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Issue Date: May 2007
Views on Technology


IMPROVING THE CHANCES FOR SUCCESS
One agency's experience with software implementation highlights what others can do to make it a smoother process
by MARLOWE GREENBERG, CHIWONISO KAITANO, and RACHEL MILLER

With the recent growth of behavioral healthcare software options on the market, more and more service agencies are taking the leap from paper-based record keeping to electronic record keeping. Some agencies have sailed through this complex transition with relative ease, while others see their software implementation projects winding down to nothing or hitting any of several walls.

What makes the difference between success and failure? What we're learning as we work with agencies to implement our case management software is that it's not the software that fails. Selecting a product, although an important decision, is really only the first step in a much larger process. Implementing a new electronic record-keeping system can be a profound change that goes to an organization's core. As such, a software implementation should be meticulously planned and monitored.

Yet even a great plan can fail. To find out why, we conducted a study in collaboration with one of our customers. The agency had successfully implemented our software in 28 of its 32 programs. While the four remaining programs provide a range of different services (including supporting seniors and substance abuse recovery), each was faced with the same software implementation challenges and theoretically had access to the same agency resources as their more successful counterparts.

Although each program had begun the software implementation process with a strategic plan, various unresolved issues ultimately unraveled those plans in the four programs. In some cases, the programs abandoned the software implementation process and reverted to inefficient and time-intensive paper record keeping. Our study revealed five key areas (outlined below) that, if addressed both before and during the implementation process, likely would have resulted in more positive outcomes for these four programs.

1. Change Is a Force for Good

An agency can gauge the probable success of the implementation process based on how change management issues are addressed at the executive level. Our research found that the programs with the least success with the implementation process had failed to embrace and effectively manage the change process. A well-executed change management strategy can mitigate some of the effects of implementing an electronic system and also help track project goals. Based on our findings, our recommendations for effective change management include:

Address the “human factor.”Acknowledge that some job responsibilities will evolve and shift based on the needs of the implementation process. With this in mind, select an implementation team that includes strong representatives from each major functional area of the agency, and provide this team with the necessary authority to make decisions.

Transparency is key.Create an environment in which concerns about the implementation process can be articulated and addressed.

Be proactive.Develop an actionable implementation plan that includes deadlines and institute regular follow-up activities (i.e., meetings, reports) that allow for monitoring progress.

Reward success.Create an environment in which the staff feels actively involved in the decision-making process and reward successful strategies.

2. Knowledge Is the Key

While skill level and/or comfort with technology do not necessarily inhibit implementation, knowledge about databases and the specific software being implemented often is lacking. While staff may be familiar with the technology's basics, many are unclear about the use and usefulness of an electronic data management system—especially line staff. More often than not, these end users do not understand the full range of features in the software or how it can fundamentally improve their day-to-day work life. If these employees, who make up the bones of the agency, feel that the software is of little help to them in their daily jobs, they will not use it, and implementation will grind to a halt. Closing this knowledge gap will have a dramatic effect on staff's willingness and ability to utilize the software. Move forward with knowledge building fearlessly, taking into account these steps:

Train, train, train.Provide frequent, targeted computer and software training opportunities as needed. Bring computer-illiterate staff up to speed with specialized beginner classes.

Initiate an internal education program.Take advantage of information resources from your software vendor, such as listservs, online help manuals, and customer support services. Encourage active learning and reward staff members who show initiative.

Benchmark.Use successful implementation examples to mark your progress. Encourage cross-program communication for knowledge sharing; your best resources are the staff members who have gone through the implementation process and are using the software.

3. Get in Sync

Understanding the alignment between the software and program/agency processes is critical to a successful implementation. Agencies often assume that the software will meet 100% of their record-keeping needs or, at the other extreme, that no available software can meet what they view as unique data collection/reporting needs. Neither of these scenarios accurately reflects reality.

A balance can be found between the unique needs of different agencies and functionality that software vendors can develop for agencies that have similar needs. Based on the experience of the customer in this study, these false perceptions can be managed; it is simply a matter of effective communication between the agency and software vendor.

Communicate with your vendor.Do not assume that the integration of your paper forms into the electronic system cannot be done. Use the software vendor as a resource and remember to share existing forms and reports and to voice any needs, concerns, and issues.

Educate your vendor about your process.Expect several on-site days with vendor representatives in which they can speak to program/agency staff and observe existing processes and data collection/reporting methods.

4. Take a Look at Yourself

An implementation will be derailed if any lack of resources is not addressed. Crucial to a successful implementation is measuring whether your hardware and staff resources are adequate for such a complex project. Resource deficiencies have to be planned for and addressed proactively. Devote enough resources (hardware and trained staff) so that all programs have the necessary tools to manage this complex process.

5. Lead the Way

Leaders' negative attitudes can be infectious, often trickling down and creating negativity in the program/agency culture and among staff. It is critical that leaders visibly embrace change, as well as squash any negativity from the get-go. An executive mandate from the highest levels is helpful in stressing the importance of the implementation to agency staff. In addition to instituting a program/agency mandate to implement the software, consider the following:

Culture is key.Focus on promoting a positive program/agency culture that seeks to embrace change and fosters a team-building spirit.

Be seen and heard.Remember that leadership should maintain a highly visible role and presence during the entire implementation process. That management is seen to be engaged and “hands-on” in the process is critical in communicating the right message.

Conclusion

A strategic plan that encompasses these five key areas will help a program/agency navigate the challenges faced during the implementation process and increase the likelihood of success. Although implementation milestones may be achieved along the way, true implementation is an ongoing and dynamic process. A successful implementation will reflect the agency's continued growth and ultimately result in a robust organization free to focus on effective service provision to those in need.

The authors are with Foothold Technology, Inc., a vendor of Web-based behavioral healthcare software headquartered in New York City. Marlowe Greenberg is the CEO, and Chiwoniso Kaitano and Rachel Miller are Client Support and Implementation Managers.


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