Virtual Software Implementations Can Succeed
Keys to Ensuring Software Implementation Success in the COVID-19 World
By Deborah Keller
CEO, Chordline Health
COVID-19 has driven the high risk of project failure for software implementation projects even higher. Domain Expertise and Vendor Tenure are the two most important factors in controlling this increased risk.
Summary
It has been a little more than a decade since the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law to promote the adoption and meaningful use of health information technology (HIT). Yet as any healthcare organization can tell you, while the law may have had good intentions in practice, the results have been less than hoped-for.
Much of this disappointment can be attributed to a dismal failure rate for HIT projects. If success is defined as a project that is on time, on budget and performs as-expected – a relatively low bar for excellence – HIT projects historically have failed up to 70% of the time. While this number is in line with IT in other industries, that achievement is hardly something to brag about when patients’ quality of life, or survival rate, is at stake.
What makes it all the more concerning is that these numbers reflect performance prior to the seminal event of 2020 – the COVID-19 global pandemic. With many healthcare organizations shifting from office-centric business practices to remote work, and hospitals and other providers restricting on-site personnel to only those who were essential for direct patient care in an effort to reduce the transmission of the virus, software implementation best practices that had been in place since the beginning of the Information Age were no longer viable.
While the healthcare industry, America and the world is by no means beyond the threat that COVID-19 creates, many healthcare and managed care organizations are recognizing that their current solutions are failing them and they can no longer afford to delay their most pressing technology projects. They must find a way to move forward even as newly operationalized remote-work arrangements persist.
The core challenge is how to implement software effectively when stakeholders, decision makers, subject matter experts, technology team members, and vendors are meeting virtually. This white paper will examine what is required to achieve a far higher than average success rate under the current pandemic-driven conditions.
The Ultimate Disruptor
People in the tech industry like to position themselves as disruptors. But nothing in the last 100 years has been as disruptive to health, business and overall lives as the COVID-19 pandemic. In a little less than three months, the novel coronavirus (as it was first identified) went from a minor concern in China (and a few select cruise ships) to the all-consuming lead story in virtually every country throughout the world.
COVID-19 gave the world little choice but to minimize contact with people outside our homes or immediate circles as much as possible. Organizations in every industry had to quickly adopt, implement, and maintain wide-spread remote-work at the same time that their software vendors were doing the same. Technical resources had to be quickly reallocated resulting in IT projects planned for Q2 and Q3 of 2020 to be placed on hold. Other IT projects such as moving core business functions from local servers to cloud infrastructure that were longer-term planned projects had to start immediately to sustain business operations.
The world changed quickly and suddenly everyone had to become an expert level user of GoToMeeting, Zoom, MS Teams, and a long list of virtual meeting tools which were often newly purchased and implemented. Time zone coordination and remote project sessions became routinely listed project risks. Add in persistent internet bandwidth issues and low technology skills of end users and it is understandable that the idea of transitioning existing software was not desirable in these conditions.
Now eight months into the pandemic, many organizations are realizing that they have to proceed with IT projects and are trying to identify how to reduce their risk of project failure. Specifically, healthcare and managed care organizations need to implement software tools to provide care now and to prepare for addressing under-utilization of preventative care post-pandemic. Removing the inherent risks related to COVID-19 is not an option so reducing risk in other project areas is critical.
Selecting software vendors that bring core attributes to a project is more important now than it has ever been. Virtual implementation projects are not quite as simple as moving meetings from in-person to virtual conference rooms. Since more independent work will be required, virtual projects demand a higher level of proficiency in two key areas – the domain expertise and longevity of partner’s virtual team.
Domain expertise drives answers rather than questions and delays
In a software implementation where the business SMEs, IT resources, and the software vendor team members are working in close physical proximity, gaps in knowledge on any team member’s part can often be quickly addressed by seeking input from another resource in close proximity or accessing process tools that are readily available. Obtaining decision-maker sign-off on business requirements is also more efficient when the decision-maker has the opportunity to easily step in and out of project work sessions that are occurring in close proximity. The ability to simply have white-board sessions in one room can often move project decisions forward. While technology to support virtual project sessions allow for communication, they simply cannot replace efficiencies such as these. This is when having a vendor with deep domain knowledge can make a critical difference. A simplistic example of this would be a clinical project SME not having a full understanding of how specific HEDIS measures should be captured for proper CMS reporting. Having a vendor with clinical SMEs on the project that know the requirements and can provide insight into the various options of how to operationalize the measure can prevent project delays, decision reversals, and configuration rework while increasing the quality of the workflow configuration.
Team member longevity bolsters success
The other critical factor that can have a profound impact on a project’s success is vendors team member tenure. Greater longevity per team member is certainly an indication of stability, whereas frequent turnover could result in new team members learning the software at the client’s expense.
A partner whose team members have an average of 10 years or more with that company gain invaluable experience in fully leveraging the capabilities of the software but more importantly, they have supported many clients in making workflow decisions which allows them to offer clients solid, viable options to achieve their goals. Conversely, they can help implementing clients avoid common pitfalls such as overuse of passive notifications versus pushing work to end users via automation.
Finally, long employee tenure is indicative of a well-developed team who believes in the company they are a part of and a passion and ownership for the work they do. They know how to work well together, what works, and what does not work because they have repeated the process together many times.
Other considerations
While those are the two most important requirements to consider before embarking on a virtual implementation project, here are three other factors that should be considered when selecting who to partner with during these challenging times:
Ability to build a cohesive virtual culture – In any IT project, the business and vendor combined project team naturally build their own culture over the course of a project. Members on each side come to learn about each other’s’ families, hobbies, interests and other personal information as well as working styles and communication preferences. For example, Phil from the vendor side may know not only not to speak with Sarah before she’s had her morning coffee but also how she takes it so he can bring her a cup when comes in. That natural culture is easily lost when working virtually. A good vendor team, however, will understand the importance of culture to the overall success of the project and will find ways to create it virtually. Even if it means a contactless delivery from a local coffee shop.
Internal versus outsourced team – Some partners will outsource certain functions in a project, such as project management. While that’s not the ideal way of working, it can succeed in a face-to-face setting because the outsourced resources can get to know the partner’s team (as well as the internal team) as the project progresses. When working virtually, however, outsourcing adds another degree of difficulty to an alreadysituation. There will be a learning curve for co-workers, and often for processes and procedures as well. When undertaking a virtual project, healthcare organizations will be better-served by teams made up entire of personnel who work for the partner – and have done so for many years. These internal teams will have formed a working relationship that includes unspoken communication and anticipation of needs that can only be developed through years in the trenches together. It may seem like a small thing, but it can make a huge difference.
Likelihood of additional surges – While some of the initial shock of COVID-19 has subsided, leading to a gradual re-opening across the country, the threat is far from over. In fact, models from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington predict additional surges throughout the fall and winter that could make what happened in March and April look like a simple prelude. Which means even if some projects have begun to move forward with traditional on-site presence, there is a high likelihood that sooner or later they will need to become virtual again. Given this reality, healthcare organizations making decisions today would be well-served to look for strong partners that already have systems and protocols in place to implement software virtually, as well as a proven track record of success. That way they can continue to move forward no matter what the future brings.