Optimization: It’s not about the IT

Each spring leading CIOs from across the nation come together to discuss top-of-mind topics at the Scottsdale Institute CIO Summit. This year’s exchange among thought leaders was valuable not just to those in the room, but also to those that benefit from the insightful wisdom these leaders share with the rest of us through the summary white paper. 

The topic for this year’s summit was IT optimization. As the healthcare industry begins to shift from a predominant focus on implementation to optimizing the EHRs and other systems that are already in place, CIOs across the nation are recognizing the need for a sound optimization strategy. One of the first things mentioned at this year’s summit is that trying to develop an optimization strategy is incredibly challenging in the face of a constantly changing healthcare IT environment. There is really never a time when health system CIOs are not in the midst of implementations, pre-implementation planning, maintenance issues, new regulatory requirements and the like. They must tackle optimization in the midst of all of that.

With that in mind, the CIOs quickly turned to discussion of the the actual definition of optimization. Webster defines optimization as “an act, process, or methodology of making something (as a design, system, or decision) as fully perfect, functional, or effective as possible.” Participants generally agreed with the standard definition, but also noted the importance of fully investigating the need for “optimization,” as a large part of the requests for optimization they receive are truly a need for improved education and adoption. One thing that they uniformly agreed on was that optimization is NOT “everything we didn’t implement at go-live.”

The group identified a number of challenges or barriers to success in optimization efforts. Among them were:

• Optimization projects often fall into the hands of the IT team, but may be in large part operational in nature. There is often a lack of understanding of the need for collaboration between IT and operations for optimization success.  Often IT teams believe optimization projects are 10 percent IT and 90 percent operations, yet the operations team believes the projects are 90 percent IT and 10 percent operations. The truth is that collaboration between both teams is critical to success.
• Clinical optimization is especially difficult. Unlike revenue cycle or human resources optimization, where it is far easier to standardize process and IT build, the inherent variables in clinical care of humans coupled with culturally protected variability in clinical workflows from site to site and between providers make clinical optimization far more challenging.
• Prioritization methods for what to optimize vary widely between organizations. Those with robust multi-factorial value realization decision matrixes are the most likely to be successful in their optimization efforts.
• With the rapid changes occurring in the industry, the rolling out of an optimized build has to happen quickly. But most organizations don’t have systems or processes in place or a plan for rapidly deploying enhancements, particularly when the bulk of the enhancements are related to workflow changes. Larger organizations are particularly challenged by rolling out optimizations to multiple sites, often in broad geographic distributions, in a timely way.

Even though many challenges exist, this group of CIOs shared some key takeaways they felt to be crucial to success in an optimization program:

• Get the Senior Leadership Team onboard to create an organization-specific definition of optimization.
• Prioritize optimization opportunities based on the vision and strategic priorities of the organization.
• Develop methods to quickly differentiate the need for increased adoption of current build with training and support from true needs for optimization of workflows or IT build.
• Create multidisciplinary teams including membership from operations, IT and performance improvement teams to maximize optimization efforts.
• Develop effective means to roll out optimization rapidly.
• Stay attuned to changes in the healthcare environment and develop the ability to be agile and flexible.
• Develop key performance indicators to measure the success of your optimization efforts.

Taking a look at this list it’s pretty clear that optimization really isn’t about the IT, except perhaps in small part. Success in optimization efforts instead is about understanding the organization’s strategic priorities. It’s about putting together a governance structure with multidisciplinary teams to prioritize optimization requests based on those strategic priorities. It’s about recognizing the difference between a need for optimization and a need for education, and then if it is education that is needed making sure there is a plan in place to accomplish that education in an efficient and effective way. It’s about utilizing your process improvement teams to help with developing streamlined and efficient processes and workflows that can be enabled or automated by IT. It’s about developing communication plans and roll-out strategies that can quickly get the entire organization on the same page.

In the ever-changing healthcare landscape, leadership teams that develop a clear understanding of these crucial concepts and remain focused and committed to implementing them will be poised to remain far ahead of the curve related to optimization efforts.

To download the complete report, “Optimizing Healthcare IT: Challenges and Strategies for Success, please click here.