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IBM - 9iun2011

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IBM - 9iun2011

  1. 1. The importance of Program Management and strategic Change Management in eHealth Bart de Witte CEE Healthcare Industry Leader IBM CEE Bart de Witte eHealth conference 2011 – 9.06.2011 - Intercontinental Hotel, Fortuna Conference Room - Bucharest
  2. 2. IBM’s role and commitment in Healthcare <ul><li>Health IT services and solution provider </li></ul><ul><ul><li>Revenue scale of Fortune 400 Company </li></ul></ul><ul><ul><li>>8,000 employees dedicated to healthcare </li></ul></ul><ul><ul><li>56 Medical doctors, 350 health professionals </li></ul></ul><ul><ul><li>Broad solution portfolio and business partner ecosystem </li></ul></ul><ul><li>Change agent </li></ul><ul><ul><li>National level reform and eHealth ( Denmark, Norway, Germany, Ireland, Spain, Italy, Slovenia, Slovakia, Czech, ME, Canada, Singapore, Australia, China, India and US ) </li></ul></ul><ul><ul><li>IBM Research and systems thinking </li></ul></ul><ul><ul><li>600+ patents in life sciences, healthcare and medical devices </li></ul></ul><ul><ul><li>Commitment to standards </li></ul></ul><ul><ul><li>EU e-health engagements: epSOS , Renewing Health , COCIR , Continua Health Alliance , EHTEL </li></ul></ul><ul><ul><li>European Healthcare CoC in France, involvement in Tromso Telemedicine Centre and European Centre for Connected Health in N Ireland </li></ul></ul>
  3. 3. eHealth News from the last 2 months &quot;Unser Problem ist jedoch, wenn es kein Gesetz gibt, gibt es keinen Roll-out&quot;,
  4. 4. Industry challenges from a global perspective globalization Health care is shifting from local to national and global contexts chronic diseases Incidence and cost of chronic and re-emerging infectious diseases are increasing staff shortage Nursing and specialist shortages demand workforce productivity and efficiency consumerism Empowered consumers expect better value, quality, and outcomes demographics Changing demographics and lifestyles drive associated costs cost Growing costs for new, revolutionary technologies and treatments
  5. 5. A smarter health system forges collaborative partnerships to deliver better acute, chronic and preventive care, while activating individuals to make smarter choices. This mandate for change is a mandate for smart.
  6. 6. An opportunity for health systems to think and act in new ways. + + = Our world is becoming INSTRUMENTED Our world is becoming INTERCONNECTED Our world is becoming more INTELLIGENT
  7. 7. I am an ePatient – where and with whom can I connect?
  8. 8. I am an ePatient – where and with whom can I connect?
  9. 9. <ul><li>“ We can’t look at health in isolation . It’s not just in the doctor’s office. It’s got to be where we live, we work, we play and we pray” </li></ul><ul><li>US Surgeon General, Regina Benjamin, LA Times, March 13, 2011 </li></ul>
  10. 10. eHealth in Europe (EU) <ul><li>Status & Results </li></ul>
  11. 11. At the national level, progress can also be registered, but the majority (20 of 34) of European countries surveyed are still at the planning stage. State of ePrescribing in European countries, 2010 Deployment stage of patient summary and EHR-like projects in European countries, 2010 Source: eHealth Strategies study, 2010
  12. 12. Disease man. Anti Coagul. Diabetes EHR-data Lab/Rad orders/tests Referrals Discharges Medicine info. Insurance Public HC Electronic Health Record National Patient DB (eLPR) Public Healthcare Reimbursement Organ donation Life Testament NIP Quality databases Regional Services HIS / EMR Medicine Booking Pharmacies Home Care GP’s National Government services Municipality Citizens Health Portal Medical Labs Prescriptions Medicine Reimb. Prescriptions Referrals Reimbursement Radiology Quality data (DAK-E) Appointments Prescription Server Medicine and Reimbursem. Referral database DAK-E Quality Datab. Quality data (NIP) Discharges Prescriptions Referrals Reimbursement Appointments Discharges Health profess. Lab/Rad ord/test eConsultations Denmark: 20 years of e-health development
  13. 13. Qualitative Results <ul><li>Example 1: Denmark: DAK-E Quality Database </li></ul>
  14. 17. Qualitative Results <ul><li>Example 2: Denmark: Telemonitoring based in EHR </li></ul>
  15. 18. Denmark Diabetes Telemonitoring Solution <ul><li>The solution is a Shared EHR for diabetes treatment. </li></ul><ul><li>A single, complete overview gives a quick outline of the current state of the individual patient as well as a status of treatments and completed examinations by all care providers. </li></ul><ul><li>Portal contains information on: Lab results, treatment, use of insulin, eye status, foot status, self-care, latest contacts, possible complications. </li></ul><ul><li>Solution is developed as a web-based service that has minimal requirements to the local infrastructure at the users and to IT support. </li></ul><ul><li>Integration to PAS, lab systems, and GP systems is done by use of standard web links and common standards. </li></ul>
  16. 19. Dialog – an IBM company
  17. 20. Quantitative Results <ul><li>Canada Health Infoway </li></ul>
  18. 21. Canada: IBM’s Role in e-health (Infoway) BC – IBM Integrated, Implemented, Operated and Maintained PharmaNet AB – IBM Designed, Developed, Installed, Maintained, Deployed and Operated PIN SK – IBM Designed, Customized, Implemented and Maintain PIN QC – IBM Selected, Designed and Implementing SQIM e- Prescription implementations: 25,000 Users, 100M+ transactions Providing MPI for e-health for 96% population
  19. 22. Canada: Electronic Health Records The Financial Payoff Access Quality Productivity Benefits = $3.4 billion/ year 2 <ul><li>Inpatient ADE = $1.6 b/yr </li></ul><ul><li>Ambulatory ADE = $1.4 b/yr </li></ul><ul><li>Post Discharge ADE = $0.4 b/yr </li></ul><ul><li>Sources </li></ul><ul><li>Health Canada – Telehealth Evaluation </li></ul><ul><li>Booz Allen Hamilton – EHR ROI Model </li></ul><ul><li>Courtyard Group – DI ROI Model </li></ul><ul><li>Diagnostic Imaging Efficiencies = $1.1 b/yr </li></ul><ul><li>Laboratory Test Efficiencies = $0.5 b/yr </li></ul>Benefits = $1.6 billion/ year 2,3 <ul><li>Medical Transportation Savings = $30 m/yr </li></ul>Benefits = $30 million/ year 1 Infoway Electronic Health Record Demographics Diagnostic Images Laboratory Results Drug Profile Clinical Reports Immunizations Telehealth <ul><ul><li>Decreased medical errors </li></ul></ul><ul><ul><li>Improved interpretation of diagnostic and laboratory results </li></ul></ul><ul><ul><li>Decreased adverse drug events </li></ul></ul><ul><ul><li>Decreased prescription errors </li></ul></ul><ul><ul><li>Improved prescribing practice </li></ul></ul><ul><ul><li>Increased speed and accuracy in detecting infectious disease outbreaks </li></ul></ul>
  20. 23. concrete deliverables on eHealth during the Swedish EU Presidency 2009
  21. 24. E-Health Program <ul><li>Most E-Health implementations involve: </li></ul><ul><ul><li>A program of many (10 to 50 or more) related projects </li></ul></ul><ul><ul><li>The projects tend to be: </li></ul></ul><ul><ul><ul><li>Interrelated </li></ul></ul></ul><ul><ul><ul><li>Complex </li></ul></ul></ul><ul><ul><ul><li>Multi-stakeholder </li></ul></ul></ul><ul><ul><ul><li>Procured from multiple suppliers </li></ul></ul></ul><ul><ul><ul><li>Delivered in many different ways </li></ul></ul></ul><ul><ul><ul><li>Affecting the same client population </li></ul></ul></ul><ul><ul><ul><li>Strong influence / change on healthcare practice </li></ul></ul></ul><ul><ul><ul><li>Strong influence / change on the way of doing “business” </li></ul></ul></ul>
  22. 25. Ministry of Health – eHealth Risks Technology Lack of Stakeholder Adoption and Usage 20% 80%
  23. 26. eHealth Adoption Barriers – Fear of Change <ul><li>Experience a loss of Personal Control </li></ul><ul><li>Have anxiety around Benchmarking (KPIs) and transparency that EHR create, on their clinical practice. </li></ul><ul><li>Fail to see value in eHealth solutions </li></ul><ul><li>Loose of Revenue due to higher documentation effort and new guidelines </li></ul><ul><li>eHealth Integration Costs </li></ul><ul><li>Lack confidence in new systems or ability to learn new skills </li></ul><ul><ul><ul><li>Lack confidence in eHealth tools </li></ul></ul></ul><ul><ul><ul><li>Have concerns about reassigned to physicians and not have access to physicians known to them </li></ul></ul></ul><ul><ul><ul><li>Not trust e-services which replace face to face encounters with administrative and clinical staff (ebooking for example) </li></ul></ul></ul><ul><ul><ul><li>Concerns about inappropriate information protection and sharing </li></ul></ul></ul>Patients may Clinical Staff may BARRIERS for eHealth Adoption
  24. 27. PMO and Strategic Change Management IBM’s approach
  25. 28. Ingredients for success in eHealth <ul><li>Learn from the past and other countries – best practices </li></ul><ul><li>Design a rock solid PMO & Governance process </li></ul><ul><ul><li>Direction </li></ul></ul><ul><ul><li>Project oversight </li></ul></ul><ul><ul><li>Stakeholder buy-in </li></ul></ul><ul><ul><li>Manage the Change </li></ul></ul><ul><li>Use Standards and methods across the program </li></ul><ul><ul><li>Project management </li></ul></ul><ul><ul><li>Common project phases & gates </li></ul></ul><ul><ul><li>Alignment with a national E-Health Architecture using a Design Authority </li></ul></ul><ul><li>Coordination through an overall Program Management Office (PMO) </li></ul><ul><ul><li>“ A &quot;Project Office&quot; is a centralized group consisting of one or more individuals within an organization established to perform project management functions for a single project or for a portfolio of projects that make the organization and its projects more effective.” </li></ul></ul>
  26. 29. Relevance for eHealth Strategy <ul><li>A PMO is necessary for E-Health success but may not be sufficient </li></ul><ul><li>Traditional PMO structures focus on project management issues and processes </li></ul><ul><li>E-Health requires more than project management and a PMO can support other important processes like: </li></ul><ul><ul><li>Methods </li></ul></ul><ul><ul><li>Standards </li></ul></ul><ul><ul><li>Architecture </li></ul></ul><ul><ul><li>Governance </li></ul></ul><ul><ul><li>Benefits Realization </li></ul></ul><ul><ul><li>Change Management </li></ul></ul>
  27. 30. People & Process & Technology
  28. 31. IBM’s Change Management Strategy Development Framework Macro Focus on Strategic Execution Micro Focus on People Change Value Realization Program Leadership & Governance Skills & Knowledge Organizational Design Stakeholders Engagement & Communications Program & Strategy Management Cultural Transform
  29. 32. Governance and stakeholder management <ul><li>In E-Health programs, a stakeholder management & communication strategy will be defined in order to: </li></ul><ul><ul><li>Stakeholder Management Strategy </li></ul></ul><ul><ul><ul><li>Identify & Analyze stakeholder groups  </li></ul></ul></ul><ul><ul><ul><li>Analyze stakeholder groups  (Impact of Change, Reaction to Change, Degree Support required, Define Incentives) </li></ul></ul></ul><ul><ul><ul><li>Create Stakeholder Map & Define Management Strategy for each group </li></ul></ul></ul><ul><ul><li>Communication Strategy </li></ul></ul><ul><ul><li>Stakeholder Planning </li></ul></ul><ul><ul><li>Communication Planning </li></ul></ul><ul><ul><li>Stakeholder Mobilization </li></ul></ul>
  30. 33. Value & Benefits Realization Approach Realizing cost benefits and sustaining them over time requires the incorporation of a benefits realization and tracking mechanism to understand change, measure it and communicate its impact throughout the organization. <ul><li>Key Activities include: </li></ul><ul><ul><li>Identify benefits </li></ul></ul><ul><ul><li>Create benefits case </li></ul></ul><ul><ul><li>Define benefits owners </li></ul></ul><ul><ul><li>Build action plans (including Incentives) </li></ul></ul><ul><ul><li>Create metrics </li></ul></ul><ul><ul><li>Build a tracking mechanism </li></ul></ul><ul><ul><li>Measure and monitor </li></ul></ul>Secure Benefits Ownership Establish and Track Benefits Measures Test Benefits Strength Build Business / Benefits Case Realize Results Execute Benefits Delivery
  31. 35. Change Management is key driver of Successful eHealth implementations The key success factors for transformation are organisational rather than technical Source : IBM Institute of Business Value
  32. 36. Summary <ul><li>E-Health programs are among the most complex business initiatives. a well structured PMO can add tremendous value </li></ul><ul><li>The optimal approach for an E-Health PMO addresses the bigger picture </li></ul><ul><ul><li>Change Management </li></ul></ul><ul><ul><li>Benefit Realization </li></ul></ul><ul><ul><li>Impact Analysis </li></ul></ul><ul><ul><li>Governance </li></ul></ul><ul><ul><li>Architecture </li></ul></ul><ul><ul><li>Methods </li></ul></ul><ul><li>Attention to the broader picture and long term goals improves chances of success </li></ul>
  33. 37. We need to connect the Islands – but we can only do this together if we have a clear view of the benefits and do this smart! Picture Source : Bart de Witte – Big Belt Bridge - Denmark
  34. 38. Thank you for your attention Bart de Witte CEE Healthcare Industry Leader witte (at) sk (dot) ibm (dot) com

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