How to Succeed with Technology

Sarah Prentice, Vice President and Tony Phemister, Director, Cap Gemini Ernst & Young, presented "How to Succeed with Technology".

Cap Gemini Ernst & Young is involved in the development and implementation of technology solutions with a strategic and operational focus rather than a focus on technology implementation.

Phemister began by outlining a number of the sort of environmental and contextual factors that might drive the implementation of technology solutions (refer slide 2). A key factor is pressure from a growth in costs that exceeds the growth in funding. Other factors include resource pressures, policy setting changes, and growth in demand driven by demographics, eg, the ageing population, and changed patient expectations, eg, the increased use of computers in day-to-day aspects of patients’ lives.

The overall requirements, regardless of the drivers, can usually be distilled down to the need to be faster, cheaper and/or better.

Among a long list of perceived issues with the current health IT landscape are outdated legacy systems, few standards, lack of integration, duplication of data capture and a lack of patient-centricity.

The crucial barrier to successful implementation of technology solutions is resistance to change, with limitations of the existing system, lack of executive consensus, lack of an executive champion and inadequate project management team skills following closely behind (refer slide 4).

"Getting it right" must begin with a general understanding of where the organisation is and its degree of readiness for change. Technological change should be looked at in the context of what an organisation is trying to achieve, thus justifying why a programme should stay or go. Each project should stand on its own and it should be clear exactly what benefits are expected from a technology solution.

The key to success was defined as the ability to recognise and balance three areas of change: technology, people and process.

In relation to people, it is important to understand different frames of reference and to engage people as soon as possible. Big changes would impact on the frames of reference of all involved and poor handling in relation to the values people hold would make it difficult to rebuild trust. It is necessary to accept the time required to buy into change (refer slide 8 ). It is necessary to manage people to reduce the time required or to build that time into the project implementation timeline.

With respect to technology, there is a move from "task-driven" to "event-driven" technological change, ie, from building functions and enabling tasks to finding and connecting value chains within and across organisations (refer slide 9). Seven guiding principles in technology are:
   1. Create value.
   2. Be "religious" about standards but "agnostic" about technology.
   3. Manage IT shifts towards brokering and orchestrating.
   4. Focus on the entire economic web.
   5. Maintain constant awareness of strategic context as tactical actions are taken.
   6. Leverage service-based architectures and frameworks.
   7. Drive continuous adaptation, not planned replacement.

With respect to process, the need for a disciplined approach to project management throughout start-up, execution and run-down was highlighted, with emphasis on the need to manage all aspects of project management at all stages (refer slide 12). Prentice reviewed the contrast between alternative and traditional approaches to process, eg, needs defined by market scanning and scenario testing versus detailing user requirements; rapid, vanilla implementation versus high customisation; iterative versus one-off implementation. In general, the alternative approach allows for checking on an ongoing basis that the outcome will fit with the business model and its associated priorities, which may change over time (refer slide 13).

Prentice highlighted the role of collaboration in process, and the importance of considering what has to be "done" as opposed to what can be borrowed from others. This applies across levels from individual entities through clusters such as IPAs and sector and national levels.

Prentice presented a case study of the application of technology in providing a single hub for procurement by government agencies from multiple suppliers, potentially generating very real cost savings (refer slides 15-17). In this example, it was a cluster view that allowed the solution to be recognised.

In conclusion, Prentice discussed what to do when planning to implement a technology solution. The imperative is a focus on achieving business objectives, rather than pushing a "personal hobby horse", and the need for evaluation checkpoints along the way. She outlined the key questions that should be asked when planning to implement a technology solution:
  â€¢ How will this help you achieve your business objectives in the short, medium and long term?
  â€¢ Why would you do this by yourself?
  â€¢ How does it link with other projects underway (or planned)?
  â€¢ Will the sponsorship and commitment (at all levels) be there?
  â€¢ How will you go about it (selection/development/implementation), eg, traditional versus alternative?
  â€¢ What checkpoints are you building in to confirm you are making progress?
  â€¢ Are the anticipated benefits:
      1. specific
      2. measurable
      3. achievable
      4. realistic
      5. timely?
  â€¢ Have you applied the seven technology guiding principles?
[View Sarah Prentice and Tony Phemister’s presentation How to Succeed with Technology]