| | March 20179UTLOOK Healthcare Tech 15. Governance should not be a new experience as many difficult decisions need to be made in the course of the project.In thinking about my prior experience at the major academic medical center implementation, the above are success factors even when hiring a system integrator. The distinction is that many times the IT footprint at larger health systems in inherently more complex with many more customizations and a high degree of vertical integration. When to bring in a system integrator:· Decision making in the organization is decentralized · Requirement for more complex workflows and order-sets compared to out-of-the-box · There exists many different IT divisions in the organization· Desire to optimize current applications (compared to soft and hard freezes)· Systems are behind on upgrade schedules for applications that will be maintained· Low capability maturity levels in IT service managementOther considerations that may merit a system integrator: · Strength and experience of EMR vendor's implementation practice· CIO and IT leadership stability (especially strength of CMIO)· Low credibility or missing skill sets in IT· Little to no governance for IT/Business related decision making· Low consumer perception or perceived low credibility of IT support services · Competitive staffing market where high turnover exists or has potential to disrupt the projectWhen selecting system integration vendor it is important to know and understand the experience level of that service. Validation of the experience is required. The vendor should agree to provide a list of people who will be on the project. It is important to understand if the vendor team will be involved in multiple projects or focused on your implementation. Juggling multiple healthcare implementations by the same team is a red flag. Expertise in bringing in experienced individual contributors is also important. Many times the speed in which the integrator can bring resources to bear allows the organization to cut off problems early. When going alone, one of the major challenges is identifying trouble areas early and having the ability to mitigate issues, first with internal staff, then with contract services. When using contract services, we have experienced some hit and miss resources. Making sure contract vendors are willing and able to respond quickly to needs and concerns is paramount. A good knowledge turnover plan is important as disengaging with the system integrator is important after the project is complete. Another really important action for independent implementation is periodic independent audits of the project. The report should go to key board members, C-level and experienced contributors. We have been lucky enough to have three CIOs and one CFO from other hospitals participate on this advisory committee. HTWhen selecting system integration vendor it is important to know and understand the experience level of that service
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