Lean Healthcare Information Technology - HITECH ActThis is the second blog in a four part series on Lean Lead 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 over-burden, the requirements, in a word, are unsustainable.  In part one I proposed a three tiered approach to meeting this challenge as follows:

  1. Use Lean principles and tools to eliminate waste from basic support processes to free resources for strategic implementation.
  2. Use Lean principles and tools to drive “defect-free” implementations.
  3. Implement a functional governance structure to drive strategic alignment and improve management of the IT investment portfolio.

The remainder of this blog will focus on the use of Lean principles and tools to eliminate waste from basic support processes; the first point in the three tiered approach above.  For Lean Healthcare delivery systems, this will be less daunting as many have recognized tremendous improvement in cost, quality, service levels and patient satisfaction by using Lean to make quality the operating system.

Meeting the challenges of the HITECH act will require healthcare IT departments to shift resources from basic support to strategic implementation.  Currently, 80 percent of the average healthcare system’s IT resources are engaged day-to-day in providing support.  This leaves only 20 percent for strategic implementation.  The demand, going forward, will require closer to a 50-50 split of these resources.  Herein lay both the opportunity and the challenge.

Practitioners of Lean Healthcare are familiar with the concepts of direct process observation, process mapping and value-stream mapping.  When these tools are applied to the hospital’s IT support processes the results can be very insightful.  The example below illustrates the process by which new employee accounts were provisioned at an institution:

Lean Healthcare IT application


A few items to note in the current state:

  1. This is only one of five different work flows followed
  2. There are 13 primary process steps
  3. 0 percent of these are automated
  4. This has prompted multiple control and tracking points
  5. These controls are all manual spreadsheets requiring substantial update effort
  6. There is significant rework in assignment of correct applications
  7. There is significant end-user confusion and wait

Compare this to the future state depicted below where:

  1. There is only one flow
  2. 13 primary process steps are collapsed into 9
  3. 90 percent of these are automated
  4. There is a single, automated control point
  5. These is no need for manual spreadsheets requiring substantial update effort
  6. There is significantly less rework in assignment of correct applications
  7. There is significantly less end-user confusion and wait

Lean Healthcare IT application


This is only one example of countless potential opportunities.  Mapping the support processes and using direct process observation to identify sources of waste and where they occur in the process are fundamental building blocks.  These techniques are simple, easy to learn and very directional to the design of new processes or countermeasures.   Other areas within support to consider include:

  • Repeatable standard work for infrastructure maintenance, including major upgrades
  • All aspects of identity management including sign-on and password reset
  • Repeatable standard work for Help Desk and Service Desk issues
  • Analysis of Help Desk and Service Desk requests to identify high-value opportunities

Application of these techniques and practices can lead to substantial reductions in waste within the processes involved.  This can lead to productivity increases of approximately 20 percent. In many cases the productivity increase could be greater if the enterprise is willing to challenge the collective, conventional wisdom by exercising critical scrutiny in classifying tasks (value-add versus non value-add) during the observation and mapping process.  The next blog in this series will focus on the use of Lean principles and tools to drive “defect-free” implementations.

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 

Continue Reading:

The Case for Lean Led Information Technology–Part Three: Basic Support

This week’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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