Healthcare IT staffs weathered many challenges and changes in 2020, but now face pent-up demand to get sidetracked technology projects in motion.
However, taking on new projects has never been easy for IT executives, who face the balancing act of assimilating the extra burdens while coping with ongoing maintenance, servicing incident resolution and fixing outages. Managing the workload can overwhelm the best intentions of a project management office.
Coping with these pressures and deploying new approaches to managing project workloads during digital transformation initiatives was the topic of a recent webinar hosted by healthsystemCIO and sponsored by Tasktop Technologies.
To meet burgeoning demands, IT executives need to shift from a project mindset – which, by necessity, emphasizes managing cost and timeframes – to a product mindset, which focuses instead on continuous delivery to help these executives lead core business strategy and optimize the customer/patient experience.
With 575 full-time equivalent positions in IT support for Hackensack Meridian Health, it can be difficult for Neal Ganguly, VP of information technology, to explain constraints on support for new projects. Large initiatives filter down to IT through an organizational business planning process, but smaller-impact projects can come from various sites within the system from outside a formal review process “in more of an organic fashion.”
At Penn Medicine, the amount of hours needed to complete a project is the determining factor in deciding whether a request needs formal review, said Mike Restuccia, SVP and CIO. Large projects come in to the network’s project management office, while requests deemed to involve less than 80 hours of work are considered service requests that can go to a director-level individual on the IT team to be prioritized and addressed.
Both executives noted that they have been overwhelmed in attempting to manage work requests, expressing frustration that the range of support requests that come in negatively affect IT’s ability to provide bandwidth for larger projects intended to meet strategic imperatives.
“The concept of run and maintain takes up a fairly significant portion of our resources,” Restuccia said. “What you have remaining (in bandwidth), you can put on new projects.” Data on past work goes into the department’s efforts to manage projects, along with ensuring that sufficient capabilities can be brought to bear – including developers, integration resources, project managers and testing analysts. “If you only have three of those, you’re probably not moving forward on the project.”
“A lot of effort is expended by the PMO that’s not captured as value, and it’s hard to explain what’s done,” Ganguly said. “A lot of time goes to maintaining the environment. We don’t really actively communicate the challenge, other than to say our bandwidth is X, which is what is left after all that required work is done.”
To cope with this, healthcare organizations need to adopt some of the practices that other industries are using when it comes to technology, says Mik Kersten, PhD, founder and CEO, Tasktop Technologies, and the author of “Project to Product: How to Survive and Thrive in the Age of Digital Disruption with the Flow Framework.”
A data-driven approach can help organizations with the digital transformation process by leveraging value-stream management to better understand the ROI of certain activities, and then adjusting the mix of services to ensure optimal productivity and performance, given constrained resources. Elevating the visibility of all IT efforts and the work that’s performed shows whether it’s matching up with value streams that matter most to organizations, Kersten said.
“When a lot of capacity goes to maintenance work, that doesn’t seem right to me,” he added. “If 60 percent to 80 percent goes to maintenance, what would it take to reduce that, so that 50 percent of capacity could go to new initiatives, which then translates to net new business? The key insight for me is around these cross-functional value streams; if we could just define those cross-functional value streams, we could actually unlock some insights.”
Bottlenecks in implementations or resulting workflows tend to command resources, he said, and so new projects need to be assessed to ensure that they reduce future maintenance works and eliminate bottlenecks. “Then, we can start to move the needle to new project work that advances business value.”
While Restuccia noted that this is an admirable goal, healthcare organizations’ IT projects are complex because of the limited investment in IT (typically 3 percent to 4 percent of net patient revenue). “That requires ruthless prioritization – upfront, you have to have the tools available and talk to leadership about this. As you get hit by requests for downstream enhancements (on projects) how do you help them get to a finished project?”
“If (senior leaders) load work on you that could break the system, you have to have the courage to say no,” Ganguly added. “We say no a lot because our resources are constrained. Leadership understands it, but that doesn’t mean that everybody loves it. We need to be able to translate back what IT support requirements are.”
“There’s this tension that we deal with – we’re not wanting to say no, and we’re having to say no,” Kersten concluded. “For most organizations, having an accurate view of capacity, of what exactly the capacity is going to be for the next release, for the next cycle, is really difficult.”
To view the archive of this webinar – Driving Continuous Delivery with Value Stream Management (Sponsored by Tasktop) – please click here.