By David Berger, MD
In this episode on helping digital startups sell their solutions, I want to focus on the issue of implementation. It is certainly important to have a wiz bang digital solution. Equally important is how to implement the solution and manage the changes it causes. All startups should understand the concerns the hospital C-suite has around the implementation process. Specifically, the startup must be prepared to answer the following:
Is the company going to take responsibility for all the administrative hurdles including the IT security approval? Customers want assurance that the company is going to answer all inquiries and assist with completing documentation. Additionally, customers will want the company to track the progress of all approvals and follow up as necessary.
Does the company have previous experience with change management? Although the hospital may have a performance improvement team skilled in change management, it is important for the company to have people who also understand this complex process in order to work collaboratively.
Is there clear understanding as to the responsibilities of both parties? It is obvious the signed contract must clearly document what part of the implementation process each party needs to cover. Conflict can arise if something unanticipated comes up during implementation. In this case the company must be prepared to accept responsibility to move things forward.
Does the new digital solution increase work for people required to use the system? This can be the death of any digital solution. I have seen a patient flow system fail because the system required the patient’s nurse to indicate that the patient was discharged. Once the nurse identified a patient was discharged they were then assigned a new patient. This created a natural disincentive to trigger the discharge event in the system resulting in poor system use.
To ensure a successful implementation the digital company must also ensure that the hospital (system) is ready for change. If the organization is not properly prepared the implementation is likely to fail. This will result in a waste of scarce startup resources and negative publicity. Ariadne Labs has established a framework to evaluate organizational readiness for change and startups should consider using this framework. These are the key issues the startup should use to evaluate any potential early customer:
Is there clear leadership commitment for implementation of the proposed solution?
Is there organizational capacity for implementation or are there other competing priorities?
Is there a well-established method for process improvement and change management in the organization?
Is there a culture of successful change management within the organization?
If the answer is no to any of the questions the company must evaluate if they can provide the missing elements. If there is any doubt that the company can resolve the issues, they are better off walking away than risking a poor implementation.
The final issue concerning implementation that the company needs to resolve is whether the hospital leadership understand that the product is not a finished one, and whether they are willing to work together to improve the product. Digital solutions are usually not “finished” products. They require testing in real world settings to get it right. Companies need to make sure that this is understood and that the client is committed and able to work with the company to iterate the product and optimize it.