Strategic Planning Misused

Strategic planning is an essential business activity. However, several common mistakes must be understood so that practice administrators can guard against them. Pointing out these mistakes is not a criticism of the process but acknowledgement of improper implementation. Medical practice leaders must recognize both the benefits and the potential pitfalls of strategic planning, because it is their responsibility to ensure that strategic planning is conducted properly to achieve the desired goals. Here are four of the most-common planning mistakes we find:

Attempting to forecast and dictate events too far into the future.

In part, this may result from the natural desire to believe we can control the future. It is a natural tendency to plan on the assumption that the future will merely be a linear continuation of present conditions, and we often underestimate the scope of changes in direction that may occur. Because we cannot anticipate the unexpected, we tend to believe it will not occur. In fact, most strategic plans are overcome by events much sooner than anticipated by practice leaders.

Trying to plan in too much detail.

This is not a criticism of detailed strategic planning but of planning in more detail than the conditions warrant. This pitfall often stems from the natural desire to leave as little as possible to chance. In general, the less certain the situation, the less detail in which we can plan. However, the natural response to the anxiety of uncertainty is to plan in greater detail, to try to cover every possibility. This effort to plan in greater detail under conditions of uncertainty can generate even more detail. The result can be an extremely detailed strategic plan that does not survive the friction of the situation and that constricts effective action.

Tendency to use planning as a scripting process that tries to prescribe actions with precision.

When practice leaders fail to recognize the limits of foresight and control, the strategic plan can become a coercive and overly regulatory mechanism that restricts initiative and flexibility. The focus for staff members becomes meeting the requirements of the strategic plan rather than deciding and acting effectively.

Tendency for rigid planning methods to lead to inflexible thinking.

While strategic planning provides a disciplined framework for approaching problems, the danger is in taking that discipline to the extreme. It is natural to develop planning routines to streamline the strategic planning effort. In situations where planning activities must be performed repeatedly with little variation, it helps to have a well-rehearsed procedure already in place. However, there are two dangers. The first is in trying to reduce those aspects of strategic planning that require intuition and creativity to simple processes and procedures. Not only can these skills not be captured in procedures, but attempts to do so will necessarily restrict intuition and creativity. The second danger is that even where procedures are appropriate, they naturally tend to become rigid over time. This directly undermines the objective of strategic planning — enabling the organization to become more adaptable. This tendency toward rigidity is one of the gravest negative characteristics of strategic planning and of strategic plans.

Indeed, strategic planning is an essential part of practice management, helping practice leaders to decide and act more effectively. As such, strategic planning is one of the principal tools used to exercise operational control. Remember though, that strategic planning involves elements of both art and science, combining analysis and calculation with intuition, inspiration, and creativity. To plan well is to demonstrate imagination and not merely to apply mechanical procedures. Done well, strategic planning is an extremely valuable activity that greatly improves practice performance and is an effective use of time. Done poorly, it can be worse than irrelevant and a waste of valuable time. The fundamental challenge of strategic planning is to reconcile the tension between the desire for preparation and the need for flexibility in recognition of the uncertainty of the healthcare industry.

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Contact ABISA for healthcare consultancy support or speaking engagements.

2017 Second Tier Hospital HITs

It’s that time of year when many are making predictions for 2017 and the subject matter of health IT in the United States continues to be a hot topic for discussion.  As we continue to see an increased threat to patient data, many in the hospital IT world are looking at a myriad of security vulnerabilities and having to weigh those with other initiatives such as maintaining the EHR evolution or delving into interfaces with connected health devices.

HIMSS Analytics teamed up with Healthcare IT News to spotlight technologies that have the greatest predicted buying activity for U.S. hospitals in the coming year.  This post is the second-part summation of their findings.  Last week we looked at the top ten IT initiatives and today we will look at the second tier initiatives.  (Quotes below are from Matt Schuchardt, director of market intelligence solutions sales at HIMSS Analytics as noted in the research with Healthcare IT News.)

  1. Asset Tracking/Management. “This is really an IT function: Tracking the certificates on your Windows machines, is everything up-to-date, are all your updates in place, are you tracking the depreciation of your servers and things like that? Certainly, as you get more tablets and things like that, tracking where they are and that they’re secure is going to be important.”
  1. Population Health Management. This is the aggregation of patient data across multiple health information technology resources, the analysis of that data into a single, actionable patient record, and the actions through which care providers can improve both clinical and financial outcomes.  “About 1,200 hospitals currently have a population health management system in place,” said Schuchardt. “We expect that to grow. If you look at the top 10 vendors for population health right now, two of them are EMR vendors, but they’ve got about 40 percent of the installs. The majority of vendors that hospitals have engaged with are slide plays into population health – I think only about 20 percent of the market right now are purpose built population health vendors.”
  1. Laboratory – Outreach Services. “This is making sure people are getting the tests that they need,” said Schuchardt. “You see the see the TV ads for biologics all the time that may cause liver damage: Are these people coming back in and having their levels checked on their liver while they’re taking them? This technology manages the process – making sure people are being notified of the results, notified for follow-up work, and things like that.”
  1. Bed Management. “The value of beds, the types of patients who are in those beds, are you getting the most of them, what’s your census rate like, what’s your average number of patients to a bed. We suspect that, like all other BI and analytics tools, we’ll continue to see growth.”
  1. Data Warehousing/Mining. A lot of hospitals have data warehousing capabilities, but they’re often “some sort of cobbled-together, self-developed system,” said Schuchardt. “We expect there to be growth there. More and more organizations are looking to turn their data into an asset. Having the data is one thing, using it effectively is an entirely different animal. And I think organizations are beginning to grapple with those concerns.”
  1. Anesthesia Information Management System. “If you think about where risk is, hospitals really focus around surgery,” said Schuchardt. “Making sure they’re monitoring anesthesia is really important: It’s the most dangerous part of any hospital stay, other than staph infections. Hospitals are looking at that, and you can see the current adoption rate is under 2,000, but we expect that to grow pretty substantially.”
  1. Telemedicine. Telemedicine is the use of telecommunication and information technology to provide clinical health care from a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities.  “Voice over Internet, telemedicine, nurse communication – all of these sort of connect together,” said Schuchardt. “If you think about organizations sharing data among themselves, you need to then think about how do they share data even internally? How is the nurse getting the right order, how are patients being routed? Those things will be more important in the post-EMR world as organizations look to better understand patient throughput and outcomes, and communicating what’s going on internally and externally.”
  1. VOIP. Voice over Internet Protocol (VoIP), is a technology that allows you to make voice calls using a broadband Internet connection instead of a regular (or analog) phone line.  “Voice over Internet, telemedicine, nurse communication – all of these sort of connect together,” said Schuchardt. “If you think about organizations sharing data among themselves, you need to then think about how do they share data even internally? How is the nurse getting the right order, how are patients being routed? Those things will be more important in the post-EMR world as organizations look to better understand patient throughput and outcomes, and communicating what’s going on internally and externally.”
  1. Storage: Vendor Neutral Archive. “There’s a lot of vendors in this space who have re-branded their archive as vendor-neutral because it’s a hot-button topic,” said Schuchardt. “But is that actually vendor-neutral? That’s a question hospitals should be asking their vendors before they buy. Is it going to let me exchange data between Philips and GE? Or is it just your old product with a new name? It’s making the data move from your PACS system into your EMR – if you go to the ER when you break your arm, and then you go to the ortho for follow-up care, can she see the original image very easily, even if she’s not on the hospital EMR, or hospital PACS? It’s the ability to store images from one vendor and then reproduce them in places agnostic to the vendor where they’re being reproduced.”
  1. Cardiology 3D Image/Display. Similar to the radiology display but focused on cardiology, this are “will have less adoption, always, than radiology, as there are a number of hospitals that just don’t offer cardiology services,” he said. “But there’s a similar growth curve with a cap on it, in that not everyone is going to be offering cardiology.”

This concludes our two-part summation of the top twenty HIT hospital initiatives for 2017.  Many thanks to Healthcare IT News and HIMSS Analytics for looking into the technologies most on the radar for 5,461 hospitals across the U.S. in 2017.  (Go here for more research from HIMSS Analytics or Healthcare IT News.)

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Contact ABISA for healthcare consultancy support or speaking engagements.

2017 Top Tier Hospital HITs

It’s that time of year when many are making predictions for 2017 and the subject matter of health IT in the United States continues to be a hot topic for discussion.  As we continue to see an increased threat to patient data, many in the hospital IT world are looking at a myriad of security vulnerabilities and having to weigh those with other initiatives such as maintaining the EHR evolution or delving into interfaces with connected health devices.

HIMSS Analytics teamed up with Healthcare IT News to spotlight technologies that have the greatest predicted buying activity for U.S. hospitals in the coming year.  Today’s post will be a two-part summation, looking first at the top ten from their findings.  (Quotes below are from Matt Schuchardt, director of market intelligence solutions sales at HIMSS Analytics as noted in the research with Healthcare IT News.)

  1. Health Information Exchange. HIE  allows health care professionals and patients to appropriately access and securely share a patient’s vital medical information electronically.  “This is one is one where there’s a bunch of new purpose-built vendors in the space,” said Schuchardt. “The majority of installs are in EMR or legacy systems, but we’re seeing some movement toward some specific systems – even in places where people are focused around an HIE that does more than connect them just within their vendor but connects them to other organizations as they look to control their catchment area, maintain where patients are going and exchange the right data while maintaining the security necessary to protect PHI. About half of hospitals have some sort of system in place but we expect some sort of movement around whether you’re using a specific vendor or not.”
  1. Encryption. “It’s still shocking to me that lots of hospitals don’t have those technologies installed. I suspect that we’ll continue to see adoption of those. But they’re by no means silver bullets.”
  1. Medical Necessity Checking Content. Medical necessity relates to activities which may be justified as reasonable, necessary, and/or appropriate, based on evidence-based clinical standards of care.  “We think there’s still a lot of growth there. It’s really about making sure the hospital is going to get paid for the procedure prior to doing it. I expect growth there to continue. It still surprises me that a lot of hospitals do these procedures with the hope of getting paid as a strategy.”
  1. Nurse Communication System. “Nurses are, for most hospitals, the majority of employees,” said Schuchardt. Making sure they’re in the right places and doing the right things and taking care of patients at the right moment is going to continue to be important as nurses will continue to be the primary caregivers in the hospital.”
  1. Infection Surveillance System. “This is about what it sounds,” said Schuchardt. “Working on reducing hospital-acquired infections, managing and monitoring that better. It’s part of the CMS (quality) scores and they’re doing a better job monitoring that, making sure the taxpayers aren’t paying for HAIs. Monitoring that will continue to be important on an ongoing basis, as there are more and more people hired for that role.”
  1. Firewall. “It’s still shocking to me that lots of hospitals don’t have those technologies installed. I suspect that we’ll continue to see adoption of those. But they’re by no means silver bullets.”
  1. Spam/Spyware Filter. “It’s still shocking to me that lots of hospitals don’t have those technologies installed. I suspect that we’ll continue to see adoption of those. But they’re by no means silver bullets.”
  1. Specimen Collection Management System. “These are really for advanced laboratory systems – managing how things are transfused, whether blood or even breast milk, and then labeling these things from a specimen management perspective: Making sure that thing are being barcoded when the phlebotomist takes it, and those barcodes are being tracked throughout the hospital, making sure you’re testing the right specimens and running the right tests,” said Schuchardt.
  1. Transfusion Management System. “These are really for advanced laboratory systems – managing how things are transfused, whether blood or even breast milk, and then labeling these things from a specimen management perspective: Making sure that thing are being barcoded when the phlebotomist takes it, and those barcodes are being tracked throughout the hospital, making sure you’re testing the right specimens and running the right tests,” said Schuchardt.
  1. Radiology 3D Image/Display. “As imaging capabilities increase, being able to see those images gets more and more complicated,” said Schuchardt. These days, after all, a three-dimensional mammogram is can be as large as a terabyte or more. “As these images get more discrete, the volume and size of those images grows pretty rapidly,” he said. “Being able to manipulate a giant 3D model like that requires special monitors, special software to make sense of it.”

Next week will be part two of this technology spotlight, looking at the second tier of hospitals’ predicted 2017 buying activity.  (Go here for more research from HIMSS Analytics or Healthcare IT News.)

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Contact ABISA for healthcare consultancy support or speaking engagements.