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● Think Tank continued from page 8

ting frustrated and overwhelmed, we dealt with it like any other small crisis, planned and executed with full team support to get back on track. Not only did we get there, it strengthened our due diligence process.

Steve Matheson, Vice President, Product Management, BridgeHead Software

A failure to balance resource focus between business applica- tions and clinical applications. Obviously, clinical care applications are important. T ey are, in

the current hi-tech healthcare provider world, what often enables healthcare delivery to happen, especially due to the retiring of paper charts and fi lm. Clinical users can be a daily focus for IT’s attention and resources; they often want what they want. When a merger is announced, one of the fi rst discussions is about a consolidation or integration of patient clinical data records. But not everything in IT is a clinical application. Business applications and their users can sometimes be a quieter

crowd, as long as everything works. Many of these applications interact with payer entities that have large and deep IT staff s, so things have been relatively quiet up to the merger. Now with the merger, these applications, their environments and their processes all must be consolidated or eliminated over time. T is activity must be planned, resourced and becomes its own high-priority activity. In other words, the business side of the provider will want IT’s attention. Chris Watson, Chief Operating Offi cer, Brightree

During merger-inspired IT convergences, both business and technology executives skid off the tracks when they don’t come together early enough in the due diligence phase to understand the challenges of such a merger and set proper expectations. It’s important for all parties to understand what will be involved in connecting systems to one another and what timeline to work against. Most importantly, everyone should understand the incremental

value that the combined systems will create for customers and the overall business. For example, when we merged with a company that provides strategic accounting and reimbursement functional- ity, we needed to have a frank discussion upfront about how our tighter relationship would play out with that company’s need to support healthcare solutions beyond ours – including ones that compete with us. We needed to commit early, not only to creative integrations with our system, but also to continued investment in supporting the broader ecosystem. T en, those commitments needed to fl ow through to our business plans and models as part of our due diligence process. Steve Fanning, Vice President, Healthcare Industry Strategy, Infor

People are the greatest risk in a merger overall, but also related to IT consolidations in particular. Interpersonal skills aren’t always the IT professionals’ strength, and the need for leader- ship and communication during a merger is essential to retain key talent and capabilities. I’ve been in a number of meetings with newly minted IT de-

partments where as you go around the table everyone introduces themselves as formerly with “ABC health system” or “XYZ hospi- tal,” reinforcing their stand-alone identity. It’s great to understand where people come from – but it’s telling that people in that room are looking backward, not forward.

10 April 2014

If you needed to prioritize the interfacing/integration of IT systems among suppliers (e.g., administration, fi nance, operations) or among providers (e.g., administration, clinical, fi nance, operations), which one(s) would be fi rst vs. last if done in succession and why?

Frank Negro, Practice Leader, Global Healthcare Consulting, Dell Services

In general, the providing and utilization of information is highly matrixed in that there is no absolute source and consumer of information. Again, the complexity of these interactions among systems is often underestimated.

Sheldon Newman, Co-Founder, CFO, Executive Vice President, Channel Partner Relationships, ViiMed

Depending on the fi nancial or market reasons for the merger, I am biased toward these general priorities: operations (services and support), sales and marketing (messaging), product plan- ning and development, administration and fi nance.

Steve Matheson, Vice President, Product Management, BridgeHead Software

Identify the external entities (clinics, surgical centers, imaging centers, other providers, etc.) that one or both IT organizations have responsibility in providing some IT service or function. It is very common during a merger for all the focus to be on application environments and their processes that reside in the major data centers. Many providers do not just deliver cinical services but very often IT services to other provider entities. Often they are small, have little to no IT staff of their own and can easily get lost in the identifi cation of priority IT activities. IT staff knows it’s not just the technology but the process in place that allows an external entity to interact with one of the providers. Very often the process is not written down; it is known by one or two IT staff . T is activity can be as simple as providing the help desk for use of Microsoft Exchange to an affi liated clinic. T e help desk may get a new telephone extension that both pro- viders communicated internally, but who told the affi liated clinic? Chris Watson, Chief Operating Offi cer, Brightree

We tend to focus on the operations (sales, marketing and services) fi rst to better understand the fl ow and pace of the business. T is also drives the requirements of the administrative and fi nancial systems to properly track and report the activity of the operations. Steve Fanning, Vice President, Healthcare Industry Strategy, Infor

Prioritization of integration opportunities should be based on a combination of the benefi t as well as the eff ort/risk. Most commonly, the administrative and operational systems provide the best combination of shared services savings and relatively lower risk to implement. Early clinical integration, such as EMR lookups, are also important. More comprehensive clini- cal integration also requires a standardization of practice that involves care transformation in addition to IT integration. T ese critical initiatives are typically clinically led and require careful planning given the potential impact to patient care.


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