Way back, in 2009, as part of Apollo HealthHiway, I was involved in implementation of hospital ERP (also called Hospital Information System), from a Program Management perspective, at couple of sites. Typically, these implementations were bereft of data driven implementation processes explaining to hospital stake-holders, what it means to them, if delays happened. Thus, delays were common and missing ‘go-live’ dates was considered normal. The two most common causes are properly understanding requirements and then doing near accurate effort estimation.
Lean Six Sigma methodologies can help plug these implementation delays. In Six Sigma, VOC/ VOB (Voice of Customer/ Business) is a pivotable ‘input’ information and allows translate ‘Problem Statement’ into a crisp, data driven communication, that includes, #s in terms of %/ time/ $ value. Thus, it attracts the attention of any senior executive, whose mandate is to improve top-line and margins, leading to immediate buy-in and interest in rapid execution. A Lean Six Sigma (LSS) professional begins with a different approach from the typical “What are your requirements?”. As the LSS professional dwells more into this different approach, the client also begins to look at the challenges with a different mindset, eventually resulting in new set of goals and objectives. These goals and objectives need to have a clear financial value to it. This generates interest in senior executive team of a hospital and that in turn has cascading effect down the chain. Certain LSS tools used here, can well articulate, this approach. These Six Sigma tools can facilitate governance and decision-making in complex multi-organizational selection processes.
Once it is well articulated, as to what’s needed, LSS professionals turn their attention into estimation. Here, following is looked at —
- Capability of teams — if there are more than one team, doing the implementation, of the Hospital ERP (HIS), then are all teams be able to do the same job, with same efficiency/ other measurable parameter, time and again, for the same product. This is also known as reproducibility. Generally and most often there is a deviation that happens here and needs to be plugged.
- The most important equation of LSS, y=f(x1, x2… xn), where x can be multiple input variables, one of the most important x is the size of the project and this leads to wrong estimation
- One of the other x in y=f(x) is details of the organization and this is important measurement parameter in doing proper estimation of the implementation timelines
- Rightsizing the expectations is another role the LSS professionals play. “A healthy baby will only come out in 9 months. Putting pressure will only lead to a pre-mature baby”. Likewise, in HIS implementation. If we try and do something in 5 days that can only happen in a month, will lead to massive adoption and usage issues
Six Sigma works on facts and we need to manage those facts. Solutions come out better by working on, analyzing and acting on facts. Ideally, we need data, but even if data is not there, we need to create probability models, to come out with most likely outcomes.
Lean Six Sigma has known to improve processes and sure it has worked in software implementation processes. LSS methodologies are beneficial, even in HIS implementation in hospitals, creating client satisfaction (bang for the buck, as ‘go-live’ happening earlier) and vendor’s peace of mind (timely implementation means lower cost overruns and faster payments).