Though my business card says Principal, I’d prefer the term Provocateur. As a year-long challenge to traditional thinking, I have proposed the notion to professional friends and colleagues that many skills, processes, and technologies in the healthcare sector have reached commodity status. That change presents great potential benefits for the entire healthcare sector.
Reactions range from enthusiastic agreement to skepticism, sometimes even denial. The skepticism is generally limited to the portion of the IT environment based on legacy solutions – a combination of talent and technologies which may have been mainstream at some point, but clearly are outdated now. At this point, in my non-scientific survey, the distribution of opinion is a bell curve shifted toward the “no way” end of the continuum, slowly moving to the left. My goal and that espoused by my partner Sue Schade is to motivate people to move from wait-and-see to 1) contemplate, 2) plan, and 3) act.
The pendulum of managed services (formerly outsourcing) has swung back to practical. Unlike previous experiences, the commodity status of the elements mentioned – skills, processes, and technologies – means a sustainable future that is better, faster, and cheaper. It is also more secure and less stressful for the responsible IT executive(s).
In this opportunity-rich environment, benefits appear to be substantial and accrue across the spectrum – in clinical, financial, and administrative areas. Partial or comprehensive managed services allow an enterprise to:
- Achieve better clinical outcomes,
- Reduce overall costs and lower capital expenditures,
- Improve some key financial metrics such as debt ratio, fixed versus variable cost, and FTE counts,
- Minimize the time to achieve value from IT investments,
- Provide a more flexible IT infrastructure to support mergers, acquisitions, and divestitures,
- Enable and support strategic initiatives (including digital transformation),
- Leverage data assets to support existing analytic efforts, to create and share information and knowledge, and to discover patterns that will promote wellness and healing,
- Provide a secure environment that continuously evolves to counter new cybersecurity threats,
- Improve the end user experience and satisfaction, and
- Ignite and support innovation.
The key to success is novel thinking using innovative approaches.
The adoption of managed services, better expressed as modernization, should be planned carefully and approached in stages. Though we talk about a selective versus comprehensive approach, it’s all selective. The candidates for modernization include, but are not limited to, the areas below.
Optimize those items which used to occupy so much space in your data center, such as network architecture, data storage, servers, backup and disaster recovery technologies. Use a managed services vendor’s NOC (Network Operations Center) to monitor, report, and respond to important events at a level of diligence that most of us could not afford to staff. NOCs have the resources to use evolving augmented intelligence and machine learning to improve resilience and vigilance. Let the vendor independently, or with assistance from your technical architects, create and manage the appropriate mix of storage and servers that grows and shrinks based on usage to optimize cost and performance and ensure flexible scalability in a redundant, secured environment.
Interfacing and Integration
In my experience, the critical path for most projects is interfacing and integrating. A backlog for an interface team is common. You will still need some end-user assistance in the testing and validation phase of projects, but let the vendor provide the initial coding and internal testing of interfaces at a pace that is based on the needs of your business, not the size and availability of your interface team.
As for integration, take advantage of the data science teams that reside inside large managed service firms. This allows you to focus on data governance and improving data quality instead of thinking about database management and all the other activities that don’t offer any competitive advantage. Your focus can switch to formulating more meaningful questions instead of simply extracting and transferring data.
End User Services and Applications
Some of the more challenging areas for CIOs are the Help Desk and Applications Suites. There are numerous examples in which these areas have been outsourced successfully. In Applications, the greatest concern is legacy support, oftentimes dependent upon an individual. Using application management services (AMS) allows you to transfer the knowledge from one or more individuals to a team.
The act of moving applications is often a catalyst for creating missing or updating outdated documentation. Hopefully, another outcome is improved workflows. When done well, you can use AMS to reduce and eliminate diversity in your applications portfolio, and to streamline processes using newer, better, and evolving features and functions.
Bad actors in the cybersecurity space are putting increasing pressure on providers. Cyber threats are everywhere and they’re getting more sophisticated every minute. Large managed service providers are constantly improving their protection, detection, and response capabilities at a pace and scale that even the largest of healthcare systems cannot do. Let the managed services provider focus on the technology countermeasures while you focus on the human factors, including better training and awareness.
Talent and Staffing
IT is expanding rapidly into every aspect of the care continuum. Complexity and diversity of technologies is accelerating. The breadth and depth of responsibilities borne by IT staff require a new way of thinking about talent management and staffing. A managed services company is more capable of attracting and managing a diverse, experienced staff familiar with the broadest spectrum of practices. They can afford the incentives to get people to work at scale effectively and efficiently with thousands of legacy, new, and emerging technologies.
Think insourcing, outsourcing, or a hybrid approach – the one that makes the most sense for your culture and helps meet your strategic goals and tactical objectives. Personalize your approach from many options, some of which are listed below.
- Augment skills not already present in your existing staff — capabilities you need but cannot afford. Fill virtual roles such as a vCISO when you need permanent help but on a limited basis, and actual roles which are hard to find, e.g., AI programmer or Chief Digital Officer on a part or full-time basis.
- Augment the skills of your existing staff to create flexible staffing, e.g., to deal with a project or address peaks in demand that your current staff cannot address due to time or competing priorities.
- Staff to backfill legacy and current support to allow your staff to focus on innovation related activities.
- Let the vendor hire some portion of your staff mixed with their staff and by leveraging scale, do so at a lower cost. That means rebadging some or all the staff that is necessary to meet your needs as defined by service level agreements. This should be done on an individual basis. Retrain if possible, and remove if necessary, both with sensitivity and compassion.
With employees, you’re often challenged to measure productivity. With a managed services firm, you can negotiate a service level agreement with remedies to make sure you get just what you need.
Celebrate the fact that much of IT has reached commodity status. Let someone else help you keep the lights on. Focus on what keeps you competitive. Champion the use of managed services to improve the efficiency, efficacy, and performance of your organization’s IT functions.