Transcript
Patagonia Health 0:08
Pat, Hello, everyone. Good afternoon, good morning. Wherever you are, joining with us today, we are so happy you're here. Welcome to today's Health Solutions webinar hosted by Patagonia Health. Today's webinar topic is how to avoid pitfalls in health, its contracting, and implementation. My name is Dayna Riddle, and I will be your moderator for today. If you're not familiar with the GoToWebinar platform, look for the communications box on the right side of your screen. All attendees will be muted throughout the presentation. This box is your way of letting us know. If you have a question, feel free to ask at any time during the presentation. We'll probably get to most of them at the end. If you have been to one of our webinars before, you will notice this one is slightly different. Instead of having just one presenter, we are so lucky to have three panelists today, our subject matter experts with backgrounds in operational readiness, procurement, and implementation. They represent companies not affiliated with Patagonia Health, except that Don don is from Patagonia Health. The other two are not, but they will be sharing the best tips for shopping, implementation, and contracting. As far as getting new health IT solutions, we will begin with the official presentation. I guess I'd love to hear from each of you quickly how you got into the health IT space, and what you do now for health organizations. I'm going to stop my screen. Capri, do you want to go first? How did you get into this space? And what do you do now for health organizations?
Capri Dye 1:56
Sure, I actually think it was a fluke. I'm not gonna lie, you can read the funny story on my website too. But 20 years ago, I was approached by an organization and landed in the healthcare space. I'll be honest, it wasn't something I ever thought I would be in, but here I am, and again, for 20 years, it's been the thing that's kept me involved, excited and just really wanting to work towards the goals of the clients, from a federal level to our private providers. Currently, I own my own consulting firm and help organizations really work through their business processes, strategies, and especially the digital strategy, so making sure they're implementing and actually using the products they already have to the fullest extent. So that's me, welcome.
Patagonia Health 2:47
Great. Darren, what about you?
Darren Xanthos 2:50
Yeah, like everyone, I think I fell into this by accident. Probably. I was a clinician. I was a behavioral health clinician. I still am a licensed social worker. So, having started as a dinosaur, using notepad and a pen, and the pen would run out, and then eventually things like we'd start using things like Word, and, wow, that was really innovative. And then moving into actual electronic health records, I went into managed care, and wound up doing a lot of implementation of new, innovative clinical programs, which was awesome. And then realized very quickly all of those great ideas, you'd go to your IT team, and they say, you know, that's great. We can do that in two and a half years. So I wanted to learn a lot more about, really, that marriage between business clinical, you know, driving innovation, and really understanding capabilities, and finding that that balance. So now I do a lot of that. I have my own consulting group as well, and a lot of it is really just focused on business integration, of bringing all of these different components, administrative, clinical, financial, and really, how do we leverage technology to support the those business needs versus what happens a lot, which is the other way around. The business has to be, you know, accommodating to its capabilities it. So, I'm really interested in helping my clients navigate that and think about that sequentially.
Patagonia Health 4:24
That's me. Thanks. I love the switch from Word to EHR; it must be a pretty big change.
Darren Xanthos 4:31
It was very innovative at the time. WordPerfect to Word it was really cool.
Patagonia Health 4:35
That's great. Alright, Don let's hear it.
Don Sargent 4:39
Well, that's quite a leap. Yeah. Word to EHR, I shudder to say that I began in the healthcare IT space back in the early 90s when, you know, when forms burst, were still being purchased, and EDI was not yet a commonplace for healthcare. I. Modern banks and the like. It was a practice management world. It was still very revenue cycle driven in those days, and I felt like this journey, seeing it from really the advent of automating private practice and clinical spaces to today, has been a remarkable, remarkable journey. I've been on the client-facing side for the entire ride, initially as an implementation consultant, business consultant, account manager, and now into progressive leadership roles for most of my career, leading service teams in this journey. So it's been, it's been a lot of fun. Currently, I'm a VP here at Patagonia Health and customer experience. It's a perfect fit for me. Our teams do those things, we implement systems, we manage projects. We have a full-service client support team with help desk support and a proactive account management team. And I'm thrilled to be on this call today with Darren and Capri.
Patagonia Health 6:06
Great. Thank you so much. All right, Capri, I'm heading back to you with our first question. What advice do you have for organizations as they plan to adopt new health technology? For example, what can they do now, even before they start looking for solutions?
Capri Dye 6:24
So first off, find a beer or a wine that you really like. No, I'm kidding. I'm really kidding. I mean, it can be, you know, whatever. No, honestly, I think the biggest thing for me, and what I've seen, especially working with a lot of different provider organizations is that, if you can, and sometimes this is hard, stop bringing assumptions into the process and to the best of your ability, and it is not always easy. Please leave those past experiences in the past, bringing up maybe past experiences, procurements, and implementations that you were a part of that maybe weren't great, or maybe were excellent. When you're bringing those assumptions into this, you're already kind of starting a little bit behind where you should be.
I would also say, to help support, that they have a really solid project champion behind this, even in firms that only have a couple of folks, right? So I've worked with organizations that maybe only had two providers, but somebody does need to kind of own this process. It really needs that champion and that lead to keep that momentum going. It is another job on top of your already full-time job. And so having somebody that's there that can champion it can work well with the vendor and the process, as well as your teams supporting this, as it's extremely important in the industry. Um, another big one is, please don't go out looking yet, until you know your own processes. And I say that because there are a lot of times that when I was working for a vendor, I would encounter folks who called they wanted to learn more about my product, and my question was like, Well, what do you do? And it was all over the place, right? Nobody could really just fully describe it. A lot of times, maybe it wasn't the right person calling me, but maybe they didn't know, I would say, a lot of times, the tech guy at the operation gets stuck in this process to go find a solution. But your tech guy isn't always your end user, right? They're not the ones working with your clients, so to put them in this process is rough, and it's rough on them, too. So, really make sure you have the right team together.
That's it, that knows it, that they're in the trenches, day to day, doing the work, and can really help support what our organization does, and what do we need then to support it? Um, which then kind of follows suit? Do your due diligence and really define out and write out those business processes and workflows first again, don't do it. It's really hard when you call a vendor and say, Hey, I need all these things. And when we say, okay, great. Can you give us a use case or an example? And it's just not there. And so if you spend that quality time up front to really say what, what is it we do, and when I don't think about what the technology should do. What is your business process? Whether you have a solution or not, you still have to schedule an appointment. And so really take the tech out of that piece of it, so that you understand truly what it is your business does and how they operate. And again, make sure you're asking those end users.
Don't assume you know how your schedule or schedules work. Um, don't assume you know how your provider documents. Um, you really need to involve and ask them. And then I would say, probably finally, um, and I'll stop talking so my other panelists can chime in here too. But um. I think I remember that processes can change, and it's okay, right? You can evolve a process, and you can do so for the better, and please embrace the change. I know people in general aren't fans of change. We see that on a daily basis, right? But this is one of those areas where you don't necessarily want to recreate the same wheel all the time. You're probably looking for a new solution because you don't like the wheel you have. So why would you want to then recreate it? And so I would just say, going back to having that champion, not bringing in those assumptions, this is the same thing, right? This is also a time to embrace your change and to really have that forward thinking. What, what can we do? And then I would say, pick up the phone and start calling. Or, I guess, do people pick up phones anymore? I don't know. But then reach out to those vendors, because you have a better idea of, honestly, who you are. So those are my few tidbits.
Darren Xanthos 11:01
Yeah, I cannot. I'll piggyback on that, too, because I think, you know, you hit all the main points. It really is one of those. You know, getting an IT vendor is going to be similar, but, like, you know, buying a house or, I mean, if you don't know what you're looking for, someone's going to say, I've got this great turnkey solution for you. May or may not be actually, but if you don't know the difference, and you don't know the nuances in your business processes, your clinical needs, your reporting and your data, you know, I think what you described is exactly right, and what I see sometimes is folks may have mapped out, even if they have gone through the discipline of putting a Visio and a process map together for some of their really key what they don't map out are some of the exceptions, right as well, and those are the things that are going to trip you up, right? So you've got this really great EHR that does 80% of the work and 20% of it. You've got post-it notes on folks, you know, monitors, because of spreadsheets, right? Or Word Perfect, or what other things, because it actually is what you bought that doesn't account for some of the, you know, the no shows or the follow-ups, or some of the things that you don't really consider. So I would say that that's really one of the things that are going to be that could be very helpful, is don't just map out the usual, but also be very, very clear about what your exceptions are, things that need to be accommodated.
So, you know, I just think that, like, and then you also said something that was really important about change, the timing that it takes to either adapt or implement a system, a year or two years out. There's so much regulatory change that happens; there's so much business change. There's, you know, clinical and best practices that happen. So it's not enough to map out what is good for you today and what you're thinking about today. You have to start thinking two years ahead and start thinking about what we need to have. So when you're working with a vendor and thinking about that vendor, it's like, oh, here are the five drop downs that matter to me today, in two years, it could be 26 and we can't have a drop down, because we're going to have four different, you know, delegated entities that we're going to be working with, and so making sure that the there, there isn't a hard coded it solution, that there's modulation and adaptability for that future state, I think, is, is, and all that stuff you can be planning out long before, as Capri said, you make that phone call start to just get a sense of where are we going to be by the time we go live.
Patagonia Health 13:32
Great. Thanks. Don Do you have anything to add about you know, what advice can you give organizations regarding planning for for new adoption of technology?
Speaker 1 13:42
Yeah, I mean, I think that we've hit on a lot of the key pieces that don't always go into the procurement process. I mean, I think that's part of the blind side here, is that there's so much to consider beyond before you get to vendor selection that most organizations need that type of help, I say it's, it's fair game to cheat, hire somebody, or talk to someone who can give you the answers and get a little bit closer to you know, the center of the target when Choosing a vendor that is a fit for your organization. And as Darren said, now and in the future as well. And what we see also is within public health in particular, some trends statewide in a lot of areas, while county to county, there are differences, generally, if there's a strong influence within the state that can be leveraged. So talk to other like organizations as well. What are they doing? Who are they using? What did you do? What was their process like? And talk as much as you possibly can, because those peers are.
They are going to be valuable in terms of helping you down the path, at least initially, to get going in my role. From an operational standpoint, I've always been on the vendor side, and I'll always tell folks, once you've gotten to that point, we always stress a champion and an implementation team within the organization. The importance of project management can actually extend out into the beginning of the purchasing process. You may want to bring in a project manager early, prior to implementation. We always so frequently associate that just with the post contract. But it really could be someone you bring in to help early, to help develop that plan. We provide a project manager for new contracts and new clients with every single contract, and we found that it's with that assistance that our customers generally create a good plan, or at least enhance one that they may already have, and that fits in sort of is adaptive to some of our standard processes. And we point out to our clients that we do this, these types of projects all the time, so feel free to let us take the lead early and keep this momentum going from all this post-sales excitement. So those are things that we feel early on in, you know, implementation, once the deal is done, that help customers move forward. I think another key point, and one that may be more obvious, is understanding, and Darren mentioned that Darren and Capri both mentioned change.
These projects are a big change for everyone in the organization, and especially for the individual staff members. You know, people handle that change very, very differently, so understanding that that your teams will learn differently and the responsibility leaders have within the organization to provide all of the resources and the support that's needed, I think that it's critical early on in the process to be communicating with your teams and make sure they understand what's happening, that it's okay and that it's not A surprise when it does. It does come to be. But I would say this as well. You know it Patagonia Health, and if there's anyone on the call that's a client, we've always stressed, sort of the the three, our three legged stool concept of product, people and processes, and you're going to hear a lot of the same terminology, but from a product standpoint, that's really you know our expertise. We'll provide those software services, and we'll set it up and configure it and train it and take your users live, but that's our key piece, and making sure that that matches your requirements is critical.
But from a process standpoint, in our experience, it doesn't matter if you're coming from, you know, another EHR or migrating, you know, from a manual paper process, or even in some cases, both, there's typically an opportunity to improve processes throughout the organization. It could, as could be prementioned, be clinical workflows. It could be revenue cycle improvements. It could just be general process improvement. Our team, again, is a great resource for how other organizations like yours operate, both good and bad, and they're always happy to answer questions, but in the end, remember, all the decisions are really yours to make, and that's a key piece. Then lastly, the people component, yeah, it's a significant change to manage. You know, the potential for big changes in your organization will impact staff in so many different ways, and some will be energized and positive about it, and others will, you know, sort of not respond as you would like. We always ask our customers, you know your folks best, and as a leader within the business, making sure that they're engaged and that they have adequate assistance throughout the process is key. So those are just a couple of things, product, people, and process, which are critical. And this is the overall process.
Capri Dye 19:35
Yeah, Don, I'm gonna be sorry, Dan, I'm gonna jump in really quick. I just thought of something. We were talking project management, and I know sometimes, especially in smaller organizations, it can seem daunting or too like that's just too much for us. Because we're a smaller org, we don't have that many people to deal with. And I remember sitting in a kickoff with one of my former clients, and their lead person was going out on maternity leave. Yeah. And I just asked a very simple question: Is she considered an issue and risk to this project? And they're like, Well, no, she's perfect for the and I said she's going to be gone for six to eight weeks during your most important, critical piece of procurement, um, you know, and, and all of a sudden, the I remember the team kind of looking at me. I'm like, this, this is kind of some of that project management, right?
Like you also have to think of some of those just outside your scope, things, you know, so if you are bringing on team members, but you know, it's simple questions, like vacation time. Is somebody going out to have a baby? You know? Are there conferences coming up that could actually impact your ability to get this work done and, and I think project management even on that, from that component, you know, not not the PMBOK, you know, structured, but even just being able to think outside a little bit there too, to, are we really ready to take this on? You know, that is a component of project management that the organizations and end users have to think of, too. And so that was great to bring that up,
Don Sargent 21:01
And it's an education. You know, they'll there are a lot of methods to help folks understand that, you know, these aren't quick projects, and to do them correctly. And where we see success, there's a plan, there's good leadership, and working backwards, sometimes from an expected or an ideal go-live date. You know, the process to realize where that contract needs to be or where that project needs to be initiated is key. But I think that there's a lot to learn so early in the process. Again, I'll say it again before vendor selection, and that will help a lot of groups have more success after they've created a contract. I think that's a key point. That's the key takeaway.
Patagonia Health 21:55
Darren, do you feel like, as the behavioral health expert, I guess, in their room, do you or the most experienced, I guess? Do you feel like there's anything here that's in behavioral health, or is there something else, or is there another layer to it? Or do you feel like it's kind of the same for all the markets? No,
Darren Xanthos 22:13
Well, no, it's a good question. I think BH specifically, because we're special, and we see ourselves that way, and it's very unique, I mean, so there's a lot actually for BH organizations to kind of consider above and beyond. So things like just basic screening and assessment tools. We love to risk-stratify. We love to throw PHQ-9s and GAD-7s and all kinds of things in there. And we like to change it, like, oh, let's do something new. Let's look at, you know, those kinds of measurements in different ways. So there. So that's one thing, just like understanding a biopsychosocial assessment with your EHR vendor and being able to map that out and say, not only is this what we want to do today, but we're moving towards integrated care. So we want to be able to understand, how do we pull in med records from physical health and labs and specialty and all of those kinds of movement I think, BH, traditionally, you know, I'm thinking of mental health, but also, Sud, a lot of care coordination, a lot more than that's on the physical health side. So there isn't just, you know, care coordination of I've got your record.
It's integrated care teams and shared care planning. There's a lot more kind of touchy feely that needs to be part of that medical record that, I think is, you know, those are, you know, clinical protocols that we're talking about when people come in for services, having clinical practice guidelines that are part of that record that would say somebody, you know, these are all maybe related to HEDIS in some way, but with particular Diags, they've got a diag of schizophrenia, and now we've got to do particular monitoring or antidepressant medication management. How can your health record actually help support that? So it's not just a manual clinical lift or feeling like it's, you know, the arbitrary, based on the knowledge of a clinician, the record can actually help. And those, those are the kinds of things that are somewhat unique to BH, the other one that I see a lot of it, and it doesn't always apply, but we like to get paid in really weird ways. And so the states traditionally, with government payments, you know, they will say, Oh, for SMI, you know, Bill, this is your payer, right? And they're gonna have a carve-out for mild to moderate.
They're gonna have a carve out for different and what gets really confusing for agencies and for organizations is to say this person comes in, I may be, you know, good enough to understand what level of care they are, and now how's my system actually going to follow it, from my assignment of their level of care all the way to my assignment of a clinician, all the way to the to the revenue cycle of it, to the billing and making sure that I'm. Billing the appropriate payer, because otherwise you're chasing it in revenue cycle, and all you do is say, I guess this is a never bill, because I keep getting denied, and I don't know why, and that becomes really challenging. So things, and I specifically things like Medicare, right? Medicare has specific rules on what clinician types can actually provide services and get paid. A lot of folks don't know that, or it's not connected in the system. So, if they're fail-safes in your electronic health record, as you're assigning patients or clients to a clinician, are they a social worker? Are they Medicare as their primary payer? Sounds good. Let's move forward. We can get paid for that, and if they're a marriage and family therapist and Medicare doesn't recognize that, that's not a good place to be, right? And so I think being able to leverage the EHR for some of those weird, funky nuances that are specific to BH is really helpful. And then I'd say the last point is probably the most important thing, things like privacy, and we like to have different rules and BH around privacy, HIPAA, CFRs, and, you know, Sud and all of those kinds of shared records. So there actually needs to be things like firewalls in your health record that not everybody in your clinic needs to know on a need-to-know basis. So, you know, we don't want to recreate the Britney Spears situation, where folks are, you know, we have access to it, but you shouldn't, right? And so you have to really be working with your vendor to make sure you understand. What does that system look like? You're going to get audited. You're going to not just, you know, get lucky and not have a breach, but you're going to have to show that your system structures and processes are all set up to ensure that those things don't happen.
And so I think that that's, that's really an important piece that's unique and and the physical health side, obviously, HIPAA applies, but the BH side applies at a much different level, and it's somewhat state specific, but they're, you know, you know, I go to the pharmacy and they yell out my name and my prescription, and everyone seems to be okay with that. That is not okay on the BH side. So I think there's a really good opportunity for organizations to work with the EHR vendor to make sure that specifically, this is not a off the shelf a we use this for a bunch of primary care sites, and we, we think it applies that's going to be a really important piece, because of the regs related to that, and obviously the the dignity of your clients. There so
Patagonia Health 27:29
Great points. Thank you. So let's shift a little bit to post go-live. Um, maybe starting with Capri, what advice would you like to give to organizations post go-live? A lot of people think of that as go live, as the end, or we're just trying to get to go live. We're trying to get there, but in reality, that may not really be the end. So could you talk a little bit more about that?
Capri Dye 27:52
Yeah, so first of all, have yourself a celebration, right? I mean, it is, you know, and Don said it too. Darren said it too, like it's a process, right? It's a lot of time, especially when, again, you already have a full-time job, right? And the folks in your end users at your organization, who are all part of this, have been giving more of themselves during this process as well. So, definitely make sure that you celebrate. However, that celebration is almost a kickoff celebration too. It's not the end. And I, not to scare you, however, what I'm saying is that it's not the end, it's just that, you know, this is a relationship. You've probably signed a three to five-year contract with this vendor, right? Maybe first, you know, six months to one year has been the implementation to get to go live, but you still have a contractual relationship with that vendor, and so don't look at it as like, great. We're live, see you later.
It's been nice knowing you, instead, really start building, and I would say from day one that you're signing that contract, right? Start building that relationship. And honestly, in my opinion, that full-on partnership, this is a group, the vendor is an organization that is supporting your organization. And so just because you're alive, don't let that end right? You guys are both kind of responsible for each other's success, in a way. And so it really becomes a partnership, not just a check that's getting cut monthly for how many end users you have, or how many lives you have in a database. But really make that a real, like an actual relationship there, many of the vendors, and I know Patagonia does this, as well as some of the others that I've worked with, you know they they offer opportunities for their clients to be involved, like on a regular basis, right? Whether it's monthly calls, events, or conferences that they put on to really keep that activity level between their clients. Join those who don't always have somebody on those calls. A lot of times, they're giving away some great tips and tricks too, that you know, and discussing kind of what's coming down the road. And. So you definitely want to stay involved. An organization that I worked for did monthly calls with all the clients, like, Hey, how's it going? You know, what's going on, what's going on with you?
And it's those important moments that you, as an end-user organization, should really be telling the vendor what you have coming down the road, right? So if you have a road map or an idea, or you're changing or adding services, you're adding or potentially reducing staff, you're looking at a merger with another organization, or expansions. You're going to another location. Like Darren brought up a prime example. Like every state has a little bit different version of HIPAA and regulations, and if you're moving into a different state with your organization to offer services there, like those, are things that the vendor also needs to know to kind of help you with, potentially adjusting workflows or configurations in your your setup, especially in rev cycle, right? And so make sure that you're very vocal as to what's going on in your organization as well. Because one of the things that it will help do is it also helps vendor plan out their roadmap. Like, if there's a lot of their clients saying, Hey, this is the route we're going, that vendor potentially, I would see saying, Hey, we need to build out this way too, because the majority of our clients are going down that road.
I mean, telehealth is a prime example during the pandemic, right? Every single vendor overnight offered telehealth because they had to, and when you have a mass of people saying, hey, we need this, they will listen, but you do have to remain active with them. And I also, from a vendor perspective, like it was really important when I worked with a vendor to know again, what my clients were planning, because we needed to make sure that we were ranked up right. I mean, staffing kind of goes both ways. And I'm sure you guys have experienced this too, that just knowing a client is potentially adding staff, merging, adding services, like there could be resources needed on the vendor side, that just having that heads up is just imperative. So those would be my few things to you know, think through, and again, it's not the end. Go Live is never an end. It's just you're live.
Darren Xanthos 32:10
Yeah, I used to tell them, I still tell my clients for all implementations getting to go live, and the planning for go live is getting to the top of the mountain, which is great, and then you have to hike back down, right? And so, you know, you think about this, you know, it's equally challenging to go back down, and you've got to plan ahead for that. And for me, part of what that means tangibly is, how do you set up, not just, I mean, everyone has key performance indicators and service level agreements that you know, those kinds of things, long term and ongoing. What are your go-live KPIs, and how quickly are you setting up structurally? You've got huddles twice a day, and you're looking to make sure the phone systems are integrated with your scheduling, and that you know. So you're talking to those smees, and you're huddling quickly, and you've got your vendor partner there, and you're, they're committed through the a warranty period that says, Yep, you know, we know, because the tough ones go live, things are going to be broken, right? It's just like, it's like, a way, right? You know, stuff is going to go exactly to plan, best laid plans, that's going to happen. Can you minimize that? And can you be aware of it, because you can fix all of these things that aren't necessarily working, but how quickly and in real time? So that takes the preparation.
And then, as you said, that long-term approach with a vendor is really moving from that, you know, intense two-period we're doing huddles twice a day. We're making sure that the claims are getting accepted, and then they're getting paid, and we're starting to look at all of those, those kinds of things, and then moving that into a maintenance of business, so there doesn't need to be that level of attention. And all of a sudden, instead of this manual making sure stuff is working, we take a step back, and things are somewhat more automated in any workarounds that we have to do for day one, we have integrated into a more seamless system for our day two and maintenance. And I think that that that's that hiking down the mountain, and then, you know, now, it's just part of our normal book of business, and you can start thinking about innovation and moving forward from that particular platform, but those that's, you know, such an important piece, because folks think that it's like, go live, we're done, right? And I think, for my clients, working with vendors, you've got to make sure that they understand that they're part of that partnership for go live as well, and get that commitment that they, you know, if they can be on site with you, that's ideal. But whatever level of commitment they can commit to, I think that's going to be important as part of your engagement with a really good vendor. So,
Patagonia Health 34:54
Yeah, Don hear what you want to get that. Yeah,
Don Sargent 34:57
I agree and on the. Underside. It's very important for us to set that expectation. That's the first thing we do. We say all the time, go live somewhere in the middle. This is where all the metaphors come out. I love the wedding metaphor. That's perfect. I've always said it's about production, not perfection, right? Like, we've just got to get going, and the best input and feedback that a vendor gets is from clients who are in production in those first six months. It's like a new hire, right? You want to what you want to learn as much as you can from folks that have fresh eyes on your product and your process, and then try to bake that in going forward. And so it's a valuable new clients are a valuable asset to vendors and understanding also what's changing in the landscape out there, in the industry that is now being considered that maybe wasn't before we do a webinar series, and we we learn a lot of these things, and then clients are their own best advocates. So I we like to do statewide user group meetings, and where we have states that work together and that are engaged their level of building roadmaps and being proactive about what they need and what to ask from us is much higher, and the timeline we have to deliver and make sure that they're taken care of is more appropriate. And there are a few urgent things, I think it's another process, too, of the knowledge transfer piece that is also part of the post-live. Like, I think we say learning an EHR is like learning a musical instrument. Like, you can kind of bang on the keys and play a song, but you don't get any finesse.
You know, it takes a lot of practice. You've got to have a lot of playing time to get comfortable or to get any good, but it isn't that it's hard, it's that you're learning. You know, there's a big distinction there that these things aren't necessarily hard; they're just an educational curve that we have to get through. I mentioned it before, people, the people aspect is huge, right? People are learning at different paces. People are going to have different needs. Posts go live again. Some come with energy. Some will be resistant, so knowing the teams and knowing how to anticipate who will need hand-holding and who's actually going to be on the ground as a knowledge transfer agent, leading from sort of street level, is good to know as early as possible. Those are the folks that we like to identify on our implementation teams, the individual contributor who can lead you know at ground level and help other users through that critical time at go live. I mean, I think those are really kind of critical. I might just add, keeping momentum going, you know. And Darren mentioned kind of cresting the mountain, but you have to keep hiking.
And it's so true that the lessons learned from go-live are exciting. We just had a very large go-live recently, and I think I went from elation to back down to Earth on the car ride home, right? It lasts a little while and we celebrate, but there's more work to do, and so there'll be another milestone. I think having those KPIs creating an extended project plan past go live, with other thresholds to cross and achievements to celebrate, is critical as well. While go live is a big one, it's just one of the significant key milestones to realizing a return on your investment and success with the adoption of technology. And then lastly, it's really about building self-sufficiency and confidence with the tool. We need the users to tell us that they find it easy to use, that their improved outputs with their, you know, their work are of higher quality. I think that, you know, user end user acceptance, to me, is really the test we can get through a lot of thresholds, but until every everyone's really identified as Okay, and their ideas have maybe been brought forward to me as a client advocate, that's really the ultimate test.
Patagonia Health 39:56
Great. Thank you so much. We only have humans. Minutes left, but I wanted to get to our questions. So let's see. Here we go. If you see my little question slide, feel free to put any questions in the chat while we are answering them. The first one I'm going to get to start off with is, what are, I mean, you guys have already kind of talked to it, but I guess if there was, like, three top reasons why an implementation doesn't go well, because, you know, and there's a bunch of people, and there's a vendor, and there's the client, but if it was on the client side, what are the main reasons why an implementation wouldn't be successful. What are the main pitfalls?
Capri Dye 40:47
I mean, early, early buy and truly from all of those end users, right? I kind of alluded to it, like, you know, you have somebody leading this project on the client side that maybe doesn't necessarily know what everybody does. And so again, how can you go procure something and implement something when you don't know what's all involved? And so having having that right team, I've been in numerous sessions before where I've heard maybe a supervisor say, I know what my team does, and then, I'm not gonna lie, you have some smirks in the back of the room from the end user, the, you know, the true day to day end user of maybe that module or business process, and and me as a consultant, when I hear that, I'm gonna go find that person in the back, and I'm gonna talk to them a little bit about what, what they do, right, what their day to day is. But I would say for those organizations like that, that is something you should be doing. And it really goes back to having the buy from the team, going back to that champion. Because when you do get to go live like you want, all of your end users say, I had a part in this, and I think a pitfall is when you don't have all the right folks in the room.
Darren Xanthos 42:05
Yeah, I think, I think, I think miscommunication or lack of communication, is important and and usually it's an important to make sure that the client is really clear and articulate, and a lot of times we, you know, as clients, don't feel like we want to push the vendor like into all of the things that maybe they're uncomfortable doing. And so there's sometimes a disconnect, too. I remember attending a couple of different demonstrations, and the client did so much delegation. They did some portion of electronic health record where they were doing direct service, and a lot of it was administrative, and they didn't feel comfortable letting the vendor know that. You know, this is good for like 20% of our business from a direct service perspective, but we really need to understand your administrative and delegation capabilities so that we can do oversight, never came through, and they tried to move forward with this relationship. And it was really, I feel, unfair to the vendor, because they didn't really understand what they were, what they needed to sell, right? And so that didn't end well. But it was really like, you know, we need to put cards on the table, up front, on both sides, and really be able to say, you know, can we do this? You've got to give the vendor an opportunity to be open and transparent with what their capabilities are as well. So I think, you know exactly the kind of piggybacking, what you said, Capri likes it. Not everybody's in the room, but then some folks are in the room, and they just don't, well, I'm not it. So I don't know if I should say this. I don't know if I'm the right person. Somebody else must know this better. So if they're not saying it, then it must. I must be crazy. And that's not usually. Nobody knows what's going on. So I think that happens quite a bit. So yeah,
Patagonia Health 43:56
Those are great points. I guess this last question will be for Don. Um, what advice would you give to really small health departments, small teams, where they kind of feel already spread thin, and this seems very overwhelming to be able to have somebody delegated to be in charge of this type of project or something like that? What advice or encouragement would you give to small teams?
Don Sargetn 44:24
It's a great question because we've implemented a fair amount of small public health and a lot of small Behavioral Health Agencies, and I look at the behavioral health side first, it's a small business first, and then, you know, and their revenue cycle is so critical. So we could break those projects into phases. If we needed to, we could reestablish, go the old school route, reestablish the revenue cycle, and then come back in with a clinical. Process on on top of it, which gives the client the importance of re establishing the cycle, maybe taking advantage of the tools that we have on the back side of the product, and more time to establish a better understanding of what's needed on the clinical workflow side with public health, we see a lot of folks that wear multiple hats all the time, so the same people have to be in all the meetings. So that's part of us listening up front. We'll consolidate the process. We'll conduct multiple operational type reviews with those teams together, we'll break things up and do more of a remote process approach, where we can give them smaller, digestible pieces at a pace that suits them as well. But we also want to make sure that the first thing we do is provide them a very good operational demonstration of the system to make sure that they understand that that it it's achievable, and then it's not overwhelming, and that what they need can be extracted into a first phase production level go live, and it can be done and not be overwhelming, and that their path can be custom to them. We can still honor our process, do all the steps that are required, but do it in a way that's tailored to their size, their pace, whatever their pressure points are. So I'd say, ask those questions, Darren articulated it. Well, we don't know what we don't know. So, being prepared coming in with what your needs are? How can we best serve you? It will help us create a plan that will work for everybody.
Patagonia Health 46:53
Great. Thank you so much. Thank you so much. Don Yeah, that is all the time we have big thank you to our panelists today, and thank you everyone for participating and for your comments and for attending this webinar. If you would like to get in touch with our panelists, you can contact them at the emails listed on this screen. Also feel free to shoot me a comment or an email if you would like a copy of those emails. It's dxanthos at x health solutions.com Capri dot die at CSD health. It advisors.com and then don at Patagonia health.com if you would like to learn more about Patagonia Health and our integrated EHR practice management and billing solution. Visit our website at Patagonia health.com or email Sales Marketing at Patagonia health.com Have a great day, everyone.
