Healthcare Vision Blog

  • Best Practices in System Implementations - Part II: Support the Big Picture by Managing the Right Details

    "My mission is to provide world class delivery to our customers integrated across consulting, hosting, application services and business process outsourcing around TriZetto software. In this monthly forum,  The New Healthcare C-Suite: Emerging Models in Best Practices , I'll be highlighting best practices adopted by health plans and other payers as our healthcare industry continues its evolution. We'll look at how today's C-Suite is taking a more active role in technology strategies and discover why some of these healthcare leaders are achieving results that exceed industry norms."  

    By: Cem Tanyel | Mar 15, 2016

    After previously discussing the importance of business/technology collaboration and CEO championship, I spoke with Richard Pruitt, Chief Information Officer of Kern Health Systems in California, about the specific initiatives he put into place to keep his major system implementation on track and on budget. Here are what Richard considers to be key project components:

    • He established a strategy and budget that let Kern utilize additional vendor resources when needed to keep the project moving forward. This was supported by a vendor partner with a strong bench of experts skilled in a wide range of technologies. Richard also allowed for an additional 12 months after system go-live to work with his vendor partner to make additional system adjustments and modifications, as needed.
    • Richard and Kern Health Systems Chief Operating Officer, Alan Avery created a monthly operations roundtable incorporating representation from every discipline (and including both internal and vendor resources). This team regularly reviewed and documented the change management process—focusing on the broader process goals without getting bogged down in the minutiae that can easily halt forward progress.
    • He established a Project Management Office to closely monitor and manage both internal and external resources to stay on track and on budget. Every expense was recorded and tracked against forecast, allowing for rapid adjustment before things could get out of hand.
    • A Business Analytics Team was created to help quantify processes, establish baselines and set target metrics to be achieved with the new system. This strategy enabled Richard to monitor progress against Kern’s larger goals of process improvement.

    When I asked him what lessons he learned during the project and what he would do differently, Richard was quick to mention two key items:

    • Make the investment in external training. Richard noted, “We tried to use an internal expert to train our staff and found that it wasn’t enough. You need the vendor’s system expertise, particularly when training people to process claims on a new system.”
    • Vet the qualifications of the people you put in charge of the project because you need to know that they have the expertise and the ability to lead the team. “We had a bit of trial and error in this area and I needed to move around some people assigned to the project, both internally and externally.”

    Richard Pruitt is an example of today’s CIO—someone who unites the best of business and technology. His work at Kern Health Systems has shown us that executive championship, supported by strong CIO leadership, team collaboration and careful plan management can drive the success of any systems implementation project.

    Kern Health Systems recently engaged TriZetto Consulting Services to support their implementation of a new TriZetto QNXT™ core administration system to serve their more than 220,000 members. Project results show auto-adjudication rates 20% higher than those of their legacy system, additional staffing requirements significantly less than expected, and the development of a new OCR process into EDI critical to meeting a KHS deadline.

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    Written by: Cem Tanyel
    Chief Services Officer, Senior Vice President, Consulting and Delivery


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