healthcaretechoutlook

As User-centered Technology Advances, So Does the Role of IT - Part I

By Ed Malinowski, CIO, BAYADA Home Health Care

Ed Malinowski, CIO, BAYADA Home Health Care

Although I work for one of the largest home health care companies in the United States, I don’t know the business of home care. I’ve never directed an office that schedules hundreds of nurses each week. I’ve never experienced the harried rush of filling shifts with varying bill and pay rates, different service codes, and hundreds of regulatory requirements. I haven’t experienced the frustration of fielding a callout at 4:59 pm on a Friday for a weekend shift, and then trying to find coverage so a medically fragile client is assured of having nursing care.

I’ve looked over the shoulders of our office employees to observe their work; performed payroll in our systems; and attended my fair share of process improvement meetings, metrics reviews, and goal planning meetings yet I’m not much closer to the real experience of running an office. I don’t actually know if I could—either successfully or profitably. I like to think that I’d be successful, but that theory goes unproven.

Conversely, my customers in the home care offices are identifying, evaluating, and adopting technology without the help of my team or me. To my knowledge, most haven’t earned degrees in computer science, worked in IT departments, attended courses in networks and software engineering, or even read IT for Dummies. Yet, business leaders are contacting vendors and arranging product demonstrations, then talking to me or my team after the fact. Frontline service office employees are signing up for web and mobile tools to make different aspects of their jobs easier. They aren’t contacting the IT department before hand, but only when they need help with their browsers, to install components, or to ask how they can eliminate multiple usernames and passwords. They’re asking how they can merge data about employees into these other systems.

Our service offices are leveraging technology to fulfill business needs without any help from our IT department—and it’s happening on a regular basis. Call the activity “shadow IT” or call them entrepreneurs or simply creative, my customers are identifying solutions that work for them and they’re doing it on their own, successfully. Yes, they miss some things that IT can help with (like security, favorable contract terms, or integration with other data sources) but let’s face facts— rarely are these items deal-breakers when the solution meets the core business need elegantly and cost-effectively. The solutions don’t always fit into IT’s master architecture plan, nor are they always easy to manage ongoing; however, we can’t ignore that the solutions meet their business needs.

How can this be? Twenty years ago, IT departments had highwalled cubicles staffed with employees who mostly preferred the privacy of the cubicles and didn’t engage extensively with customers. IT was a black box where problems went in  Healthcare Tech something happened, and solutions came out or, at least, they were supposed to.

The technology was not user-friendly, not easily understood by customers, and mostly relegated to transactional processing. We trained our users on systems that used F-Keys for shortcuts, no mouse, and arcane terminology on command lines. Even with the advent of the personal computer and user empowerment, the mystery of creating technology solutions was confined to the “systems folks.”

In the last decade, the business function of Information Technology has evolved, with changes in the availability of and access to technology. The explosion of the internet and the dot-com era brought millions of storefronts online and into billions of homes.

In 2007, with the introduction of the iPhone, an amazing thing happened—a new world of small, intuitive, user-friendly applications or “apps” took IT out of its mysterious enclave and delivered it to the masses. Combined with the availability of other smart phones, tablets, and increasingly low-cost internet access, technology became a part of our everyday lives. IT departments, on the other hand, had trouble keeping up with this nimble world of consumer-accessible technology. In fact, many consumers in the last five years have reported better technology in their homes than in the office.

Following this new pattern of usercentered technology, websites began writing applications that were “mobile ready” or “mobile first,” instantly distributing software via mobile phones and the web at the same time. This massive swing in the user-friendliness of software changed everything.

Manipulating digital functions with a single finger replaced the more complex hand-eye-coordination of mouse and screen. Consumers use personal mobile phones and applications to handle just about any need. “There’s an app for that” became a joking refrain. Modern consumers have continuous access to high-speed internet via lightweight, mobile tablet computers. Meanwhile, computer systems for solving business problems were going through their own transformation. Software as a Service (SaaS) and “the Cloud” are fancy marketing terms for business computer applications that physically reside somewhere other than your company. These services began springing up all over the internet in late 2010, and the sales pitch to companies and IT departments was brilliant: “Don’t worry about buying hardware, connecting networks and setting up the systems. We’ll do that all for you! We’ll manage it, make it secure, and provide it to you over the internet. All you need to do is use it.” It worked.

Companies shopping for software systems no longer needed to purchase depreciable assets or spend lots of money on high-priced professionals to support the system.

With these two evolutionary leaps forward (user-centered design and software as a service) the function of Information Technology is no longer the sole domain of the IT department. The quantum-leap achieved in user-centered design allows business employees to obtain technology and run their business themselves. Underlying technical systems have been abstracted for them; all they see is the presentation layer. Business leaders know their business and the functionality they require from their technology. They don’t need technical training or knowledge to discern whether a solution meets their needs. Usercentered design erases the need for technical savvy, leaving users with just one simple question: Will this technology improve my business?

This fundamental shift of non-IT business functional areas being able to acquire and, to some degree, manage technology means that the traditional IT skills of business requirements analysis, vendor evaluation, and application management are becoming competencies outside of IT. This change in the accessibility of technology is a very different story from what most people think of when they talk about Shadow IT.”

The term Shadow IT emerged as a negative commentary on the traditional IT department’s inability to rapidly respond to customer demand. It began to take root and grow as more customers of IT decided to take matters into their own hands to create mini-IT departments. Company leaders who supported this passive-aggressive behavior created islands of technology that, in most cases, led to tangled webs of duplication, chaos, and bad relationships between business and the centralized IT department. The absence of standards or a model by which collaboration occurred between groups often led to poor results and wasted money.

In the new model for IT, some skill sets are decentralizing. For the skill sets that are not, we need a new engagement model to optimize the newfound partnership between the tech-savvy customer and the seasoned IT employee.