Enter the decade of Hospital 4.0.  It would make sense that the back-office operations of healthcare across America also receive a 4.0 upgrade.  Hospital 4.0 was to be realized in 2020 by most predictions and involves IoT, AI, robotics, data and analytics, 3D printing, virtual reality and ease of access.  For the last few years, the pace of innovation around healthcare from a technology perspective has been fast and furious.  You may think, finally, healthcare is going to change and improve.  While the expenditure of all this energy into healthcare is for sure positive, many organizations are left overwhelmed and without an overarching strategy to take advantage of it.


The ERP landscape is a place of change as well.  Most systems have matured to platforms that are primarily cloud-based to take advantage of the scalability and lower cost.  That alone isn’t very exciting, but it is when coupled with enhancements like global dynamic ledgers and robust modules such as grant management, lease applications and analytics geared to a role.  Add in the layer that’s being integrated such as robotic process automation (RPA), voice integration with Alexa or Google, chatbots and assistants and now you have something that can change the way we work.  What do I mean by that?  Change the way we work can mean so many things, but the digital transformation I am interested in relates to employing technology that allows us to take the mundane and give it to a digital worker, so our employees can do more meaningful tasks.  If you picture an employee who spends the bulk of their day creating reports, moving files, or entering data, that can’t be fulfilling to them. They would much rather be helping your customers and patients or working on the next new service line, etc.  To understand how this benefits the organization, one must think about the cost avoidance of being able to free up current employees to do future tasks without having to hire more people. In simple terms, do more with less.

In general, ERP has evolved since the last implementation of software companies did 15 years ago to now be process-based.  But, Unicorn, I was just told everything was role-based?  A role relates to the function a user does within the application or in their job, for sure.  What I mean by process-based, relates to how the ERP and tools like RPA look at the end to end process to create the automation necessary to free up the role to do more meaningful tasks.  I can map a process, and it begins and ends across many roles.  Very rarely does a process start and end with one person.  The software has matured with tools beyond API and integrations to now be human-assisted or totally automated.  Leveraging tools like OCR we can take forms and data and carry that in an automated fashion through the lifecycle in the ERP.  We can take an applicant, from candidate to hiring to benefited, etc. without typing in our ERP.  We can create a chatbot that talks to our candidates and answers most questions employees have like PTO balances, etc. thus creating capacity for our employees to help them with more meaningful tasks.

The opportunity to rethink processes now that we have technology lightyears ahead of what we had when ERP in healthcare was last implemented.  In the culture when healthcare is trying to do more with less and lower overall costs across their organization, I challenge you that the money is in the back office, not the clinical space.  We just came out of the age of EHR and those processes may need revision, but they generally are newly designed leveraging the latest EHR technologies and systems.  ERP has long been the stepchild and in that time the processes have been ignored.  Yes, we have done upgrades but taken advantage of process redesign in rethinking all the end to end and taking advantage of 15 years of tech advancement we have not.  Now some may have taken some interim steps with OCR in your AP process or perhaps you moved to digital document storage in HR.  These are for sure good steps in the right direction but pale in comparison to what is possible.  Yep, I am talking millions of dollars in savings if done correctly.  Don’t believe me, well I am a unicorn and so if you don’t believe in magic, you probably are right.  Keep doing what you have been doing as your competitors like Kaiser and the big systems automate and improve all their operations, then move into your market.  Everyone in Healthcare needs to act now.

Within the ERP systems, they are all integrating robust process automation tools and significantly better mobile/self-service applications.  Additionally, the look and feel of these systems have changed dramatically they now get the concept of usability.  How this has changed is in the way of personas.  This means they understand the whole concept of delivering functionality to the person that is specific to the job they are doing.  No more is it a blank slate you must try and limit by security.  When users log in, it knows they are the Controller and delivers functionality like reports and analytics they want to see daily to their dashboard.  Minor tweaks sure may be needed but this is a huge paradigm shift.  It saves you time on the configuration of security and custom development.  The system also knows what users want and delivers robust self-service capabilities. These have the potential for the first time to allow you to insource and centralize functions probably outsourced like benefits administration.  It will for sure reduce the calls coming in from employees and provide them a first-class user experience.  I like to say you can’t say it is a critical process, important to your employees and then outsource it.  Nobody will care about your employees as you do.

Oh, I mentioned customizations, let’s talk about those.  Many of you have hundreds (some of you have thousands) of customizations you have made over the years.  These all require a ton of maintenance and honestly are the Achilles heel that breaks.  With all the advancements and the move to the cloud, these go away!  Whether you like it or not, it is not smart to customize in the cloud and with the development of many healthcare-specific modules and functionality, it is rarely necessary.  Some ERP’s simply tell you “tough” you can’t do customization and others have ways, but they don’t let you know.  Now, this is a process to identify all your customizations and map that to the new functionality to identify where there may be gaps still.  If there are gaps, this means everyone in the world does it differently than you and guess what, it is time to fix your process, not customize the application.  Seriously the new versions of ERP allow you a lot of flexibility and the argument that you need a “differentiator”, I challenge you the differentiator does not come from your back-office ERP.  This differentiator will be in the policies and self-service you offer your employers and customers.

As the functionality of ERP has advanced, it is time to discuss application lifecycle management.  Call it whatever you wish (ALM, APM, App Management, etc.) this is the right time to address this.  The first step is to ensure you have an accurate portrait of your landscape.  For many, this is an Excel spreadsheet, and that is ok to start with, but we will want to really build on this.  It needs extensive details to be useful in the capacity of application planning.  I mean it needs to include an operating system, database, integrations, users, modules, etc.  The more detailed the better.  In a perfect world, you would consider a platform like Service Now or Planview to help administer this and make it interactive with the application owners to keep updated.  This then becomes the hub whenever your environment changes to help you manage the impact assessment.  But for ERP this helps us identify where we may be able to reduce this portfolio by consolidating into new ERP functionality and thus offset some of the cost.  Things like recruitment software, travel software, budgeting and planning, and reporting tools are top of mind for consideration.  Governance from sponsorship is key to help here, to ensure we aren’t simply keeping software with duplicate functionality because “we have had it for a long time”. The rule I use is 70% of current functionality met in the new ERP you are moving.  This can save hundreds of thousands in maintenance not to mention improve usability within the new ERP.

Reports are another opportunity. Many of you are still running Crystal – yes you are even if you deny it, I guarantee I’ll find some Crystal reports.  Worse you are using Excel like it is a key part of your processes.  Maybe you have evolved to MS Access on Johns’ computer, either way, this is all bad news.  I can’t talk about reporting without talking about enterprise content management.  Where is your information and how do people access it? Now is the time to address this gorilla too and I can help.  This will touch non-ERP areas such as SharePoint or O365 but making sense of your data is important.  For reports, working toward an enterprise reporting strategy with a robust tool like BIRST or even Tableau can help with wasted effort creating reports that are duplicative or worse yet, just wrong. With the advent of tools such as Tableau, licenses are now distributed across your environment vs. being consolidated which creates a few opportunities.  You don’t know what reports folks are creating or who they are distributing them to for what purpose.  What if the calculations are wrong?  What if three people are creating essentially the same reports?  How are they integrated into the process, and could they be automated?  What are they used for?  Do we need a report really?  Time to take a look at what we are doing here.

Given all the complexities of healthcare today, chances are you need to look at a redesign of your GL.  Especially if you are on Infor and moving to the cloud, where you will now have a dimensional general ledger called Global Ledger.  This is the perfect time to move away from smart numbering to a more strategic dimensional GL that reflects your business.  Spending time here really in advance of implementation to design the GL is time well spent.  Watch my webinar on GL pre-planning for some helpful insight here.

The supply chain 10 years ago was where all the value in ERP implementation was realized.  Well, guess what, it is a star in the show again this time.  With over 1,200 enhancements made to the application within Infor and new modules coming from Workday and Oracle, this area has a lot to take advantage of.  It will require some new technologies like RFID and RPA to really be optimized, however.  How are you doing PO’s?  Are you still using a FAX?  My kids don’t even know what a fax is.  Where are you on your EDI journey?  In today’s tech-filled world, there is a ton that can be done here to achieve an expedited and cost benefiting process. 

Okay, we are finally at human resources in the ERP family of modules.  I believe this is where the most focus of the last few years has been discussed but not fully realized.  In this space, RPA and ERP combined can have the greatest reduction of costs, most improvement to the timeliness of process and greatest impact on employee experience.  This really deserves its own post.  However, I can share stories of customers with the correct guidance, reduced call center traffic and staff in HR/Payroll by over 50%.  How you may ask?  Automation and self-service now included in ERP are a huge step forward.  Rethinking your best of breed strategy in HR systems is a key here as well. When you consolidate your applications, you reduce the swivel chair integration that exists even with the best integrations and creates a seamless real-time environment where data moves seamlessly.  You then can begin to key off HR data in your ERP to drive all kinds of external processes like access and security or travel, etc.  Not all ERP will be able to stand alone here without some spot help from RPA.  Regardless of the tool (Kofax and Blue Prism are my choices) they really complement the tools in ERP and automate your end to end processes.  Processes like payroll (yes may not be owned by HR, I am aware), benefits, recruiting, administration of termination, leaves, separation, etc. I could go on and on.  What I am stressing is this whole area has seen a focus in the past few years that now can be realized.  You can easily create a roadmap on these technologies too over a few years to make them consumable.  You should be able to repurpose 30% of your HR workforce depending on the size of the department. 

So, as you can see Healthcare ERP is so exciting right now.  I am skipping other topics like the revolution in analytics in HR that is becoming predictive.  Yes, predictive, meaning that we can tell you if a candidate is the right fit for a position or perhaps where they would be better placed.  We can have data help point to why turnover is so high.  Okay, let’s just talk about this.  There are a lot of companies in the field, with Infor having its own player Talent Science.  Visier is another key player all trying to make sense of the data.  The last decade was the period of data collection.  Data warehouses, data lakes, data gathering, so much data.  Now we created cool terms like normalization and interoperability, but can we be done with this and actually use the darn data.  This is where a good analytics strategy come ins. Notice, I didn’t say reporting.  Reporting to me is flat, it is a printout, not dynamic and rarely is predictive.  I want analytics that is preemptive and helps my front line take appropriate action.  I don’t care what happened 30-60-90 days ago unless it is relevant at the moment I need to act.  What if I told you we could reduce your turnover by 10%?  Think about this, one nurse turnover has a cost of about $59,000 and the average turnover is 17% and a large hospital has about 20% of their workforce being nurses.  Now do the math and the number is staggering.  I can help.  Engagement is driven off by understanding data around why people are leaving. If you tell me Unicorn, we do exit surveys, I will probably chuckle.  It is a pretty complex process to understand what drives your high performers and why they leave.  If you don’t figure it out, your competition will and then you will have a huge problem.

So now whew I am really done I promise.  I could go on and discuss virtual reality, cloud, surgical scheduling, virtual visits, OR scheduling optimization, etc.  All these have touchpoints to ERP and if you want to know more, I will send you a Unicorn plush to have a conversation with me about it.  I get jazzed talking to my healthcare clients about these items and more and happy to help you plan and facilitate workshops to get you going.  There you have it, some key topics on Healthcare ERP, now to rest my Unicorn fingers.