Lean Healthcare Information Technology - HITECH ActThis is the third blog in a four part series on Lean Led Information Technology.  In part one, I presented some very scary statistics regarding the staffing requirements necessary to implement and support the requirements of the HITECH Act.  In a period of declining reimbursements and systemic overburden, the requirements, in a word, are unsustainable.  In part 2, I illustrated how Lean Healthcare tools and techniques may be leveraged to drive waste from key support processes.

The remainder of this blog will focus on the use of Lean principles and tools to drive defect-free implementation of new IT products and services.

One of the challenges of systemic overburden (Muri) in healthcare IT departments is that it tends to drive suboptimal implementation of new products.  This has a tendency to appear in three critical places:

  1. Development of technical requirements for implementation
  2. Consideration of work-flow impact and work-flow redesign
  3. Pre-go-live testing

Failure in these three critical aspects of new product implementation can have very serious consequences and will drive substantial demand for support services, exacerbating the overburden.

A powerful Lean Healthcare tool that can aid in alleviating these issues is the 3P methodology (product, preparation, process).  Think of 3P as a systematic method of concurrent design where the product (or service), the process for building or delivering, and implementation planning are performed concurrently instead of in a cascaded method.  By taking on these tasks in a concurrent (as opposed to a cascaded) approach, implementation times can be shortened while simultaneously maintaining high levels of implementation quality.  This approach alleviates the overburden.

The basic steps in applying the process in the context illustrated above include the following:

  • Understand the voice of the customer: The team seeks to understand the core customer needs that need to be met in the future state.
  • Translate the voice of the customer into service delivery requirements.
  • Analyze current state or known existing methods of achieving the above requirements and describe the changes or transformation to be made at each key point within the service delivery model.
  • Translate the desired changes or transformation into a set of functional requirements.  This should be approached from both a technical and process perspective with form following function.
  • Generate several ways to meet the functional requirements.  This is often referred to as a 7 Ways exercise.
  • Design and evaluate the service delivery model based upon the best elements identified within the 7 Ways exercise.
  • Review the design concept(s) selected for further refinement with customers and key stakeholders.
  • Develop the implementation plan.

The above steps may be organized into 3P events which are typically three to four days in duration and require the full attention of a dedicated team during their execution.  Very complex projects such as an eHR implementation may be broken into a series of events.  By leveraging the 3P process to perform design and implementation tasks in parallel with structure and rigor, we are able to implement with speed and fewer resources.  By careful flow-down of customer critical-to-quality parameters into service delivery requirements and, ultimately, functional requirements for the technical and workflow components of the design, we move closer to defect-free implementations.  Collectively, these are powerful drivers in reducing systemic overburden within Lean Healthcare IT departments.

Interested in learning more about Lean Led IT?  New Hanover Regional Medical Center will be presenting a breakout session at the upcoming Lean Healthcare PowerDay on how they are meeting the challenges of the HITECH Act while improving IT infrastructure.  www.LeanHealthcarePowerDay.com 


Brad Schultz, Vice President for Lean Healthcare and Process Improvement Consulting at HPPToday’s blog was written by Brad Schultz, a Vice President with HPP.

Brad serves as a Lean Healthcare facilitator, business consultant, and executive coach internationally with HPP.  Brad began his career in manufacturing with GE Healthcare and joined GE’s Performance Solutions during its infancy and remained with the business unit for seven years. He provided significant leadership to adapt the firm’s products to the unique needs of healthcare clients and to translate the firm’s published materials into the language of healthcare.

Brad’s educational background includes a B.S. in Business Administration from Cardinal Stritch University in Milwaukee, Post Graduate Certification in Quality Engineering from Milwaukee School of Engineering, a M.A. in Business Administration from Marquette University in Milwaukee, Six Sigma Master Black Belt Certification from General Electric, and Front-Line Leadership Development Certification from Achieve Global.

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