Enterprise Resource Planning: Critical Factors for Increasing End-User Adoption

The following is a guest blog post by Mark Muddiman, Sallie Parkhurst & Maureen Tellefson from Atos.

Healthcare organizations continue to be bombarded with technology implementations that span every critical path in healthcare, from clinical applications to business processes.  EHR implementations alone increased over 75 percent from 2009 to 2015 (NCHS, 2015).  The change continues at a pace that makes adoption of these systems a difficult journey for IT leadership, administrators, clinicians, and the teams who support them.  Mergers and acquisitions within healthcare are at an all-time high.  Acquiring or being acquired requires system consolidation, new technologies, and decisions about workflow and training.  Sharing the lessons learned from successful implementations will drive improved outcomes and create a better understanding of the factors that contribute to successful adoption.

Surgery Partners, a leading operator of surgical facilities and ancillary services, continues to grow both organically and through acquisitions.  With financial systems at end of life, Surgery Partners worked in partnership with Atos to select a new ERP to help manage their business.  ERP systems play a critical role in the transition to value-based care.  About 69 percent of IT leaders said they will prioritize healthcare supply chain in 2017 as “the most valuable asset for actionable data mining” rather than population health and data analytics tools (Black Book, 2016).  Surgery Partners engaged Atos as a consultant to assist with a thorough system selection that would best meet their needs.  The resulting strategic decision was to implement Infor Lawson to replace all legacy systems for Finance and Supply Chain.

The multitude of challenges that arise during large technology implementations are rarely captured, but can provide significant value when shared.  The leadership team at Surgery Partners was highly engaged and disciplined in how they managed and measured adoption of Infor Lawson.  They utilized a research-based methodology, The Breakaway Methodology, published in a book titled Beyond Implementation: A Prescription for the Adoption of Healthcare Technology.  As their partner, Atos provided expert guidance in navigating the adoption process and measuring the work outcomes according to the methodology.

Surgery Partners understood that their business had to overcome a few unique challenges during their implementation.  With hundreds of users spanning 20 locations in 12 states, their geographic footprint made it challenging to educate their employees on the new Infor Lawson solution.  Traditional classroom training is expensive and time-consuming when users are spread across multiple locations. And, without proper training, many ERP system implementations fail.  Instead, Surgery Partners used a novel approach based on The Breakaway Methodology to educate their employees on Infor Lawson.  Atos developed “simulators” which allowed every user to practice relevant tasks and workflows in a realistic environment that mimicked the actual system without compromising real application data.

Atos and Surgery Partners measured the effectiveness of this novel approach throughout their implementation and continue to measure these factors post-implementation.  Eighty-seven percent of employees assigned to the supply chain learning completed their education and 69% of employees assigned to the accounts payable learning completed their education.  In comparison, less than 60% of employees typically complete traditional e-learning.  More importantly, the employees who completed the supply chain learning achieved an average proficiency score of 94% on challenging, workflow-based assessments in a simulated environment.  Employees who completed the finance learning achieved an average proficiency score of 89%.  In addition, users were asked to rate the quality and effectiveness of every simulation.  Based on 656 responses, 94% believed the simulator courses were valuable to their role.  Eighty-eight percent indicated that the simulations provided the knowledge they needed to perform key tasks in the new system, and 90% would recommend the simulations to colleagues going through similar implementations.

A key component of Surgery Partners strategy for managing change involved engaged leadership.  Executive leadership communicated messages to learners that were jointly developed with Atos.  Varying levels of leadership, from Senior Directors through local leaders, were selected as adoption coaches to assist learners with questions and direct them to the appropriate resources.  This approach that was defined as leading by example, set a tone throughout the organization that the adoption of Infor Lawson was imperative and that leaders were there to ensure success.

Achieving ERP adoption also requires continued investment long after go-live.  Surgery Partners developed standard processes to re-examine workflows and continue to educate users on changes or modifications due to system upgrades.  Adoption of technology often erodes over time due to employee turnover, so they put programs in place to teach new users how to use Lawson Infor and develop the same high levels of proficiency in the system achieved during the initial implementation.

Technology adoption creates significant changes in workflow, resource needs and overall governance.  Surgery Partners knew that simply installing a new ERP wouldn’t be enough; to realize the value they expected from the purchase, they had to ensure that every user across their organization successfully adopted the system.  The results Surgery Partners experienced provide important insight for other organizations going through similar technology implementations.

Recommendations and Best Practices:

  • Align business needs and vendor capabilities using a disciplined vendor selection process. Surgery Partners understood the value of selecting the right system and following a disciplined process for achieving adoption.
  • Executive engagement is a significant predictor of implementation success: prioritize the effort across the entire organization, remove organizational barriers, and develop a communication strategy.
  • Lack of training can cause failure. Provide role-based education that is relevant to user roles and allow users to practice realistic workflows. Simulation learning saves time and results in higher user proficiency.
  • Customize your policy and procedure learning. Implement best practices for specific procedures consistently across all locations, and ensure that the simulator training reflects best practices.
  • Develop a plan to sustain high levels of adoption after go-live. Surgery Partners updates their learning regularly and educates new employees to prevent erosion of adoption over time.

“We were highly committed to adopting Infor Lawson and we appreciated the guidance, leadership, responsiveness, and  expertise of the Atos team.” – Cathy Borst, Senior Vice President, IT.

“The learning has gone very smoothly.  I think this has been extremely valuable.”  – Rick Daniel, Senior Director of Supply Chain and Materials Management at Surgery Partners.

Thank you to the leadership at Surgery Partners for their dedication to this project: Cathy Borst (SVP of IT), Chris Vandercook (Director, Technical Services Hospital Division), Sallie Parkhurst-PM, Carol Mortimer (SME), John Hart (CFO), Kara Baker (VP Finance/Corporate Controller), and Doug Watkins (VP of Supply Chain Management).

About the Authors
Mark Muddiman is an Engagement Manager for Breakaway Adoption Solutions, Atos
Sallie Parkhurst is a Project Manager for Digital Health Solutions Consulting, Atos
Maureen Tellefson is an Engagement Manager for Digital Health Solutions Consulting, Atos

About Atos Digital Health Solutions
Atos Digital Health Solutions helps healthcare organizations clarify business objectives while pursuing safer, more effective healthcare that manages costs and engagement across the care continuum. Our leadership team, consultants, and certified project and program managers bring years of practical and operational hospital experience to each engagement. Together, we’ll work closely with you to deliver meaningful outcomes that support your organization’s goals. Our team works shoulder-to-shoulder with your staff, sharing what we know openly. The knowledge transfer throughout the process improves skills and expertise among your team as well as ours. We support a full spectrum of products and services across the healthcare enterprise including Population Health, Value-Based Care, Security and Enterprise Business Strategy Advisory Services, Revenue Cycle Expertise, Adoption and Simulation Programs, ERP and Workforce Management, Go-Live Solutions, EHR Application Expertise, as well as Legacy and Technical Expertise. Atos is a proud sponsor of Healthcare Scene.