Pitching your EHR project to senior management
Before discussing the strategies that can be used to influence senior management to invest in EHR technology, it is important to understand why buy-in at the C-level is important. Just as is the case for any level of staff buy-in, it is important to ensure that all parties are aligned with the same goal. Buy-in with C-Level staff is also crucial for an obvious reason: C-Level staff is primarily the group who control fiscal decision in an organization. Therefore buy-in among this group is important, but also likely necessary to see a project to fruition.
When discussing the issue of buy-in at the executive level, just as is the case with buy-in at any other level in the organization, all stakeholders must be aligned to move forward. For C-Level staff to be aligned with a proposed project, buy-in must be obtained. Gaining buy-in from C-Level staff is a process of making the case that a certain course of action or project is aligned with an organization’s goals and is a worthwhile pursuit, rather than something that must be tolerated or viewed as a “necessary evil.”
Find a C-Level champion
Just as is the case when pitching an EHR project among clinical and administrative staff, finding a champion (or a few) among C-Level staff can help increase the probability of success when making a pitch to senior management. Finding a champion is beneficial in that it offers the chance to have an insider who can advocate for your project before and after the pitch is made, but also is useful given that a C-Level insider willing to champion your project can also provide valuable insight into what it might take to push the proposal to success and accordingly can also provide valuable feedback by pointing out the strengths and weaknesses in your proposal.
Evidence and sound methods matter
Making a pitch to C-Level must be based on evidence and reliable methods. Although assumptions may be used, they must be backed up by evidence. For example, if one makes the case that an EHR investment will result in increased revenue due to the increased patient volume, the best approach is to find evidence of similar cases where this outcome has occurred. Find similar size organizations and use them as examples. Examples can be found in formal research studies or case studies commissioned by private sector agencies or think tanks. If an exactly similar case is not available to use, find the best available evidence and insert a caveat that although it is not exactly on point, it can still provide useful insight.
Secondly, when offering projections and calculations that make representations regarding potential costs and benefits or ROI projections, it is important to model these calculations using accepted methods and again sound real-world evidence. In this case, consult individuals familiar with healthcare finance and budgeting to check your work.
Making a case for added value and the elimination of inefficiencies
As such, the proposed EHR project must satisfy some type of need. Organizational needs about healthcare technology can fall under two broad categories: technology that solves an existing problem found within the technology currently in place or technology that addresses a need not currently being met by the technology in place. In either case, the pitch must include evidence that either value is being added to the organization’s operations or inefficiencies are being eliminated.
Making the case for added value or reduced waste can fall under a number of areas. For example, credible evidence from the Journal Risk Management and Healthcare Policy shows an EHR can provide tangible benefits to a practice including increased efficiency, quality, and reduction of waste.
Future-proofing an organization
Future-proofing is a buzzword that often is used without a great deal of consideration as to what it actually implies. Future-proofing basically involves staying ahead of the curve by anticipating trends and reacting in a manner that allows an organization to make the best out of changes in the environment outside of their organization. For example, 10 years ago healthcare practices were likely future-proofing themselves against regulations that mandated EHR use. Today future-proofing an organization involves making healthcare organizations more efficient in delivering quality services and realizing that providing health care services is a business that must be mindful that patients are consumers and that their satisfaction matters.
For example, patient satisfaction as an issue of value creation is illustrated in the eighth annual Black Book industry surveys of inpatient EHR users. The report states that "involvement with healthcare consumers through technologies is proving to be a significant element of patient satisfaction," Doug Brown, managing partner of Black Book Research goes on to report that "healthcare consumers more frequently interact through electronic media in 2018, and while they value contact with their providers, they don't have the patience for lacks in hospital interoperability, incorrect billing, and access to scheduling and results." These statements are further supported by the fact that 89% of healthcare consumers under 40 polled disclosed they are unsatisfied with the technology capabilities of the healthcare organizations with which they seek services. 84% percent of respondents stated that they are seeking the most technologically advanced and electronically communicative medical organizations available for their healthcare alternatives. As such, future-proofing an organization can in some cases mean providing the best technology for clinical operations, but also enhancing how an organization interacts with its customers.
Demonstrate comprehensive and organization-wide buy-in
A lack of buy-in from C-Level staff may be overcome if the case can be made that clinicians and staff are on board with the proposal. In this case, gathering staff and clinician input on the proposed project can be used as an effective persuasive tool. For example, clinicians or other staff may provide proof that the current system is creating inefficiencies in workflows and that upgrading existing technology or investing in new technology may help clinicians and staff make the best use of the EHR.
Packaging the pitch
Packaging the pitch is almost as important as its contents in many regards. A pitch that is delivered in a sloppy manner will often create the impression that its contents lack credibility. Therefore, treat any proposals that are made internally to C-Level staff as if it were being made to a group of outside investors. Accordingly, make supporting documentation available, and allow the audience to review your pitch in advance so that any questions can be addressed. Also, and perhaps most importantly, provide copies of any calculations or supporting material so that the audience can review your assumptions and how you arrived at them prior rather than asking the audience to search out the material for themselves.
Managing stumbles and addressing questions
One of the most important aspects of making a persuasive argument rests in the ability to not only advocate for your own proposals but also to have the ability to address shortfalls or limitations in your case. As such, when making a pitch for EHR investment it is important to consider potential weaknesses in your reasoning, but also to be able to discuss them in the context of potential alternative solutions. Therefore, if someone questions the assumptions being used or the viability of a proposal one should avoid going into defensive mode, rather explain your reasoning and then offer alternatives that may be plausible to the target audience.
CIOs from 13 prominent healthcare organizations who met in 2017 at the annual Scottsdale Institute Spring Conference CIO Summit were surveyed during a session involving the topic of providing value to healthcare organizations through technology.
Participants stated with regard to proving value, many of the CIOs noted that C-level members of their organizations are not being asked to do so. As reported in the online publication Healthcare Informatics, respondents such as Robert Eardley, Houston Methodist, noted that although the organization expects value from the EHR, “he is not being pushed to provide hard dollar return on investment.” Accordingly one can assume from this evidence that organizations often struggle to define the type of value an EHR can provide and are not engaging in important discussions regarding barriers and opportunities in this regard.
Patrick O’Hare notes, “teasing out the EHR value versus people and process is just too difficult. The cost of the EHR is embedded in operational cost. It is a cost of doing business…IT tools are used to help achieve quality.”
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