www.winthropresources.com 1 Forces of Change Test Dan Mandy Director of Business Development Winthrop Resources Corporation Member HFMA, HIMSS, MGMA & ELFA February 14, 2012 Objectives Discuss the linkage of Business and Technology Strategies What are the “Forces of Change” that can break the link between business/financial and technology strategies? How can healthcare providers determine the susceptibility to change for various technology projects? How can healthcare providers plan for change?
Transcript
www.winthropresources.com 1
Forces of Change Test
Dan MandyDirector of Business DevelopmentWinthrop Resources CorporationMember HFMA, HIMSS, MGMA & ELFA
February 14, 2012
Objectives
� Discuss the linkage of Business and Technology Stra tegies
� What are the “Forces of Change” that can break the link between business/financial and technology strategies?
� How can healthcare providers determine the susceptibility to change for various technology projects?
� How can healthcare providers plan for change?
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BUSINESS STRATEGIES
TECHNOLOGY STRATEGIES
DRIVESENABLES
W O R L D C L A S S H E A LT H C A R E O R G A N I Z AT I O N S H AV E S T R O N G L I N K A G E
Linking Business & Technology Strategies
Business
Patient Quality of Care
Patient Safety
Retain/Recruit World-Class MDs
Leading Womens’ Health
Patient Convenience/Access
Technology
EHR
Pharmacy Cabinets, Barcode/RFID
Latest Surgical Rooms/Equipment
State-of-the-Art Imaging
Patient Portal
Linkage of Business & Technology Strategies
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BUSINESS STRATEGIES
TECHNOLOGY STRATEGIES
DRIVESENABLES
How Will Change Affect Strategies?
W i l l C h a n g e C r e a t e O p p o r t u n i t y o r C h a l l e n g e ?
OPPORTUNITY
RISK
Objectives
� Discuss the linkage of Business and Technology Strategies
� What are the “Forces of Change” that can break the link between business and technology strategies?
� How can healthcare providers determine the susceptibility to change for various technology projects?
� How can healthcare providers plan for change?
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MARKET
� Regulatory / Government
� ARRA & HITECH Stimulus
� Recovery Audit Contractors
� ICD-10
� Stark Laws / IT Donations
� Presidential Elections
� Healthcare Reform
� Reimbursement Changes
� Accountable Care Organizations
� New Reimbursement Models
� Bundled Payments, Pay-for-
Performance, Fee for Service &
Capitation
� Interoperability
� Focus Shift from
Production/Volume to Outcomes
� Privacy / Security - HIPAA
� Economy
HOSPITAL
� Mission & Values
� Patient Safety
� Quality of Care
� Innovation
� Strategy
� Consolidation
� Expansion / Acquisition
� Competition
� Hospitals
� Medical Tourism
� Recruiting / Retaining
Physicians
� Financial
� Bank Covenants
� Days Cash on Hand
� Bond Rating
� Access to Capital
� Better, Cheaper, Faster
� Disaster Recovery
� Vendor Trials / Tribulations
� Point of Care Solutions
� COWs, Wall-Mounts, Tablets
TECHNOLOGY
� Clinical Equipment Advances
� Radiation Doses
� Digitization of
Medical Images
� Telemedicine
� Digital Data Proliferation
� Storage/Capacity
� Access & Sharing
� Interoperability
� Data & Network Security
Healthcare Forces of Change
MARKET
� Regulatory / Government
� ARRA & HITECH Stimulus
� Recovery Audit Contractors
� ICD-10
� Stark Laws / IT Donations
� Presidential Elections
� Healthcare Reform
� Reimbursement Changes
� Accountable Care Organizations
� New Reimbursement Models
� Bundled Payments, Pay-for-Performance, Fee
for Service & Capitation
� Interoperability
� Focus Shift from Production/Volume to
Outcomes
� Privacy / Security - HIPAA
� Economy
HOSPITAL
� Mission & Values
� Patient Safety
� Quality of Care
� Innovation
� Strategy
� Consolidation
� Expansion / Acquisition
� Competition
� Hospitals
� Consumerism
� Medical Tourism
� Recruiting / Retaining Physicians
� Financial
� Bank Covenants
� Days Cash on Hand
� Bond Rating
� Access to Capital
� Better, Cheaper, Faster
� Disaster Recovery
� Vendor Trials / Tribulations
� Point of Care Solutions
� COWs, Wall-Mounts,
Tablets
TECHNOLOGY� Clinical Equipment
Advances
� Radiation Doses
� Digitization of
Medical Images
� Telemedicine
� Digital Data Proliferation
� Storage/Capacity
� Access & Sharing
� Interoperability
� Data & Network Security
Technology Forces
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320320
2
16
4
32
8
64 256
2000
Today
Technology - CT Innovation
Film Mammo
Digital Mamm
o
Breast
MR
Breast-specific gamma imaging
Whole Breast
Ultrasound
Molecular Breast
Imaging (MBI)
Breast Tomosynthe
sis
Breast MR
Whole Breast US
Digital Mammo
Breast Specific Gamma Imaging
Molecular Breast
Imaging
Breast Tomosynthesis
FILM MAMMO
CR Mammo
Technology - Women’s Imaging
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Technology - Vendor Consolidation
1999
Datamedic
Infocure
Vitalworks
2003
Cerner
AMICAS
Emageon
Ultravisual
AMICAS
Merge
Cedara
Merge
Conforma
2010
Merge
??
2000
TodayThick ClientDICOM Push
Teleradiology
Web Access
EnterpriseWeb
Advanced Visualization
CPACS
EnterpriseNeutral Archive
Technology - PACS Innovation
Automated Results
Reporting
Advanced Rad Worklist
Technology
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Technology - Innovation
1985 Today
Technology - Recalls
Infusion Pumps
LASIK
Glucose Testing Devices
Radiation-Emitting Products
Personal Protective Equipment
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MARKET
� Regulatory / Government
� ARRA & HITECH Stimulus
� Recovery Audit Contractors
� ICD-10
� Stark Laws / IT Donations
� Presidential Elections
� Healthcare Reform
� Reimbursement Changes
� Accountable Care Organizations
� New Reimbursement Models
� Bundled Payments, Pay-for-Performance, Fee
for Service & Capitation
� Interoperability
� Focus Shift from Production/Volume to
Outcomes
� Privacy / Security - HIPAA
� Economy
HOSPITAL
� Mission & Values
� Patient Safety
� Quality of Care
� Innovation
� Strategy
� Consolidation
� Expansion /
Acquisition
� Competition
� Hospitals
� Medical Tourism
� Recruiting /
Retaining Physicians
� Financial
� Bank Covenants
� Days Cash on Hand
� Bond Rating
� Access to Capital� Better, Cheaper, Faster
� Disaster Recovery
� Vendor Trials / Tribulations
� Point of Care Solutions
� COWs, Wall-Mounts, Tablets
TECHNOLOGY
� Digital Data Proliferation
� Storage/Capacity
� Access & Sharing
� Interoperability
� Data & Network Security
Hospital Forces
• Urologists
• Cardiologists
• Surgeons
• Radiologists
Hospital – Acquiring, Recruiting & Retaining MDs
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Hospital - Financial
Key finding: 40% experienced challenges related to capital funding; 22% experienced increased cost of debt.
Hospital - Competition
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MARKET
� Regulatory / Government
� ARRA & HITECH Stimulus
� Recovery Audit Contractors
� ICD-10
� Stark Laws / IT Donations
� Presidential Elections
� Healthcare Reform
� Reimbursement Changes
� Accountable Care
Organizations
� New Reimbursement Models
� Bundled Payments, Pay-for-
Performance, Fee for Service &
Capitation
� Interoperability
� Focus Shift from
Production/Volume to
Outcomes
� Privacy / Security - HIPAA
� Economy
� Consumerism
HOSPITAL
� Mission & Values
� Patient Safety
� Quality of Care
� Innovation
� Strategy
� Consolidation
� Expansion / Acquisition
� Competition
� Hospitals
� Consumerism
� Medical Tourism
� Recruiting / Retaining Physicians
� Financial
� Bank Covenants
� Days Cash on Hand
� Bond Rating
� Access to Capital
TECHNOLOGY
� Clinical Equipment Advances
� Radiation Doses
� Digitization of Medical
Images
� Telemedicine
� Digital Data Proliferation
� Storage/Capacity
� Access & Sharing
� Interoperability
� Data & Network Security
Market Forces
Market – Economy
PRESSURE ON LIQUIDITY
• Cash/Investment Losses• Pension Funding
STRAINED OPERATING PERFORMANCE
• Decreased Outpatient/Surgery• Bad Debt Increases• Likely State/Federal Reimbursement Cuts
CAPITAL NEEDS OUTWEIGH RESOURCES• Transition to employed MDs• Aging Facilities• Required new technologies• Bond Markets Still in Transition
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Market – ARRA & MU
Stage 1 Stage 3Stage 2
Affects of Forces of Change
• Healthcare Reform, New Regulation• ARRA Incentives/Penalties• Definitions of Stages 2 & 3• Hospital Financials• Consumerism• Recruiting/Retaining MDs• Tax Exempt Status
health information have also contributed comments,
reviews or updates.”
- Healthcare IT News
Market - Consumerism
Objectives
� Discuss the linkage of Business and Technology Strategies
� What are the “Forces of Change” that can break the link between business/financial and technology strategies?
� How can healthcare providers determine the suscepti bility to change for various technology projects?
� How can healthcare providers plan for change?
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The Old Paradigm
Estimating, Controlling, Predicting the useful life of technology has become
more difficult…if not impossible…
Wind
Precipitation
Temperature
Pressure
HOW DO WE PREDICT?
Predict Susceptibility for Change
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Market
Technology
Hospital
Today?
?
?
?
HOW DO WE PREDICT?
Predict Susceptibility for Change
Ca
pit
al
Pro
jec
ts
Transportation Helicopters, Ambulances
EHR Infrastructure (Servers, Storage, Networking)
Software
Training, Implementation, Maintenance
Imaging Equipment
CR, DR, Pet, CT, MRI, Digital Mammagraphy, Nuclear Cameras, etc.
Clinical Equipment
Surgical Robots, Cath labs, IV pumps, scopes, EKG, etc.
Non-clinical ERP, Workforce Mgmt, Security
Building Parking Garage, Office or other build-out
Forces of Change Test
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Forces of Change Test
Ca
pit
al
Pro
jec
ts
Fo
rce
s o
f C
ha
ng
e
What is the likelihood the following might have an affect on the project?
Market 1 2 3
Technology 1 2 3
Hospital 1 2 3
�Unlikely Likely�
Ca
pit
al
Pro
jec
ts
Fo
rce
s o
f C
ha
ng
e Is the project affected as a ripple?
Rip
ple
Eff
ec
t
Yes No
Forces of Change Test
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Network Infrastructure
Storage
Interfaces
Support & Service
Implementation & Training
Community Outreach
Specialty Applications
Ripple Effects of Technology
CTDigital
MammoNurse Call
EMR
C-PACS
Digital Patient
Monitoring
Smart Pumps
SANWAN
Ca
pit
al
Pro
jec
ts
Fo
rce
s o
f C
ha
ng
e
Overall Susceptibility for Change
Rip
ple
Eff
ec
t
Ov
era
ll S
us
ce
pti
bil
ity
fo
r C
ha
ng
e
1 2 3
�Unlikely Likely�
Forces of Change Test
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w.w
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C a p i t a l P r o j e c t s
F o r c e s o f C h a n g eP
er AH
A G
uide
R i p p l e E f f e c t
O ve r a l l S u s c e p t i b i l i t y f o r C h a n g e
L i f e E x p e c t a n c y
Forces of C
hange Test
C a p i t a l P r o j e c t s
F o r c e s o f C h a n g e
Probability Life E
xpectancy w
ill be less
R i p p l e E f f e c t
O ve r a l l S u s c e p t i b i l i t y f o r C h a n g e
A H A L i f e E x p e c t a n c y
L i f e E x p e c t a n c y Va r i a b i l i t y
Likely�
�Unlikely
%
Forces of C
hange Test
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Ma
rke
t
Tech
no
log
y
Ho
spit
al
Eff
ect
ed
as
Rip
ple
Ove
rall
Su
cep
tab
ility
for
Ch
an
ge
AH
A L
ife
Exp
en
tan
cy
Life
Exp
en
tan
cy
Va
ria
iblit
y
Capital Projects
Transportation (Helicopters,
Ambulances) 1 1 1 No 1 10 0%
E H R (Infrastructure, Software,
Training Implementation) 2 3 1 No 2 5 50%Imaging Equipment (CT, MRI, PET,
CR/DR, Mammo, Ultrasound, Nuclear
Camera, etc.) 1 3 1 No 3 5 75%
Clinical Equipment (Surgical Robots,
Cath Lab, IV Pumps, Scopes, EKG, etc.) 2 3 2 No 3 3 50%Non-Clinical Software/Equipment
(ERP, Workforce Mgmt, Revenue Cycle
Mgmt, etc.) 1 2 1 No 2 5 25%
Building 2 3 1 No 1 20 0%
Advanced Clinical Applications (EDM,
PACS, Lab, etc.) 2 2 1 No 2 5 75%
Forces of Change Test
Objectives
� Discuss the linkage of Business and Technology Strategies
� What are the “Forces of Change” that can break the link between business/financial and technology strategies?
� How can healthcare providers determine the susceptibility to change for various technology projects?
� How can healthcare providers plan for change?
www.winthropresources.com 20
Forces of Change Test
Forces of Change Test
CHARACTERISTICS
• Constant Change
• Acts Like a Consumable
• Innovation is
Accelerating
• Cheaper, Faster, Better
• Rapidly Depreciating
• Maintenance Costs
Multiply Over Time
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Flexible,Short-term
Fixed, Long-term
Match the Tool to the Project
Summary
� Discuss the linkage of Business and Technology Strategies
� What are the “Forces of Change” that can break the link between business/financial and technology strategies?� Technology, Market & Hospital – all connected and po tentially cascaded via a
ripple effect
� How can healthcare providers determine the susceptibility to change for various technology projects?� The Forces of Change Test
� How can healthcare providers plan for change?� Get Educated� Leverage the “Right Tool for the Right Job”
