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MMIS-to-ERP Conversion Breeds Jitters and Bugs



MMIS-to-ERP conversion breeds jitters and bugs

Supply chain must be prepared to plug and play or be plugged and played

by Rick Dana Barlow

For sme supply chain professionals, trading up to an organization-wide enterprise resource planning system’s supply chain module from a department-specific materials management information system feels more like selling out — especially if it’s forced.

Unless supply chain’s department head was consulted prior to any decision on brand or vendor, let alone the justification for a conversion to an ERP that effectively would replace their MMIS, the decision may seem like a C-suite edict. In fact, supply chain may presume that the decision was designed to help the finance, information technology or clinical departments, at the expense of other operations.

Whatever the case, the ensuing kerfuffle is enough to unnerve anyone.

So what can supply chain professionals do about it? How might they anticipate the need for such a conversion early enough to contribute their thoughts and then ultimately prepare for its inevitability? Are there any ways to ease the frustrations, facilitate the workflow processes and minimize disruptions?

What’s clear is that this conversion process is more complex and enterprise-wide comprehensive than many recognize until they flip the on switch so they must plan to smooth any rough-hewn edges before they emerge. And emerge they will.

Control the chaos

But it’s important to be flexible and open-minded amidst the complexity, according to Alex Zimmerman, Director, Supply Chain Informatics, Christus Health, Irving, TX.

"One thing to prepare for is change to functionality," Zimmerman told Healthcare Purchasing News. "The new system will offer features you will like and features you won’t want to accept. Some things you may like or dislike at the time of install you will change your mind about down the road after working with the system. The point is to recognize that your new system works best when used as designed and that business processes must adapt to the new software, not the other way around."

Further, team building and time management become paramount, Zimmerman insisted, as well as ceding control.

"Get ready for change requests, work queues, test plans, planning meetings and resource sharing," he indicated. "An ERP requires tight coordination between verticals because of the myriad of stakeholders involved. In short, be prepared for less control. If you are using an MMIS and migrating to an ERP you will lose the ability to autonomously perform upgrades, leverage enhancements, make system changes, etc. Everything you do from the initial project implementation to system upgrades even to bug-fixes will now require a tight coordinated effort between supply chain and the other verticals."

Supply chain professionals need to make friends with information technology (IT).

"Take them to lunch, buy them flowers, whatever you need to do," Zimmerman added. "With an ERP you gain an even greater dependence on IT because individual departments simply do not see the big picture and IT does. When using an MMIS your primary concern is preserving the interface. With an ERP everything is integrated so any change affects all verticals not just your own and IT is there to run point on all change requests."

Joe Colonna, Vice President, Supply Chain, Piedmont Healthcare, Atlanta, managed to skate around any MMIS-to-ERP conversion projects through much of his career until last year. The experience was an eye-opener for him.

"Unless you have been through a recent ERP conversion in the last five years, I do not think that you can possibly grasp the complexity of a conversion," Colonna noted. "I know that I for one did not. I had accidently managed to miss those moments through most of my career. Although I spoke to my peers and they told me it would be rough, I just did not appreciate all of the moving parts, and most of all, the human elements.

"On April 1, appropriately enough, we went live," he continued. "On April 3, we ground to a halt and went almost completely manual for all of our systems. Luckily there were enough of us old timers around to talk the younger folks off the ledge and explain how we used to fill orders without all this fancy technology. I am proud to say that the Supply Chain team and our customers worked together to figure out work-arounds until we had the system up and running."

A relationship with IT helps, Colonna insisted, but be realistic with expectations.

"One should remember that they [IT] are implementing the system you design and, right or wrong, it is your design," he said: "They should not be expected to ‘know’ supply chain, read your mind, nor know what you meant when you said what you said, etc."

Another caveat involves working with third-party consultants for implementation. Supply chain professionals should treat them akin to how they treat the internal IT department, according to Colonna.

"They should know about ERP implementations, but remember they will not know your implementation," he said. "You must participate in the processes and question everything that does not seem to make sense for your organization or does not support your vision. On the other hand you should listen to these highly paid ‘been-there-done-that’ folks. They have insights and knowledge that you will need for implementation.

"Having said that, not all experts are created equal so be sure to check credentials and do your reference checks — not just on the company but also the specific individuals assigned to your engagement," Colonna added. "Most of us are one to two degrees separated from our peers in this industry. Use that network to check out those who you are trusting with your implementation."

Amy Chieppa, Piedmont’s Supply Chain ERP Team Leader, intimated that it’s easy to miss the forest from the trees — the big picture effects on the entire operation.

"ERP/MMIS conversions are never just system changes," Chieppa said. "The system changes are more than just the system you are implementing and sun setting. It’s all systems that touch the old and the new, be it from interface or integration or reliance upon data from either or both systems. Project management of the conversion must include all other projects and daily operations impacting any and all resources that will be needed for the project — the issue being more important to timing and capacity more so than if their involvement is a lot or a little."

John Mateka, Executive Director, Supply Chain Operations, Greenville (SC) Health System, concurred.

"With ERPs typically incorporating the financial suite of products, including Finance, Budget, AP, Accounting, Purchasing, Inventory, and in many cases Payroll, Capital Accounts, etc., the Materials program is a piece of the big picture," Mateka noted. "MMIS systems are built specifically to accommodate the supply chain and interfaces with financial and payable systems. ERPs are integrated systems whereby in varying degrees lose some of the specialty nature in which the MMIS was built. AP and Purchasing become attached at the hip in most ERP systems, thus the complexity is doubled over a standalone MMIS."

Organization-wide preparations must be made for collaboration, cooperation and tolerance, according to Tony Trupiano, Senior Vice President, Supply Chain, WellStar Health System, Marietta, GA.

"Having a culture ready to accept the change inherent in implementing an ERP system is vital," Trupiano said. "ERP systems are tightly integrated and require seamless information flow between IT, end users, supply chain and accounting. Senior leadership of the organization should be informed and must support the organizational and process changes that allow the health system to optimize the ERP solution."

WellStar earned HPN’s 2011 Supply Chain Department of the Year Award under Trupiano’s leadership. He previously directed the 2007 award winner, too.

"It’s important for organizations to understand the impact of how you manage master data and processes that are now integrated across the supply chain and financials," said Keith Lohkamp, Product Director, Infor, St. Paul, MN. "You have to look at ways to take better advantage of integrated data."

Supply chain professionals must come to terms that an ERP conversion won’t be a headache-free finite project to complete before moving on to something else.

"Realize that this is going to be painful, be prepared for frustration by most people who are touching this in any way," advised Jeff Wagner, Vice President, MidMichigan Health, Midland, MI. "Understand that external help is needed, but you have to take ownership to make it successful. Do some discovery by finding a site that did a conversion between 18 and 36 months prior and spend a day with their key [materials management] folks to pick their brains relative to the pitfalls they encountered and what they would do differently. Get engaged in the process of determining the consultant group that will be assisting in the conversion. This implies that help is needed, definitely. Ideally they have progressive visionaries mixed with grounded, pragmatic staff."

At core, clear communication lines between supply chain, finance and accounts payable are needed "because a good system build is important to the req-to-check process," said Jon Athey, MMIS Specialist, MidMichigan.

"There is no hiding from the fact that a conversion will take an inordinate amount of your time from the very inception of the idea until…possibly forever," noted Michael Bohon, CPSM, CMRP, Founding Principal, HealthCare Solutions Bureau LLC, Show Low, AZ. "No matter how detailed the planning and preparation stages, there will be glitches and problems. Don’t panic! That will serve no purpose. Work through the issues with the well-prepared team you have in place and ready yourself for the next problem which will eventually — and soon — occur."

Red alert

Supply chain professionals nearing a conversion project launch or currently immersed in one should look for a variety of warning signs to spot challenges they may face.

Start with the conversion timeline, which affects available resources.

"The timeline for an ERP project is always too short, and the resources too few," Trupiano said. "However, it is important to select an implementation date and make every effort to meet it. Consultants make millions on delayed go-live and project extensions."

Move to interdepartmental interaction.

"If accounting and supply chain are not spending significant time together, the project is in trouble," Trupiano warned. "There are a number of decisions involved in an ERP implementation that need to be made across functions."

Colonna agreed that a lack of participation in the process can be problematic.

"While the SC ERP team is going to be fully engaged there will be the need for Supply Chain staff and customers to fully participate in the processes," he said. "It is dangerous for these other ERP participants to be allowed to assume that they do not have a role or that they will be allowed to resist change. In a full ERP implementation typically four areas are involved: Supply Chain, Human Resources, Finance and IT. All of these teams need to be aware of and sensitive to the needs of the other teams. They often work on separate parts of the puzzle, sometimes in silos. It is important to bring them together to the whole puzzle and how the pieces connect. I call it, ‘showing the box top.’"

Bohon cautioned against accepting perceived, but unverified, grandiose claims.

"Alarms should go off when you hear the IT people tell your senior leadership team how experienced they are in supply chain operations and functions," he said. "If that was the case, why have you not been aware of such in-depth knowledge?"

Zimmerman highlighted several red flags hampering collaboration and cooperation, specifically "leaders from other verticals who refuse to give ground," he noted. "New software requires changes to business processes, and if other verticals oppose this change it can spell bad news. When the system is not used as designed undesirable consequences eventually rise to the surface."

Their lack of involvement creates challenges, too, he continued. "By nature ERPs encompass multiple verticals integrated together in one seamless system. Obviously, configurations selected in one vertical impact everyone so close coordination is a must. Not involving the stakeholders of impending changes can result in a shakeup of those entrusted to deliver the system. Friction early on in the project is better than contempt and blame at the end. Involving stakeholders early-on is one way to stave off potential demise."

Managing the conversations and discussions can be vital, too, according to Wagner.

"Negative talk by the [materials management] staff will hinder the process," he said. "Keep a level of communication that allows open dialogue of concerns that can be addressed in front of a group so everyone gets the same message. Also make sure that the future state picture is clear and that documentation of decisions and process changes are kept for review to alleviate finger pointing and memory failure."

Following the bouncing digits can make a difference as well.

"Make sure you have input into the targeted [return-on-investment] of an ERP project," Trupiano urged. "Healthcare ERP projects usually lean heavily on supply chain savings projections. While there are supply chain cost efficiencies as a result of ERP, it is important that the ROI projection is objective and realistic. In fact in many cases, the ERP implementation should be viewed as an investment in IT infrastructure, rather than solely upon ROI."

Apply to the budget, too, according to Bohon.

"Pay close attention to the budgeting for the entire project," he advised. "If you sense they are planning to do it on the cheap, then prepare for disaster. For every dollar that they are going to try and save on the implementation, they will spend more than two on trying to correct the problems that resulted from such economizing."

Mateka recommended understanding how the system works and how operational processes must adapt and change, as well as the users and training requirements.

"Supply chain tends to create a lot of work-arounds to circumvent functions not supported well by existing software," Zimmerman noted. "When converting to a new system there is a tendency to cling to these processes as the de-facto way of doing business forgetting how these processes were created. It should serve as a red flag when stakeholders speak out vehemently against changing processes."

Finally, be aware of "ERP fatigue," Colonna added.

"It can take a long time between the announcement and the implementation," he said. "All parties may be at risk for losing a sense of urgency or understanding that the change is really coming."

Careening off the highway

When an organization decides to change IT lanes, supply chain can veer onto the shoulder and steer themselves into dead-ended detours.

"Many instances folks will build the infrastructure of the new system based on how they worked with the old system, then wonder why the new system doesn’t work like the old one and doesn’t deliver what the new one was designed to do," Mateka said. "Building the Master file for example, not just an upload from the old, needs to be scrubbed and given an appropriate format that will support the data requirements for the new system."

Zimmerman recalled something similar. "In one implementation our purchasing department chose to use features of the ERP software differently than designed, rather than changing business processes to fit the software," he said. "At first they thought they were doing the right thing but a couple of years later they confessed to wishing they had listened to the consultants from the onset. Now they are too far entrenched to change and the resulting inefficiencies are now set in stone.

Bohon agreed with Mateka and Zimmerman. "Most frequently supply chains do not spend sufficient time reviewing their processes and incorporating changes to them with the advent of new software," he said. "The chance is there to streamline the operation and not continue with the old thinking. If anyone believes that they will do this after the implementation is underway, they are badly mistaken. They will have lost the ideal opportunity.

"Also, one of the major keys to success is good data," echoing Mateka’s example. "Without clean and organized data you are doomed. After all, this is a data dependent system you are trying to install. We worked our dataset until we thought we had it right. Boy, were we wrong and we ended up paying for it for months as we attempted to correct things."

That’s why expectations need to be set up front about "selling the benefit," Lohkamp suggested. Organizations must re-examine the overall workflow.

"Too often, supply chain professionals look for the new system to replicate their current processes rather than figuring out how they can maximize the built in processes in the ERP," he added.

Wagner and Athey argued that supply chain may go into denial mode instead of embracing change.

"First, we don’t blow up the current system and allow the process to follow the design of the ERP," Wagner said. "We tend to believe that our way is the best way," Athey followed.

"Second, we underestimate the amount of work it takes to get these done successfully," Wagner continued. "We need to get very detailed in finding out what process changes will mean downstream. We must be accepting that processes will have to change, take advantage of this opportunity to get away from workarounds and bad habits."

"Third, we do not dedicate resources to the task at hand," Athey continued. "Instead, we stack the work on top of current duties. And finally, we don’t have complete upper management support or involvement. Top-down support is key for end-user buy-in."

Supply chain may not fully understand the integrated nature of a full ERP solution that incorporates supply chain, human resources, finance and IT, according to Colonna. "There are components of every other area that will impact Supply Chain operations," he said. "For example, in our system the ability to approve a requisition, which is Supply Chain, is tied to title, which is Human Resources, which is tied to payment authorization, which is Finance – A/P, which is tied to security levels, which is IT."

Timing remains a lingering problem, too.

"They may underestimate the man hours needed both pre and post go-live — especially post go-live," Colonna said. "Six months later, we are still using temp labor in some areas to augment permanent staff as there are still some unresolved issues."

Still, focusing on the end game should matter as much.

"We spend too much time planning on how to build the system and very little time on the efficiencies to be gained and information we want to pull out of the system," Trupiano insisted. "These projects typically are on tight timelines due to budget constraints, and reporting, for example, often becomes a post implementation project. Supply chain professionals need to balance time spent between system functionality and really deciding how the ERP system is going to improve processes, reduce cost and support strategic direction."

Staying on track

Just as some supply chain professionals can veer off course, others keep plodding forward, even during difficult conversions that may interrupt product access and flow.

"Supply chain professionals are very good at remaining calm in the face of chaos so when the ‘fit hits the shan,’ we can take a quick step back, assess the damage, plan and forge ahead with some fixes," Wagner quipped. "For example, when the inventory conversion does not come across correctly and your $1 million inventory turns to $21 million with a click of the go-live button, you need to be able to go back to the legacy system, reassess where things went wrong, and get to work with the fix. Be prepared to work long hours, feed your staff, get the mundane tasks off of your key conversion personnel."

Colonna agreed. "Supply Chain professionals are pretty good at crises management and understand the need for the supplies to get where they need to go when they need to be there," he said. "Even when systems are down, they will find a way. Post go-live we had daily huddles, sometimes twice a day, with all of our locations to determine what was needed and comparing what the system was telling us to what was really going on."

Bohon experienced that first hand, too. "The supply chain will undoubtedly bend over backwards in order to ensure that all departments are able to continue to operate effectively and as normally as possible in spite of any difficulties that have occurred," he said. http://www.hpnonline.com/images/2007%20images/HPNdingbat.jpg



Prep work can smooth MMIS-to-ERP conversions 

Do you want to know how to work the kinks out of a rocky MMIS-to-ERP conversion process, or better yet, eliminate as many of them as possible ahead of time? Here are more than 30 actionable tips that a group of supply chain experts recommended to Healthcare Purchasing News.

  • Make certain you have identified and secured the appropriate resources to build and bring the new system up. Also make certain you can perform your full-time job and build/install a new system. Identify your champions and backfill their positions until installation and training are complete.
  • Understand how the new system will operate and perform major tasks, which is the end state. This will facilitate implementation and operational changes necessary to enjoy the benefits of the new system.
  • Some systems take a year to implement so allow ample time to plan, execute, train and perform.
  • Set your deadline/target, team and project plan and stick to it.
  • Celebrate successes along the way and at the conclusion.

– John Mateka, executive director, supply chain operations,
Greenville (SC) Health System

  • Select your best and brightest supply chain experts to work on the ERP project.
  • If using an implementation consultant; choose carefully.
  • Begin the communication process to the entire organization early. ERP systems require disruptive process change.
  • Visit organizations that have implemented your ERP system successfully and learn from their experience.
  • Don’t skimp on training. Train the trainer is a good implementation strategy, but it is critical to provide a solid sustainable training program to maintain process improvement.

– Tony Trupiano, senior vice president, supply chain,
WellStar Health System, Marietta, GA

  • When the ERP vendor says, “Yes, our system can do that,” make them show you how and count the number of steps it takes to do it.
  • Don’t turn the system on until you are ready.
  • Backfill positions, if necessary, so your key people can focus on the task of preparation.
  • Work as a team to ensure that the supply chain piece interfaces well with others including, Accounts Payable, General Ledger, Operating Room, etc.
  • Build a system of continuous communication with the senior executives and with your customer departments. Better that the C-suite hears of problems from you rather than the clinicians. Better that you know about issues from the nursing areas as soon as possible.

– Michael Bohon, CPSM, CMRP, founding principal,
HealthCare Solutions Bureau LLC, Show Low, AZ

  • Make sure that the person you assign from your team to lead the ERP Supply Chain team understands your vision and will design around your vision for Supply Chain. We did and the system reflects and will support that vision.
  • Checkout your implementation partner – not just the company, but the people assigned as well…push back and ask for different resources if you do not feel comfortable. You are paying these companies a lot of money that should respond to your request.
  • Communicate, communicate, communicate. Not just with your Supply Chain team but your customers and your leadership team.
  • Identify all of the potential bolt-ons and include those business partners in the early stages of design and implementation. For instance, will you be using GHX, handhelds, some kind of document imaging, etc.?
  • Understand the impact and limitations of your new ERP systems and also the level of integration with other departments such as Finance, Human Resources, Information Technology, Electronic Medical Records (EMR).

– Joe Colonna, vice president, supply chain,
Piedmont Healthcare, Atlanta

  • Make decisions timely with the right information and stick to them unless there is truly a reason to not.
  • Continuity of leadership and members are key – if you can’t have that, you need documentation to keep good records of what decisions were made or not made and more importantly, why they were made.
  • Don’t underestimate the impact of changing/reversing decisions – or taking a lengthy time to make them.
  • Communicate changes based on what users will understand and not what sounds good/packages well (e.g., New ERP system is coming –people may know what that stands for and may know the system is being implemented; fewer will know what system is going away, fewer will know that it impacts other system they use – especially if they don’t use the one going away or being implemented).

– Amy Chieppa, supply chain ERP team leader,
Piedmont Healthcare, Atlanta

  • Start your item master clean up at least 18 months ahead of your conversion and get it done. Reduce your item master access to a very, very limited group of people.
  • Get your inventory down to the lowest unit of measure.
  • At go-live, have a dedicated Q&A hotline manned with a very knowledgeable resource. During training, keep in mind that all end users are not created equal. You will encounter various levels of computer literacy and be prepared for some hand holding.
  • Stay involved so you have a working level understanding of the new system and the difference between legacy and new.

– Jeff Wagner, vice president,
MidMichigan Health, Midland, MI

  • Identify key players and redistribute their responsibilities so they can devote their time. Do not rely solely on consultants to do the work. Staff familiar with the data should do most of the work.

– Jon Athey, MMIS specialist,
MidMichigan Health, Midland, MI

  • Involve the stakeholders. Without stakeholder involvement the entire way through you are setting yourself up for disappointment due to misunderstood intentions and plane ol’ lack of involvement.
  • Take advantage of the resources while you have the chance; financial and human. This is the time to take advantage of resources set aside for the implementation. Take advantage of consultants, interface engineers, third-party software, etc. Once the implementation is complete Finance will be looking for their payback, which is ambiguous to derive at best, and that means resource scarcity.
  • Make sure to coordinate closely with the other ERP verticals. All the verticals are in this together. You can’t configure anything in a vacuum. Any change affects everyone system-wide.
  • Do not try to bend the software to fit existing business processes. This needs to work the other way around. Software is configured to support specific tried and true workable business processes. Do not try to make the software fit your legacy processes.
  • Do be afraid to push the limits… you do not have to settle for the status quo. Today there are more options than ever before for supply chain. If you don’t like the ERP’s requisitioning process, take it to the cloud (i.e., options include Ariba, SciQuest, Procuri, etc…). If you feel IT is unyielding and difficult to work with then move push to have the environment hosted, IT will still be necessary just not as much. If the point-of-use scanning is inadequate there are many other solutions in the marketplace (i.e., Optiflex, AtPar, Par Excellence, etc). Third-party systems interact so seamlessly with today’s ERP system there is no reason not to make use of them.

– Alex Zimmerman, director, supply chain informatics,
Christus Health, Irving, TX


When to hit enter vs. control-alt-delete

MMIS-to-ERP conversion processes can be successful, ultimately, but with roadblocks and speedbumps to hurdle along the way, or some can turn out to be dismal failures at first. Supply chain experts shared their recollected experiences with Healthcare Purchasing News. Look for the evident common denominators.

Hit enter and send

We had planned a roll-out for electronic requisitioning over the course of several months. When we got started with the e-req training at go-live, it became clear that the impact on the purchasing process was such that we needed to do the big bang. So we ended up doing it all right out of the gate. This way we leveraged training sessions, were able to adapt and keep improving the training process, and get the purchasing staff out of the paper world quicker and into the value add arena.

– Jeff Wagner, vice president,
MidMichigan Health, Midland, MI

In my past experience, the success of our ERP conversion was built upon the organization’s well established continuous quality improvement culture. These processes were so ingrained into the culture of the organization that it created a solid foundation upon which the ERP conversion could be built. The ERP teams consisted of team members that were accustomed to working outside of silos and putting the organization’s success first.

– Tony Trupiano, senior vice president, supply chain,
WellStar Health System, Marietta, GA

During a recent install we recruited and hired two top notch “chip heads” who were driven and motivated. We backfilled a few key positions to allow for building and training with weekly meetings, and joined Purchasing and Accounts Payable at the hip. We implemented on time, within budget.

– John Mateka, executive director, supply chain operations,
Greenville (SC) Health System

Although I was not directly involved, I do know of what was the probably the smoothest ERP implementation ever. The reason for success was that the hospital made the decision to spend the time, money and labor necessary to prepare for the conversion. They backfilled positions and spent money in advance rather than after the fact.

– Michael Bohon, CPSM, CMRP, founding principal,
HealthCare Solutions Bureau LLC, Show Low, AZ

In the first one I participated in we experienced both a strong success and a notable failure. The success stemmed from the coordination of the project. Regular project status meetings were held with a broad group, not just from the [project management office] level. These meetings included the C level, the PMO, the Vertical Leads, the [project managers] and the [subject matter experts]. The project plan was as thick as a book and the meetings were always packed. Packed but engaged. The project was completed on time and on budget due to strong coordination and collaboration throughout the project.

– Alex Zimmerman, director, supply chain informatics,
Christus Health, Irving, TX

Press control-alt-delete, stat!

While working in a previous multi-state system, time constraints limited pre go-live testing. As a result, vendor master and item master errors resulted in significant supply interruptions. For example, pacemaker orders were directed to the spine division of [the manufacturer] and units of measure were incorrect. This culminated with a call to my home from our COO on Christmas Eve, who was with an irate nurse at one of our hospitals because we were out of resuscitation bags. She threatened to call him to perform mouth-to-mouth if there was a code!

– Tony Trupiano, senior vice president, supply chain,
WellStar Health System, Marietta, GA

I was not directly involved, but a colleague who was the supply chain leader at an academic medical center told me his horror story. He said that he realized that they were not completely ready to “flip the switch” and appealed to the senior executives to delay the actual start of the conversion. He was told the schedule had to be adhered to. As he described it, “It was not like there were some problems. Nothing worked. It was a complete disaster!”

– Michael Bohon, CPSM, CMRP, founding principal,
HealthCare Solutions Bureau LLC, Show Low, AZ

We allowed IT to postpone some testing and ran out of time. During the install some programs didn’t work causing delays, frustration and aggravation.

– John Mateka, executive director, supply chain operations,
Greenville (SC) Health System

We struggled with a couple of inventory conversions requiring a tremendous amount of clean-up and extremely long hours. The key reason behind the failure was the lack of running through various scenarios on spreadsheets before we did the conversions. Conversions done on a weekend allow for more prep and fix time and that will depend on your timing for catching a month-end.

– Jeff Wagner, vice president,
MidMichigan Health, Midland, MI

In this same example [involving a success story] a serious failure manifested after the ERP was installed. This was primarily due to customizations that were insisted upon by the business users. Despite the fact that these customizations were supported by the software vendor they did not work well in practice. This is because software is designed to support specific business processes. If you do not change the underlying business processes and instead try to bend the software to fit legacy processes problems occur and inefficiencies manifest. Inefficient work-arounds become an annoyance over time and become increasingly so during software upgrades and critical patch installs. I would recommend at all cost re-evaluating deviations from recommended work paths. It is important to remember that the very business processes in place in an organization may in fact exist due to lack of functionality in legacy software that may now be available in new systems. It is illogical to continually support inefficient processes indefinitely.

– Alex Zimmerman, director, supply chain informatics,
Christus Health, Irving, TX


The ERP time machine

Because time travel remains a tried, true and trusted, if not over-used, plot device in books, comics and movies Healthcare Purchasing News asked a group of supply chain experts what they would tell themselves if they traveled back in time to when they were just starting their MMIS-to-ERP conversion process. Neither “Don’t do it!” and “Run for the hills!” qualified as acceptable responses. Here’s what they told HPN.

I would have over-communicated the level of change that the new system was bringing to our customers and our Supply Chain team. The messaging would have been deeper, more dramatic, and required affirmative responses to understanding and participation from all involved. The metaphor would have been: We are burning your old house to the ground. It simply won’t be there anymore: there is no going back, there is no “make my new house look like my hold house.” We are all going to be roommates in this new house and we need to learn to live together and function well: and we need to do that before we burn your old house to the ground.

– Joe Colonna, vice president, supply chain,
Piedmont Healthcare, Atlanta

Get as much information as you can from the site visit with the vendor client site that has a strong MMIS running. Be ready to adapt quickly to unforeseen circumstances. Get the right people dedicated to the task at hand. Listen to the staff involved and/or impacted by the conversion. Stock up on the coffee, Mountain Dew, and 5-hour Energy drinks. Smile, [because the] pain is temporary.

– Jeff Wagner, vice president,
MidMichigan Health, Midland, MI

I would say embrace the change. Change offers opportunities to exploit the latest and greatest practices with all the newest bells and whistles. I would also suggest not locking yourself into only what the ERP offers. When an organization embarks upon an ERP implementation that means they are prepared to spend lots of money. This offers a great opportunity to really think out of the box. For instance today you have the choice between a cloud-based hosted solution or a local install. You could also seek out best-of-breed components that integrate with the ERP instead of relying upon the ERP system to do everything. Examples include point-of-use systems, cloud-based requisitioning platforms, supplier vendor portals, contract management systems, etc. You can also bake best practices into the configuration like making better use of scanning technology and transacting with GS1 standards. We all know it is coming why not support it now.

– Alex Zimmerman, director, supply chain informatics,
Christus Health, Irving, TX

I don’t really need to travel back in time as WellStar is implementing a new ERP solution on April 1, 2013. Hopefully, by making site visits early and learning from other’s success and failures, we have put together a realistic project plan, with sufficient time on the front end for planning and time at the back end for testing. We are striving not to fall behind, as doing so creates too much risk for error when trying to get back on schedule. We may have some breakdowns during implementation, so we will be sure to have contingency plans in place prior to go live.

– Tony Trupiano, senior vice president, supply chain,
WellStar Health System, Marietta, GA

I would take a stronger role in the planning and preparation than I did and not depend so much on others to get things right. I would also try to ensure that we had the necessary resources and not let the IT people run things to the degree that they did.

– Michael Bohon, CPSM, CMRP, founding principal,
HealthCare Solutions Bureau LLC, Show Low, AZ

Having gone through a few implementations, I have learned to select a system that will bring value and facilitate customer satisfaction, be user friendly and most importantly fight, fight, fight for the resources upfront to install, operate and maintain the system and test till satisfied.

– John Mateka, executive director, supply chain operations,
Greenville (SC) Health System


What can go wrong?

What are some of the common, typical mistakes and oversights supply chain management professionals make during the MMIS-to-ERP conversion process? Industry experts sound off.

Not cleaning-up the old systems data before conversion, including Item files, contract files, vendor files, etc. Assuming there will be enough time to get everything done prior to go-live. There won’t be. Assuming there is ongoing and effective communication between all team members. Assuming that the implementation partner has everything under control and all of the answers. Not listening well and acting on staff concerns.

– Joe Colonna, vice president, supply chain,
Piedmont Healthcare, Atlanta

One common mistake is made when migrating data from the old system to the new. It seems with each implementation I have participated in there was something funny about the data after the fact. It could be leading or trailing spaces before or after field values, or text instead of numeric fields, or truncated decimals. Either way it causes problems that plague users indefinitely. Much care should be taken in a test environment to ensure fields appear as expected prior to final conversion.

– Jeff Wagner, vice president,
MidMichigan Health, Midland, MI

One common mistake is made when migrating data from the old system to the new. It seems with each implementation I have participated in there was something funny about the data after the fact. It could be leading or trailing spaces before or after field values, or text instead of numeric fields, or truncated decimals. Either way it causes problems that plague users indefinitely. Much care should be taken in a test environment to ensure fields appear as expected prior to final conversion.

– Alex Zimmerman, director, supply chain informatics,
Christus Health, Irving, TX

First it is important to complete a process redesign to align with ERP system capabilities. Healthcare organizations often fail to realize the full benefit of an ERP implementation because they try to align current processes with the ERP solution. Second, ERP systems are typically not as intuitive as legacy MMIS, therefore clinicians can sometimes struggle if adequate training is not provided. Third, dedicate adequate resources to implement the system right. Some systems invest millions in an ERP solution but take years to recover from a poor implementation because they resourced the project on the cheap.

– Tony Trupiano, senior vice president, supply chain,
WellStar Health System, Marietta, GA

A common error made is in the selection of consultants to assist in the conversion. You must have people who are not only extremely conversant with the software system being installed, but who are experienced not only in supply chain, but specifically healthcare supply chain processes. Without those caveats you are going to spend a lot of time teaching the very people who are supposed to be helping you.

– Michael Bohon, CPSM, CMRP, founding principal,
HealthCare Solutions Bureau LLC, Show Low, AZ

Insufficient time and resources to install and test until satisfied. Don’t wait or put off testing because you will invariably run out of time.

– John Mateka, executive director, supply chain operations,
Greenville (SC) Health System


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