cost management, consumer interaction, consumer wellness and treatment, data management, and population health management.
- Administrative cost management includes reporting and controls around detailed costs that should be included with all aspects of delivering services including revenue cycle for each payer.
- Consumer interaction includes measurements of consumer satisfaction, efficiency measurements, including access to care and follow-up effectiveness.
- Consumer wellness and treatment includes effectively every treatment modality and impacts of consumers getting well and staying well while avoiding crisis’ leading to hospital admissions.
- Data management includes analytics, dashboards, and ‘just-in’-time’ information delivered to the appropriate individual at the moment they will need it yielding to better decisions.
- Population health management accounts for larger impacts on individuals within communities and your organization’s ability to affect improved quality and lowering costs.
(For more on the types of health and human service technologies, check out OPEN MINDS Health Technology Navigator database.)
With that base of understanding, executive teams can draw the link between strategy and technology. The focus should be on how a new or enhanced technology can change organizational performance and the scope of any solution. Questions to ask are does it need to be interoperable, does it need to integrate with the electronic health record, does it need to be mobile-friendly, etc. And of course, any technology acquisition needs a timeframe to implement the solution; an understanding of how the technology will be integrated into the current tech platform and workflows; and the measures that will determine if the solution is working or not.
For example, if the competency needed to support strategy is shorter waiting times for appointments, the solution may be a centralized scheduling function. From the consumer perspective, this would permit the ability to schedule appointments by telephone and online. This would require software for centralized service scheduling across the organization, new telephone system software to centralize response to incoming telephone calls, and added website functionality for online scheduling.
Phase 2: Determining The ROI Of A Technology Investment
Even the “best” technology may not be the right choice for an organization if it can’t deliver a financial return. In addition to identifying solutions, executive teams need to look at their financial impact. This analysis has two elements. The most basic is including the costs—and the impact on profitability—of the new technology (acquisition, implementation, and ongoing maintenance) in service line budgets and the overall organizational budget. The other analysis is a return-on-investment (ROI) analysis of the overall financial impact of that specific technology acquisition. I recommend using a simple ROI model—calculating the net financial benefit. This is calculated using the financial impact of the technology on the organization and the costs of the technology acquisition, implementation, and management.
The first step is to establish performance benchmarks and goals that can help you determine the benefits from where any new technologies should help you gain efficiencies and help your organization gain competitive advantages. Benchmarking can be internal—comparing functions within an organization; competitive—comparing functions with direct competitors; functional—comparing business functions with different organizations; or generic—comparing business process with a different industry. You could compare net promoter score (for customer satisfaction) across different service sites within your organization or to that of competitors; compare collections time or bad debt ratios with other industries; or even compare consumer check-in times to hotel check-in times.
The second step is to look at both hard and soft costs and calculate savings. Hard costs are definitive dollar figures that are applied toward the implementation of a solution. How much will the organization pay for this solution versus another? How much money will the organization save by implementing this solution versus doing nothing at all? Soft savings are less tangible but equally important and could include lowered employee stress levels from task automation or better customer service and increased consumer satisfaction.
The third step in determining ROI of tech investments is to determine the net financial benefit. The ROI should be calculated as a percentage that can be applied to various aspects of the organization—clinical, administrative, marketing, etc. to gain competitive advantage.
Phase 3: Technology Vendor Selection
Once an organization has determined the core suite of technologies needed to achieve business objectives, the question is what are the steps to follow that allow for the highest chances of a successful selection and meeting your organization’s needs. The best practices approach for selecting any technology solution has four steps—organizational assessment and developing a functionality requirements document, preliminary vendor selection and proposal scoring against functionality requirements, vetting finalists and making the final selection, and contract negotiation and preparing for implementation.
The first step is to determine organizational needs and develop a comprehensive functionality requirements checklist. Consider what you want the technology to do and what the desired process improvements, outputs, and impact. In essence, define what problems you are trying to solve with the technology, and consider what functionality will help in achieving your strategic plan objectives.
Then start researching your vendors. Look online but also contact other provider organizations already implementing the solution to learn from their experience. Start having conversations with vendors and check out the details of what they offer. Make sure the vendors you are interested in hearing from receive your Request for Proposal that documents your needs.
Next is the more detailed evaluation and selection of vendors offering the key functionalities that match your organization’s needs.. Review the proposals that come in and score each vendor’s offerings against your functionality checklist. Then determine which vendors to invite for a demo to your team.Get a group of experienced evaluators from key areas of your organization on a committee that will review demos and make the final selection. Give vendors scenarios in which to demonstrate how their solution would work. You will want to see the tech system actually demonstrating the functionality—not just look at static PowerPoint slides or hear that the functionality is ‘coming soon.’ The committee has to choose a vendor with a backup option.
Finally, it comes down to negotiating price, time to implement, and contractual provisions. Most tech investments are usually long-term and often capital-intensive commitments—so negotiate a win-win solution that will set the new partnership on a successful trajectory. This is when the implementation and project planning should start. Be certain to include measurements from the ROI calculations so you have a North Star to guide your evaluation of success with the technology implementation.
Phase 4: “Best Practice” Implementation Of New Technology
Once the organization decides to move forward, the hard work begins. Organizing processes and systems, teams, and resources to achieve desired metrics is no easy task. New roles and responsibilities have to be defined from the executive level down to frontline staff.
The technology implementation process can be broken down into four stages—routine elements, complex elements, system and final preparation, and expanding and leveraging the implementation. Routine elements comprise vendor training and implementation, technology acquisition and configuration, data conversion, and mobile system use planning. The complex elements are clinical workflow and development, reports and analytics development, updating workflows, system set-up and testing, and design of user interfaces. The system and final preparation tasks include workflow testing, training materials and execution, and final go-live preparation. After the core technology is launched, implementing additional features and functionality, monitoring data on use, and finding additional clinical and analytic uses will enhance the ROI.
For significant new technology investments, it would be ideal to conduct a pilot. The pilot must have clear goals, a timeline, and a carefully defined test group. Before launching the pilot, the plan for how to monitor progress and obtain feedback must also be defined. A well-designed pilot will help an organization assess not only the effectiveness of the technologies but also the strategic and cultural readiness of leadership and staff to adopt the technologies and leverage them to achieve business goals.
Common pitfalls that keep new technology adoption from being successful are lack of planning for service integration and workflow, lack of executive team commitment to change, cultural resistance of staff to working with the new technology, staff turnover, erroneous calculation of ROI, and insufficient financial resources for full implementation.
To avoid these pitfalls, project planning and project management of implementation is critical as in personalized and continuous training and support. Organizations should not leave implementation entirely to vendors but should own and define the processes and planning. It would be good to foster the understanding that implementation will be a part of ongoing operations. Establishing a cross-functional implementation team (ideally limited to eight to ten key players) and ensuring that members of this team have the time and resources to dedicate to implementation is also key.
Phase 5: Ongoing Optimization Of Technology Functionality
Organizational performance on key metrics should be continuously monitored—and compared to customer expectations and competitor performance. Within this continuous performance improvement process, assessing how to leverage existing technology is key. The monitoring process includes defining key success metrics, continuously evaluating performance against those metrics, and course correcting as needed. Metrics could relate to process improvements, cost savings, consumer satisfaction, and the ROI of technology investments.
Data reinforces objectives, promotes order over control, and supports communication as it creates a common vocabulary and understanding. Data must be measured in real-time, with processes automated as much as possible. Data must also be “democratized” and allow line-of-sight impacts across the organization while ensuring that managers at the right level see the right data and remain accountable for performance.
While the specifics of what is measured will depend on the organization’s strategic objectives, keep in mind that technology implementation should support multiple levels of efficiencies within an organization, provide a platform for clearer and more decisive actions, impact consumers, create measurable competitive advantages, and act as a catalyst for innovation within the organization.
At the end of the day, “digitizing” a specialty health care provider organization is crucial to success, and even survival, in the “next normal.” The process of selecting, implementing, and optimizing the right technologies at the right time is arduous but the effort will pay off many times over with appropriate planning, people, and project management.