From Strategic Planning
To Tech Strategy —
How To Select, Implement,
& Leverage The Technology
Your Organization Needs To
Succeed
Monica E. Oss, Chief Executive Officer, OPEN MINDS
Florida Conference on Substance Use Disorders and Mental Health
August 7, 2014 | 10:30 am – 12:00 pm
www.openminds.com
163 York Street, Gettysburg, PA 17325
Phone: 717-334-1329 - Email: [email protected]
Agenda
I.
Best Practice Tech Strategy Development
II. Choosing New Technology — EHRs, Treatment
Technologies, & Analytics Tools
III. Why It’s All In The Implementation & What You Can
Do To Speed Bringing New Technology On Board
IV. Using Technology For Competitive Advantage — How
To Gain Market Leverage From Your Tech
Investment
© 2014 OPEN MINDS. All rights reserved.
2
I. Best Practice Tech
Strategy Development
© 2014 OPEN MINDS. All rights reserved.
3
Executive Challenges In Time of Changing
Technology
Selecting
technologies for
investment
Continual
organizational
change -- and
speed of change
Timing of tech
investments
© 2014 OPEN MINDS. All rights reserved.
4
Challenge #1: Selection Of Technologies Critical To
Maintaining Competitive Advantage
Who has competitive
advantage?
The organization that
delivers the same benefits
to customers at a lower
cost (cost advantage)
or benefits that are
superior to customers
(differentiation advantage)
© 2014 OPEN MINDS. All rights reserved.
5
The Service Line Planning Issue. .
For each service line,
the key is to select
technologies that
improve competitive
advantage in any one
of three domains.
Programmatic offering
– what services and
programs. . .
Financing options –
FFS, P4P, case rates,
capitation. . .
© 2014 OPEN MINDS. All rights reserved.
System structural
positioning – ASO,
medical home, health
home, disease
management program,
waiver program. . .
6
For Each Service Line, Use Technology To
Improve Competitive Positioning
Strategic Functions Of Tech
Tool Investments
•
•
•
•
•
•
•
•
•
•
Reduce cost per unit
Reduce cost per case
Improve payer preference
Improve consumer preference
Improve operational performance
Improve convenience
Improve consumer outcome or
functioning
Facilitate new consumer service
Facilitate new payer relationships
Facilitate larger ‘scale’ of current
services
© 2014 OPEN MINDS. All rights reserved.
7
Challenge #2: Timing Of Tech Investments
• The tipping
point
• First mover
advantage
• The leading
edge vs. the
bleeding edge
© 2014 OPEN MINDS. All rights reserved.
8
Where Does This
Technology Evaluation
Happen? In Your
Strategic Planning
Process. . .
© 2014 OPEN MINDS. All rights reserved.
9
The Role Of Strategic Planning. . .
• A thoughtful and structured process for responding
to “change drivers” in your environment
• The allocation of resources to programmed activities
calculated to achieve a series of organizational goals
in a dynamic, competitive environment
• A road map that establishes a plan for achieving
specific goals
© 2014 OPEN MINDS. All rights reserved.
10
© 2014 OPEN MINDS. All rights reserved.
11
Technology Alignment Is Critical
Make sure that your business strategy and goals are
aligned with your technology strategy and goals
Business strategy
and goals
Technology
strategy and goals
© 2014 OPEN MINDS. All rights reserved.
12
Why Integrate IT Planning With
Organizational Strategic Planning?
An increasingly competitive marketplace does
not allow for wasted resources—“misdirected” or
“ineffective” IT spending is too costly
– Investment expense
– Opportunity cost
– Effects on economic efficiencies
© 2014 OPEN MINDS. All rights reserved.
13
IT Planning: Old Versus New
Old Way
New Way
• IT investments are anecdotal
and based on desires of IT staff
•
IT plans and objectives are
driven by systems staff
• Systems staff is not part of
customer-serving infrastructure
and have little customer
interaction
• Planning is a periodic, formal
process that results in a nice
binder that is never used again
 IT investments are incorporated in
budgets set during planning process
 IT plans are dervied from marketing,
operations, and financing plans in
business strategy
 Systems staff have on-going
interaction with customers and
operations teams
 Planning is an on-going process with
project management, tracking of
operational milestones and periodic
plan updates
© 2014 OPEN MINDS. All rights reserved.
14
From Strategic Plan to IT Plan –
Six Key Steps
1. Identify specific strategy and tactics in strategic plan
2. Conduct functionality comparison
– Current information system capabilities vs. system capabilities required for
proposed strategies/tactics
3. Estimate costs of adding functionality
–
–
–
–
Enhance
Buy
Build and/or
Service bureau options
© 2014 OPEN MINDS. All rights reserved.
15
From Strategic Plan to IT Plan –
Six Key Steps (cont.)
4. Incorporate costs in budget model to test strategic
plan investment and ROI
5. Be decisive
– Proceed OR
– Reject based on budget model feasibility
6. If “reject” then, rework functionality requirements
and technology options to find acceptable model
© 2014 OPEN MINDS. All rights reserved.
16
II. Choosing New Technology — EHRs,
Analytics Tools, & Treatment
Technologies
© 2014 OPEN MINDS. All rights reserved.
17
Differentiation Of Technologies Based On
Variable Impact On Competitive Advantage
What
How
When
•New science changes treatment
•Pharmaceuticals, neurotech devices, computerbased cognitive retraining, etc.
•Use of technology to connect consumer to
professional
•Ehealth and remote monitoring make ‘place’ less
critical to service delivery
•“Big Data” and decision support
• Determines when professionals should do
something – and when consumers are likely to
choose something
© 2014 OPEN MINDS. All rights reserved.
18
Technology Needs For Information
Management
Data Gathering Tools –
EHRs, CRM, Social Media,
HR Systems, Financial
Management Systems. . .
Analytics Tools – HIE,
Data Warehouses,
Reporting Tools,
Dashboards. . .
© 2014 OPEN MINDS. All rights reserved.
MetricsBased
Management
& Decision
Support
19
Treatment Technologies Emerging In New
Delivery System Models
Neurotech:
Service delivery
mechanism
The “What” of Service
Telehealth:
Platform for service
delivery
The “How” of Service
© 2014 OPEN MINDS. All rights reserved.
New
Service
Delivery
Paradigm
20
Scientific Discoveries Fueling Commercial
Neuroscience Offerings
Emerging
Developments in
Neuroscience
Ability to monitor
brain
functionality and
changes
Discovery of
possibility of
brain cell
regeneration
Changing theory of
brain development
and maturity –
longer and later
Better
understanding of
brain chemistry
Identification of genetic
and epigenetic factors in
behavioral and cognitive
disability
© 2014 OPEN MINDS. All rights reserved.
21
Current Commercial Developments In
Neuroscience
•
•
•
•
Innovative drug delivery systems – patches, injectables,
and genetically-designed drugs – for mental illness,
addictions, dementias, intellectual disabilities
Better diagnostics – brain scans, biomarkers, and more
– for mental, addictive, intellectual, and cognitive
disorders
Virtual reality and alternative reality treatment
applications
Neurotech treatments – stimulation-based and exercisebased
© 2014 OPEN MINDS. All rights reserved.
22
Telehealth Technologies
New Functionality In
Telecommunications
Telehealth
Telecare &
Assistive
Technology
Smart home
Technology
Companion
robots
ehealth
Remote
monitoring
systems
Remote
vital sign
sensors
Wearable
wireless
devices
© 2014 OPEN MINDS. All rights reserved.
mhealth
Telehealth
Smartphone
applications
Real-time
consultation
Text message
alerts
Remote
audio/video
therapy
23
Tx Technologies Available All Along The
Service Continuum
Diagnostics
• Telepsychiatry
using
IronWorks™
• M3 (My
Mood
Monitor™)
• Brain
scanning
tech
Diagnostics
Consumer
Education/
Decision Support
• Video Doctor
• Common
Ground
• Virtual
Handheld
Clinic
• PTSD Coach
• True Colours
• ChronoRecord
®
• Health Steps
for Bipolar
• Biomarker:
BDNF levels
Consumer
Education/
Decision
Support
Clinical
Treatment
• TMS
Therapy®
• Beating the
Blues
• Mystrength.c
om
Clinical
Treatment
Cognitive
Function
Restoration
• My Mood
Map
• eCBT Mood©
• MyBrain
Solutions
Cognitive
Function
Restoration
Early Detection
of Relapse
• Automatic
Trail Making
Tests™
• fMRI
• ITAREPS
• MONARCA
• Actiwatch
• Health
Buddy®
• OPTIMI
Early
Detection of
Relapse
© 2014 OPEN MINDS. All rights reserved.
Relapse
Prevention
• Technology
Enhanced
Recovery™
• REAC-CRM
(REAC-lithium)
• PSYCHE
• Personalised
Ambient
Monitoring
(PAM)
• MoodMapping
™
Relapse
Prevention
Remote Monitoring
of Patient Health
• ViTelCare™ T400
• SenseWear®
Armband System
• MagneTrace
• ID-Cap
• Electronic
Medication
Management
Assistant®
(EMMA)
• Implantable RF
Transceiver
ZL70102
• Motionlogger
Actigraph
• Helius™
• MOBUS
Remote
Monitoring of
Patient Health
24
Tx Technologies Have Variable Service
Delivery Characteristics
Service Delivery Model
Example
Face-2-Face -- Treatment technologies enhancing
the F2F consumer-professional experience
Tech incorporated in F2F
treatment process (TMS,
VNS, etc.)
Synchronous -- Synchronous (real-time)
technologies linking the consumer and the service
professional remotely
Video-based telehealth
Asynchronous -- Asynchronous (not real-time)
technologies linking the consumer and the service
professional remotely
“Store-and-forward”
diagnostic interviews
Expert System -- Expert system technologies
requiring no participation by the service
professional
On-line CBT
Passive -- Passive technologies requiring no
participation by the consumer
Passive biometrics
monitoring
© 2014 OPEN MINDS. All rights reserved.
25
Three-Phase Review of Treatment Technologies
Strategic
review
phase
Clinical
review
phase
© 2014 OPEN MINDS. All rights reserved.
Business
model
review
phase
26
Start With Strategy & Positioning Of Each
Service Line
Strategy should set the context
for tech selection – what
markets and what service lines
Key question is competitive
advantage of each service line in
the selected markets
© 2014 OPEN MINDS. All rights reserved.
What are the
competitive
threats to
keeping
targeted
customer and
consumer
markets?
27
Key Consideration – For Each Service Line, Compare How
Your Organization Stacks Up Against the Competition
© 2014 OPEN MINDS. All rights reserved.
28
Treatment Technology Investment Should
Serve Strategic Purpose
1.
2.
3.
4.
5.
6.
7.
8.
Reduce cost of service per unit
Reduce cost of service per case
Improve payer preference
Improve consumer preference
Improve operating performance
Improve consumer outcome or functioning
Facilitate new consumer service
Facilitate new payer relationship
Strategic review
Short list of treatment
technologies for each
service line
© 2014 OPEN MINDS. All rights reserved.
Clinical review
29
Phase 2: Clinical Review Phase
•
•
•
The technologies that meet the
strategic review criteria form a
short list for clinical review.
Review of clinical leadership of
proposed technology
– Clinical methodology and operational use of
technology
– Scientific development and research data
– Outcomes and performance data
– Customer/consumer acceptance
Select treatment technologies to
build into service process
© 2014 OPEN MINDS. All rights reserved.
Does the new
technology meet
your
organization’s
clinical
standards?
30
Phase 3: Business Model Review Phase
Define the revised service line business model
with embedded technology
Determine financing model and reimbursement
for service
Process mapping of revised service line
Develop a financial sustainability plan for the
business model – breakeven and P/L
Establish key performance metrics for tracking
performance
© 2014 OPEN MINDS. All rights reserved.
31
Step 1 & Step 2. Define The Business Model
& The Financing Model For The Service Line
Structural
Financing
Model
© 2014 OPEN MINDS. All rights reserved.
Service
Delivery
Model
32
Step 3. Process Mapping Of Revised Service
Line
© 2014 OPEN MINDS. All rights reserved.
33
Step 4. Develop Financial Sustainability Plan
For Business Model
Conduct a breakeven
analysis
Develop profit/loss
projections
© 2014 OPEN MINDS. All rights reserved.
Business model to
imbed in
organizational
strategic plan,
operating plans, and
final budget
34
Conduct Breakeven
Analysis
Breakeven analysis answers
question ‘at what level of revenue
(how many consumers) will the
program break even”?
Breakeven analysis is a supply side
(i.e. costs only) analysis – does not
address revenue side of the
equation
Construct breakeven analysis for
the specific coordinated care
business model both with and
without organizational overhead
•
Key breakeven analysis factors:
◦ Annual yield/productivity of service units (by type)
per direct service (billable) clinical team member
◦ Average annual total compensation cost per direct
service (billable) clinical team member
•
Assumptions in breakeven analysis:
◦ Constant fixed costs
◦ Average variable costs with assumptions
◦ Relationship of revenue to variable expense in
assumptions
◦ Factors affecting assumption of yield/productivity
of team members
© 2014 OPEN MINDS. All rights reserved.
35
Develop Profit/Loss
Projections
P/L determines the margin of service line
based on revenue projections and
operating cost model
•
Financial statement summarizing
revenues (with associated costs and
expenses) incurred during a specific
period of time
•
Illustrate the ability of the program to
generate a margin by increasing revenue
and reducing costs
Revenue projections – and assumptions –
are key element of P/L projections
Typically, revenue projections in health
and human services are created by
payer/contract
•
•
•
•
All services provided
Number of annual unique
consumers by payer
Number of annual service units
(by type) per consumer by payer
Negotiated contract rate for
each service unit, case, or
population, by type and by
payer
Billing and collections yield (%
of total units billed that are
collected) by payer
If P4P bonuses or penalties, the
projected performance on each
P4P performance measure
© 2014 OPEN MINDS. All rights reserved.
36
Analysis Of Program Business Model
1. Does the investment in
technology achieve objectives
and improve the performance
of the service line?
2. Improve margin and
sustainability?
3. Reduce costs to customers
(payer or consumer)?
4. Improve performance or
outcome in metrics that are of
interest to customers?
© 2014 OPEN MINDS. All rights reserved.
37
Step 5: Establish Key Performance Metrics To
Track Clinical & Financial Performance
Having a plan is not enough – tracking and managing
performance of plan is key . . .
Whatever gets measured...
Gets attention
Gets done
If you don’t measure it, you can’t manage it
© 2014 OPEN MINDS. All rights reserved.
38
Five Key ROI Questions About New
Treatment Technologies
1. Does the technology and your investment in it align with
strategic and operational objectives for a particular service
line?
2. What is the cost of implementation over what period in
time?
3. Which benefits can be quantified and which cannot?
4. Do the benefits outweigh the costs?
5. How long into the implementation will the benefits be
realized?
6. What metrics will reflect when actual costs and benefits
match those predicted in the ROI analysis?
© 2014 OPEN MINDS. All rights reserved.
39
III. Why It’s All In The Implementation &
What You Can Do To Speed Bringing New
Technology On Board
© 2014 OPEN MINDS. All rights reserved.
40
Executive Challenges In Time of Changing
Technology
Selecting
technologies for
investment
Continual
organizational
change -- and
speed of change
Timing of tech
investments
© 2014 OPEN MINDS. All rights reserved.
41
The Executive’s Challenge -- Managing Continual Change
© 2014 OPEN MINDS. All rights reserved.
42
Why Does New Technology Adoption Fail?
• Lack of planning of service integration and
workflow
• Lack of executive team commitment to change
• Cultural resistance of organization and/or team
• Improper alignment of costs and benefits
• Insufficient financial resources
© 2014 OPEN MINDS. All rights reserved.
43
Technology Adoption Challenges
Lack of standards of processes and procedures
– Considerable time required to develop comprehensive “dictionary” of drugs,
doses of medication and methods of administration
Fear of technology
– Staff suspicion and uneasiness
Staff turnover
– High turnover rates may necessitate re-training and re-education of staff
responsible for patient care
© 2014 OPEN MINDS. All rights reserved.
44
Motivate Staff & Inspire Commitment To
Technology Adoption
1. Obtain staff buy-in
2. Emphasize that technology is a means, not the end
3. Demonstrate the improvements in staff work-life
possible with the technology
4. Focus on technology as a tool to assist in improving
the quality of patient care
5. Demonstrate that the technology implementation
will have a direct impact on consumers – both
service and care quality
© 2014 OPEN MINDS. All rights reserved.
45
Maintain Realistic Expectations When
Working With Vendors
• Own your own processes – and don’t assume
vendors will understand them
• Do not look solely to vendors to educate staff about
potential pitfalls of their product
• Allow time for any customization, set-up, hardware
and technical issues that may arise
• Develop collaborations when working with vendors
– Explore working with other like-minded organizations as a collaborative group
– Vendors may be more receptive to customize a product for a larger audience
© 2014 OPEN MINDS. All rights reserved.
46
Manage the Implementation
•
•
•
Project planning and project management of
implementation is key
Use change management principles
Provide personalized and continuous training within
the environment
– Make training support readily available during the implementation phase
•
Recognize that the “implementation phase” is not a
fixed period of time
– Foster an understanding that implementation will be a part of on-going
operations
© 2014 OPEN MINDS. All rights reserved.
47
IV. Using Technology For Competitive
Advantage — How To Gain Market Leverage
From Your Tech Investment
© 2014 OPEN MINDS. All rights reserved.
48
Performance Is The Focus. . .
The execution or
accomplishment of
work, acts, or feats
Technology investments
should be focused on
improved performance
© 2014 OPEN MINDS. All rights reserved.
49
Many Kinds Of Performance Measures In The
Field Can Seem Confusing. . .
1.
Organizational or program sales
or revenue
1.
Readmission rates – hospital,
residential facility, jail
2.
Organizational or program cost
2.
Reunification with family
3.
Organizational or program
profit/margin
3.
Payer satisfaction
4.
Cost per consumer care episode
5.
Annual cost per consumer
6.
Contract compliance
7.
Productivity of clinical team
members
8.
Yield (occupancy) of facilitybased care
9.
Staff retention and turnover
4.
Program market share
5.
Cash flow
6.
Consumer clinical outcomes
7.
Consumer functional outcomes
8.
Consumer satisfaction
9.
Community tenure
10. Emergency room use
10. Service volume
© 2014 OPEN MINDS. All rights reserved.
50
Guideline: Where You Focus Performance Improvement
Investment Depends On Strategy For Competitive
Advantage
Organizational
Performance
Market
Positioning
&
Competitive
Advantage
Communication
© 2014 OPEN MINDS. All rights reserved.
51
When Does Organizational Performance
Not Matter?
In a monopoly
market, where
there is no
competition
In a commodity
market, where
all products or
services are
viewed as
‘identical
Otherwise,
performance
matters . . .
© 2014 OPEN MINDS. All rights reserved.
52
Strategic Advantage &
Market Positioning
Payer
Performance
Expectations
Contract
Performance
Consumer
Performance
Expectations
Accreditation & Licensure
Performance
Metrics-Based Management
Strategy Evolution
Operational
Execution
Strategy Development
Market Intelligence
Customer, Competitor, Regulatory, Legal
© 2014 OPEN MINDS. All rights reserved.
53
Keys To
Performance
Management
Success. . .
Why competitive advantage? It is what differentiates
you from your competition – and makes
consumers/payers select your organization.
• A superiority gained by an organization when it can provide the same value
as its competitors but at a lower price – or can charge a higher prices by
providing greater value through differentiation.
Without planning, prioritization of investments of time
and resources (and identification of “performance”
requirements) not possible.
© 2014 OPEN MINDS. All rights reserved.
54
Keys To
Performance
Management
Success. . .
What consumers want vs. what payers want
Not all “customers” are the same
Consumer/payer combination groups make up
“market segments”
© 2014 OPEN MINDS. All rights reserved.
55
Keys To
Performance
Management
Success. . .
© 2014 OPEN MINDS. All rights reserved.
56
Keys To
Performance
Management
Success. . .
The ROI of performance improvement investments
must be made in lens of gain in strategic objectives
(improved consumer or payer satisfaction, reduced
cost, etc.)
“Strategic quality” concept of David Garvin
© 2014 OPEN MINDS. All rights reserved.
57
Keys To
Performance
Management
Success. . .
• Metrics-based management sounds easy
• Organizing processes and systems, teams, and
resources to achieve metrics required by the
market is hard work – and a huge culture change
• The new role of supervision
• The new executive team responsibility
© 2014 OPEN MINDS. All rights reserved.
58
A Few Words of Wisdom. . .
Never underestimate the power
of a simple tool.
- Craig Bruce
“It is a poor workman who
blames his tools.” - Anonymous
© 2014 OPEN MINDS. All rights reserved.
59
The market intelligence to navigate.
The management expertise to succeed.
www.openminds.com
163 York Street, Gettysburg, PA 17325
Phone: 717-334-1329 - Email: [email protected]
© 2014 OPEN MINDS. All rights reserved.
60