transformation journey

Moving to the cloud? Five lessons one hospital learned on its Oracle Cloud journey

Authored by Jeffrey Haynes

Once an organization decides to move its systems to a cloud-based platform, even more difficult decisions follow — namely, determining what system is right for the organization and who should do the implementation. Those critical choices will determine the success of its cloud transformation.

At the Healthcare Industry User Group’s (HIUG) recent virtual conference, Baker Tilly Digital director, Jeff Haynes talked with the Children’s Hospital and Medical Center of Omaha’s Janel Allen, chief human resources officer and Jerry Vuchak, chief information officer, about the phased journey the hospital system took to unify its systems using Oracle Cloud.

Lesson one: Choosing the right platform for your organization’s needs

When Children’s discovered it was facing a costly upgrade of its legacy application, the organization undertook an analysis of its needs and decided it should explore the market to see what else was available. It compared its incumbent platform with Oracle Cloud and another leading software. Vuchak said the hospital system chose Oracle Cloud based on the forward thinking and possibilities of the cloud that Oracle demonstrated throughout the selection process.

No matter who Children’s chose to execute the transformation, the expectation was the implementation would be completed in two phases since this would be a massive change for the organization, which was still manually performing many of its processes. The first phase encompassed core HR and payroll functionality as well as supply chain management. The second phase would build out additional HR functionality since the hospital system was still doing performance appraisals and merit calculations on paper.

Lesson two: Finding an implementation partner that will collaborate with you

Vuchak had not yet joined Children’s when it chose its implementation software. He started about 60 days after the first phase had gone live, but he immediately identified four issues that were impeding the organization’s success and delaying the start of phase two — some attributable to the implementation of phase one, related to some application.

First, things just weren’t working as they should. There were multiple service requests out to correct those and there were a number of performance issues due to the way the application had been built and configured, specifically on the supply chain side. The system was not as effective and as efficient as expected.  Some internal work was already being performed to look at how to re-architect and correct those issues. Additionally, there were some problems "process-wise."  Vuchak knew that any major software implementation must address process redesign and the attendant change management. In those first 60 days, he observed Children’s trying to use its limited resources to work through those issues and knew that those topics should have been addressed upfront in the beginning of phase one – not after "go-live" with internal resources.  Finally, the phase-one implementation partner had not trained or performed adequate knowledge transfer with any of Children’s internal team.

Vuchak complimented Oracle for helping them tackle issues, but he put a pause on launching into phase two until his team could really get its arms around the problems and could add more structure to the process.

Even though Children’s was able to resolve the phase-one struggles, Vuchak realized the initial implementation could have been improved with a view toward process redesign and improved business outcomes, better governance around the project and stronger executive sponsorship. He said it was being run more like an IT project than a "business initiative." Vuchak said the other glaring issue was the implementation partner, which was using a process that wasn’t strategically sound, and Children’s contract with them lacked the ‘teeth’ to hold them accountable.

Lesson three: Reassessing mid-project if things are not going to plan

Vuchak knew that in order to move forward with phase two, he needed to get governance in place and a strong executive sponsorship around it. Once the organization’s executives and board agreed, he went to Oracle to get advice on next steps, explaining that he wasn’t comfortable with the current implementation partner and didn’t believe it had a strong methodology to help the organization be successful in phase two. With Oracle’s assistance, Vuchak’s team took a step back and looked at different implementation partner.  At Oracle’s suggestion, Children’s decided on Baker Tilly.

Allen, the new CHRO, joined shortly after phase two started, and Vuchak knew she would provide the strong executive sponsorship the organization needed on the business side. Because Allen had been through an Oracle Cloud transformation at her previous employer, she understood how beneficial a move to the cloud could be. She was also aware of the inefficiencies in HR that were still plaguing the organization even after phase one. And, coincidentally, Allen knew Baker Tilly was right for this role having successfully worked with the firm at her previous employer!

Lesson four: Realizing the power of collaboration

Before launching into phase two, Vuchak and Allen talked about how they could energize their teams and get them to work together. They branded the project “O2HR,” essentially, oxygenating HR or bringing new life to the project.

Armed with Baker Tilly’s methodology and Allen’s knowledge from past experiences, the core team comprising HR, IT, marketing and business unit advisors embraced the best practices built into the Oracle Cloud. The team created a set of guiding principles and a list of success statements, which would be used throughout the process as a beacon to keep them on the path to where they wanted to go.

Haynes describes this as the “harmonize” phase: aligning guiding principles, establishing what success looks like, focusing on process design —building common models and laying a strong foundation for the project.

In addition to collaboration among the internal teams and better partnership from key stakeholders, Vuchak knew he needed a different relationship with his implementation partner.  After feeling exposed from a contractual perspective with the first implementation partner, Vuchak and Haynes worked on an agreement and statement of work that included milestone-based payments, which meant that if Baker Tilly didn’t execute its portions of the project at agreed-upon times, it didn’t get paid until it had. (Children’s ended up paying the previous partner three times the original cost projection because of delays and extensions.)

Furthermore, Baker Tilly brought forward a methodology that was easily understood, based in solid project management principles and had robust governance around the process. Phase two started in January 2020 with a go-live date in mid-September. The original plan was to have Baker Tilly on-site, but with COVID-19 that was not going to happen. Through mutual collaboration, flexibility, trust, and strong project management, the team did not miss a beat as the project moved to virtual.Even with everyone working remotely, the project was completed on time and within budget.


Lesson five: Going live is not the end, but a different beginning

On the majority of these types of implementation projects, the go-live day marks the end of an engagement for Baker Tilly, which would usually stay on with the client maybe a month or so after to make sure everything is running smoothly and the internal team that will be sustaining the platform feels comfortable.

A few things were different as Children’s went live, though. For one, Allen had referred to the go-live day as a kickoff for the organization. To Allen, it just made sense to her since going live was Day One of employing new processes and tools and executing on strategies that had been in development for months. Haynes said that reference shifted his perspective, and now he talks about go-live days as “go-begin” days for his clients. 

Another twist to Children’s “go-begin” is that Vuchak engaged Baker Tilly in their “platinum” support model, — adding six months of support focused on knowledge transfer, new-hire training, process refinement, etc. The investment of time, resources and money into the implementation was significant for Children’s. Haynes said the additional time commitment was a testament to how successful Vuchak wanted the project to be and how important setting the foundation was to managing it going forward.

Baker Tilly used those months to do continuous knowledge transfer, provide further training and confirm the roles among the internal teams were well defined. For Children’s, having Baker Tilly involved also gave the organization space to make sure team members understood what to do when Oracle’s quarterly updates came through and new functionality needed to be enabled and enacted.

When Vuchak started at Children’s in early 2019, the organization had no lifecycle management program for any aspect of technology. Now, after Allen and Vuchak explained to the organization’s leadership the importance of maintaining the ever-growing and ever-evolving Oracle Cloud journey it was on, the hospital system started building into both its operating and capital budgets optimization efforts for not only its cloud applications but other systems that had been stagnant for years.

The hospital system is currently looking at other opportunities within the organization to streamline and add functionality where it makes sense. Vuchak and Allen said Children’s is committed to the Oracle Cloud platform and looks forward to the return on their investment as Oracle’s innovation and Baker Tilly’s services propel them forward.

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