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Successful implementation

October 1, 2010
by Roberto Muñiz, MPA, LNHA, FACHCA and Donna Lazartic, MBA, LNHA
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Is technology a strategic asset for your organization?

Adopting technology in a long-term care community requires treating it as a strategic asset. Strategic assets require well-thought-out plans and implementation processes with a commitment to multi-year capital and operating investments.

It requires top-down critical thinking of what's appropriate for your setting, what's important to your organization, and what's needed to operate and grow more effectively. Engaging your leadership team, staff, and other key stakeholders to participate throughout the entire process is essential. Most important is searching out and investing in the expertise of leaders with successful technology backgrounds.

No road map

Like most long-term care providers, The Francis E. Parker Memorial Home (Parker) historically pursued technology investments absent a guiding road map and explicit governance structure. The sole internal information technology (IT) resource was a contracted, part-time IT professional. When Parker doubled in size with the construction of an assisted living residence, adult day health program, and other value-added services, Parker's management and board saw the need to reorganize and enhance the senior management team and board governance structures. During this process, IT was a specific qualification requirement for the chief resource officer (CRO), a new member of the senior executive team, and the board recruited a new trustee with deep IT experience.

The IT-experienced trustee and CRO led the formation of a technology task force chartered by the board. The task force established a clear objective to create a technology strategy and plan to enable successful achievement of Parker's strategic direction and operational goals. Initially, the task force benchmarked best practice peers, learning that the best approached technology strategically with investment decisions driven by overall strategy and goals.

Parker's strategic planning.

Developing a road map

Next, the board approved funds to engage an experienced consultant to work alongside the task force to develop a technology strategy and road map. The selected consultant had a rigorous technology strategic planning methodology (see Figure 1). The first step was to develop Parker's technology vision and outcomes and a desired future state to enable the 10-year strategic vision. The second step included a thorough evaluation of the current state of Parker's technology and a future-current state gap analysis.

Step three identified several strategic options for filling the gaps and assessed them qualitatively against decision criteria, such as strong support of unmet user needs, minimum risk, time-to-value, minimum conversion trauma, and lowest possible cost. Best options were selected and implementation projects outlined with estimates of onetime and ongoing costs. The projects were mapped over a multiyear timeframe with the understanding that investment budgets and decisions would come in three leaps (see Figure 2). Leap 1, building a foundation, was necessary before Leap 2, investing in operational excellence, and Leap 3, technology innovations to differentiate in the market.

Transformative care

The board was asked to align on the technology strategic plan and three-leap investment forecast, and specifically asked to not approve any specific project or spending at that time. It was emphasized by the board chair that top-tier organizations in any industry all use technology in a significant way today. Similarly, if Parker was to remain a leader, the board needed to take a “leap of faith” that technology, well-planned and implemented, would truly enable Parker's mission of transformative care.

Building on a sound foundation.

The board had a comprehensive discussion about measuring the benefit of technology investments. The task force pointed to numerous studies identifying success factors to realize economic value from technology. First of all, IT should not be an end in itself, but should enable strategic objectives and goals. Secondly, if strategic goals can be achieved in an unplugged, paper-based environment, then technology is not value-added and should not be pursued. And thirdly, it is critical to measure strategic objectives before and after technology deployment and to hold management accountable for results.

Any organization making technology investments is always challenged by the project outcomes, timelines, and expenditures. Parker expects to face the same challenges, thus a robust technology governance structure was critical to maneuvering through them. To avoid one of the biggest failures in strategic planning-not implementing it-Parker immediately took action to transition the Technology Task Force into a formal IT governance structure. The second key action was to build the first phase of an internal Parker technology support function including recruitment of an IT manager and IT applications analyst. The lower-valued technology infrastructure function continues to be outsourced.

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