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The digital transformation in healthcare has had many impacts, from precision medicine to artificial intelligence and hospitals being held ransom over its data.  One that has been less discussed, is the impact to the healthcare IT labor force.  Health systems have a newfound need to manage numerous technical skills—now required to sustain IT operations and execute organizational initiatives.  This has created the need for hyper-specialized knowledge workers and a constantly rotating pool of on-demand contract workers and permanent staff.  Healthcare IT leaders are facing the challenge trying to walk the line between supplying highly skilled labor to deliver on organizational initiatives and the increasing pressures of financial constraints of a healthcare industry under pressure to lower costs.  This study explores this topic and proposes a framework for Healthcare IT leaders to assess the balance of their talent pool to prepare their organizations to deliver on both the demands for IT initiatives while also providing good stewardship to the hospital’s financial resources.

Research on 41 hospital acquisitions taking place between 2014 and 2015 – comparing the quality scores reported through the Hospital Compare database for the years prior to and post-acquisition. The findings indicate that the quality of care, in the acquired hospital, declines by an average percentile ranking of 5 points during the year immediately following the acquisition.  While the overall quality performance declined, some health systems showed quality improvements. Why do some hospitals see such improvements while others experience declining quality? To answer this, we analyzed the top and bottom performers to identify common traits and provide guidelines for smoother future transitions resulting in less disruption to the quality of care.

Applying Agile Principles to Epic Upgrades

Maintaining an Epic system can be a significant drain on a healthcare organization’s resources.  A typical upgrade can cost an average hospital $1M or more in total project costs.  Since 2009, there have been 6 of these releases, occurring every 17 months, with the next scheduled for February of 2018.  This accounts for $7M or more in cumulative maintenance cost over the 9-year period.

An alternative approach to the management of these upgrades could reduce this cost by as much as 25% while maintaining or improving the quality of the outcomes, yielding a combined savings of almost $2M.

It happens.  At one point or another, one of your projects will get into trouble.  Lack of commitment from the stakeholders, team conflict, unmet expectations.  These are just a few reasons projects can find themselves in very challenging situations.  There are many reasons why a project can get off track. This paper provides 8 steps on to turn that troubled project around.

The Comprehensive Care for Joint Replacement (CCJR) model is a new initiative by CMS to test bundled payments and quality measurements for an episode of care associated with hip and knee replacements. This paper presents how the newly developed Time-Driven Activity Based Costing (TDABC) model can help hospitals measure and understand their costs to succeed with bundled payments.

This paper provides an overview of application of The Balanced Scorecard to healthcare IT operations.  The framework was originally developed through research conducted at Harvard Business School and is increasingly utilized as a strategic management framework across various industries.  The balanced scorecard framework provides the connection between the organizational strategy and the day-to-day execution of the objectives, allowing for a common set of key performance indicators.  This paper outlines examples and case studies for applying this framework to a hospital IT strategic planning process.

This paper presents a pilot study on application of the Time-Driven Activity Based Costing (TDABC) method.  The study was performed by E&A at a primary care clinic in Missouri, using the TDABC methodology, E&A analysts discovered the cost of a single patient visit along with additional insights into the financial benefits associated to to the clinic's Lean process redesign initiative.

Time-Driven Activity Based Costing (TDABC) is a new application helping hospitals assign costs accurately to process steps by creating a framework of time equations and cost drivers. This paper provides E&A's method of performing TDABC research in a healthcare setting.

As the healthcare industry transitions to value-based payment models and population health management, hospital construction of new and replacement facilities is on a rise. This paper serves as a resource guide to senior leadership on how to plan for construction and how to best accommodate for a new care delivery system.

In 2015, the healthcare industry saw a growth in the number of Accountable Care Organizations (ACOs) and in the development of payment reforms, both changing the traditional business model of care delivery. This paper provides a strategy to (1) measure and understand costs using the Time-Driven Activity Based Costing (TDABC) method (2) create IT infrastructure fit for a value-based health care environment.

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