The importance of balancing clinician needs with patient outcomes is key to successful digital transformation. Encouraging stakeholder engagement by actively gathering requirements, listening deeply, and clarifying expectations from the outset is vitally important. Developing trust while remaining open to new possibilties can go a long way to ensuring better outcomes for clinicians and patients alike.
On this episode of In Network’s The Consulting Show, hosts Chad Garrett, Katy Ptaszynski, and Justin Burnett are joined by Senior Consultant Kevin Flannagin. Their discussion centers on the challenges of adapting to changing requirements, scope creep, and the strategies they use to address these issues effectively. By incorporating agile methodologies, Kevin illustrates how iterative testing and user feedback can lead to better project outcomes and reduce the risk of rework. His experiences, such as transitioning a reporting system to Microsoft Power BI for an antimicrobial stewardship program, demonstrate how innovative solutions can streamline processes and enhance service delivery.
Listen here:
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Show Notes:
[00:00] Intros
[01:21] Kevin’s background
[03:47] Service delivery strategies
[11:20] Common challenges around service delivery
[15:25] Implementing net new technologies like Microsoft Power BI
[22:10] Building and maintain trust with clients
[24:20] Implementing the antimicrobial stewardship project
[26:43] Remaining agile while building trust with clients
[28:35] Preparing for artificial intelligence incorporation into workflows
[30:14] Outros
Transcript:
Chad Garrett: Alright. Welcome, everybody, to another episode of our podcast. I'd like to say a brief welcome to our co-hosts, Katy and Justin. But more importantly, we have a distinguished guest this week. Kevin Flannagin, one of our A+ consultants, if you will, is joining us for our discussion today. So, Kevin, I'd like to pass the baton up to you and share a little bit about your background and your role at Nordic and what it is that you do.
Kevin Flannagin: Yeah, sure. Happy to be here. So, I'm a licensed pharmacist by background. And, I had over time moved into supporting informatics. Moved into project management. I'm a board-certified pharmacotherapy specialist. I hold a PMP, and several Epic certifications. As a pharmacist, I practiced for seven years, in direct patient care, mostly focused on critical care. And I also supported several quality initiatives, surgical care improvement projects, mechanical ventilation, sedation, quality improvement things. And then, moved into supporting the Epic inpatient pharmacy module and then, the rest is history. So, I spent eight years in healthcare IT, two years as a consultant. I've supported Epic, Willow, Healthy Planet, ambulatory, Bugsy, reporting, and a number of third-party integrations and really, for me, my interest in technology started, as a kid, I wanted to go to the garage sales and buy a computer and take it apart, put it back together. But I chose pharmacy for some reason. But once I was in pharmacy school, I saw opportunities to take some electives. I did some reporting electives, getting claims, data-based research and things like that. And then just every time opportunities came up in the workspace to help out with spreadsheets or reporting in Epic, I was raising my hand. That's how I sort of got my foot in the door in the informatics space. And then in terms of consulting, I worked with a number of great consultants. I had a friend who joined Nordic, and just really saw consulting as an additional opportunity to continue to grow and learn and support our clients. And so currently, functioning as a technical project manager and population health data and analytics. And really enjoying the challenges and new experiences.
Chad Garrett: That's great. I mean, is there anything you haven't done Kevin? That's a pretty long list!
Kevin Flannagin: I don’t have the most focused experience, but I have a pretty broad experience.
Katy Ptaszynski: So, Kevin, today's topic is delivering superior service. The strategies that we use to deliver those services. And when we were planning this podcast, we immediately thought of you. Even though you’re relatively newer in the consulting world, I've worked with you personally, and I can say that you came to my mind for this subject because on the project we worked on, you immediately came in, and it was very clear to many people on the project that you were very capable of delivering superior quality service. So, I want you to talk a little bit about why delivering superior service is important. Why is it important in healthcare, healthcare IT, and specifically in the context of EHR consulting?
Kevin Flannagin: Yeah, absolutely. I think in in consulting, we've got our customer, our client in mind, their goals, their needs. And then we also have the patient. Patient outcomes are extremely important. So, you have to keep both in balance. And what I've seen is when, a site brings on a consultant, they're looking for both the technical knowledge, but also implementation experience. You know, you bring on someone new as an FTE, and you've got to grow them up and build that skillset when you bring in a consultant. Oftentimes we have previous experience in that specific area, or we have, you know, connections within our consulting firm or outside. To be able to bring that particular experience. I know, for instance, that the project that I worked on with Katy, we saw sort of a slow start, to things as we were waiting on stakeholders’ decisions, but we had all the staff on deck ready to go. And because I had implemented this before, I knew that part of the Epic project plan had something slated for a very late phase in the project, that didn't require any particular stakeholder decisions but was going to require quite a bit of time. So, because I knew what was coming, we were able to go ahead and get started on configuring a number of medication records. And get that done. And that meant at the late stage, when we're trying to tie up all the loose ends, we weren't having to go back and do this, this highly technical work which supports that project.
Justin Burnett: Kevin, it sounds like for all of the different things that you've done, you've got this breadth of experience. I'm guessing that means that you're frequently doing things that are new to you. So especially if it's new to you, what strategies do you have to go with and better understand the customer goals and what it is you have to accomplish in that potentially new, or at least partially new space?
Kevin Flannagin: You know, I think that initial engagement is really important. And really carefully gathering requirements. Finding out a hearing from the customer, what do they need? What preconceived notions they bring to the table about what it is that we're doing. And then also identifying stakeholders early in the project. I like to ask the question of who else should I be talking to about this? Because that will bring additional groups, additional people kind of out of the woodwork. And that lets us look at what we need to bring into scope or what requirements may have been missed in the initial, initial process.
Justin Burnett: I suppose in order to hit a target, you have to know what that target is.
Kevin Flannagin: Absolutely. Yeah.
Chad Garrett: So, Kevin, in terms of successful implementation, in terms of leading a project, what do you find outside of stakeholder engagement? Because that's key, right? If you don't know who the stakeholders are you're probably doing something wrong. But outside of stakeholder management, what are some of the best practices you've learned over the years? And of course, I'm not necessarily even talking about consulting, but just over your career for delivering the best possible service to clients. You know, there's your background as a pharmacist, playing a role in that. Can you, can you talk more about that?
Kevin Flannagin: Yeah, absolutely. You know, as a pharmacist, I was frequently needing to contact physicians about questions or issues, medication orders or provide recommendations about, how to align with, with current therapies. And you would have, you page the position, you're waiting for the callback, you're waiting for the call back. They're extremely busy. And you've got like, 30 seconds of attention when they call. Particularly in a hospital setting where I was, and so I needed to be prepped. I needed to have. Exactly, here are the points I want to hit here. The questions I need to ask. I needed to confirm that understanding and then take action on it. And same thing with patient interactions. You know, when as a pharmacist, if I'm counseling a patient, I've got maybe 3 to 5 points. I want to make sure that that patient walks away with and it's not good enough just to express that information. I've got to confirm their understanding. And so that sort of context around the way I communicate, I bring to the projects I manage, I bring to the analysts work that I do to where I want to make sure I know I'm prepped. So, preparation is one of those best practices that I know exactly what we're going to talk about. And I want to make that interaction meaningful, that I'm hitting actionable items, that I'm hitting, decision points. And then as I'm hitting those things, I want to make sure that I'm capturing that all in a transparent manner. Transparency builds trust. So, I, do a lot of active live note taking. I'm going to share my screen as I'm taking notes. I've got my agenda up, and I'm trying to capture and clarify points, summarize things back over. I find this really helps with the engagement of the audience that they go, hey, what I'm saying matters. It's being written down. Hey, that's not right. You got that wrong. Let's fix it. And then trying to walk away with. What are those decision points? What are those action items? With that transparency. And then you build trust by not dropping them. I make a major effort to hold on to those follow-ups. Hold on to those action items. So the stakeholders say, hey, this stuff is actually going to happen. These meetings matter. And I'm getting what I need out of the interactions.
Chad Garrett: Yeah, that's really funny, I can speak from past experience on that one, Kevin. I'm taking notes live. I would share my screen just like you. And that accountability piece is great. So not only is it transparent, but also accountable because you're a human right, you're going to mishear or mistype, which I do all the time. And so, your audience and your stakeholders or the team that you're working with at that time, very often just call out anything you're writing on the screen. And sometimes it's actually good, not only because maybe you were phrasing it incorrectly or we're leaving out a key detail, but it can also spur additional thoughts. So maybe everybody in the meeting was listening, but then they're reading it and it triggers something for them and then they can contribute more to the conversation for sure.
Justin Burnett: That’s a key difference between some of our visual versus auditory learners is it's amazing what those real-time notes can add to a conversation.
Kevin Flannagin: Absolutely.
Katy Ptaszynski: So, Kevin, we talked a lot about how you have all these tools in your toolbelt to deliver great service. But let's talk about challenges. What are some common challenges that you face when you try to deliver superior service? How do you overcome those challenges?
Kevin Flannagin: I think a lot of times we run into changing requirements, scope creep and just a lack of clarity around exactly what, what is intended to be part of the project. I've inherited a lot of projects that are already in flight. And there can be some, some misconceptions about what it is exactly. So, I like to meet with the project sponsor and hear from them what it is they think that we're going to do. And where there are things that are, I think usually they're all really good ideas. But we've got a particular project we're trying to accomplish, and so we'll try to determine what things can we need within the scope of the project as it was approved. And then if there are, you know, enhancements that we can work in, we determine, hey, can we get it into this project? If not, I try to facilitate a handoff to resources that will be there long term. Who can, bring those things to pass? Another big challenge I see is, a lot of Epic implementations are still based around a waterfall approach. I feel like, what we're building is often more like building a skyscraper, than it is, like, a new piece of dynamic software or an app for your phone. We have an end goal in mind, and there's a lot of steps along the way. But, you know, with that approach, that can mean that when the stakeholders start to see what it is you're building, they go, well, that's not what I wanted. I didn't want it to work. So, I try to insert more agile strategies, iterative and incremental approaches where I can and so we may take a particularly complex part of the project and add in some additional user acceptance testing or additional demos beyond what Epic has planned, because we want to try to make sure that we get that part right. So, we can always deliver that increment into production. But we can, along the way, sort of pause and double check with our end users. Is this meeting your expectation? Does it meet your needs? And that prevents rework? And there are bigger morale detractors than having to rework. Thanks for the team. And so, these demos, sometimes they, you know, it doesn't take much of a sell to say, to the team, hey, if we do this, then we can feel confident about moving forward and we don't have to rebuild it.
Chad Garrett: That was a great example. And I kid you not, I kid you not. I was literally thinking of a skyscraper example before you mentioned it. Because when most I would say a lot of projects outside of software development are a waterfall approach. You have a specific end goal in mind. It's to deliver that thing. So, in this example, it would be that skyscraper. However, once the skyscraper is built, it needs to be maintained. You know, elevator cables need to be replaced, greased, whatever those processes are. And that's where we get into the agile part of a project. Right. So, I always just like yourself, I always think, hey, we're doing this thing, and this is the goal. However, here's our roadmap afterwards. So, like you said, the stakeholders or the sponsor may say, hey, I thought we were doing this. And you're like, we are, but that's not till phase four or whatever the long-term timeline roadmap looks like
Justin Burnett: Kevin, we talked to a couple different examples about how we use certain technologies in terms of delivering superior service. Talked about even things as simple as making sure you're sharing notes, which for a long time we could share notes on the screen, maybe in a conference room. And when we went remote, it became even more critical for us, to do maybe virtually. But there's a lot of different technology that we deal with in our jobs. And do you have any examples that you want to speak to about, solutions that you've implemented or changes that you've made where people maybe had tools, they thought they were great, but there's ways that we were able to keep an eye on what's new and innovative and be able to build on that.
Kevin Flannagin: I worked closely with the formation of an antimicrobial stewardship program at a previous employer, and we traditionally were providing reports at that place with, Excel, workbooks, PDF reports. And that was what the teams were accustomed to asking for. And so, we went through, we built out some, some really complex, queries and really complex sheets. And, we're having to make a lot of modifications over time because as it was a new program, the reporting needs were rapidly changing. So, I started looking at what was a way that we could more, more adaptive lead, manage their changing requirements. And so, I identified, that we could use Microsoft Power BI. It wasn't part of that organization's typical report delivery structure. But it was something that I had some comfort level with. And so, I got it approved to bring that into the mix. And transitioned their reports into Power BI. And was able to develop a number of visualizations, some automations for them. And it really helped meet their needs. And then when it came time to add the next item, the maintenance, the rework was so much less than, an easy-to-break Excel sheet that we had out there. So, they also were spending a lot of time taking, spreadsheets and converting them into reports for distribution. So, we were still able to extract sheets for them when they needed it. But I also automated a 20-page report that went out to, all of our 11 hospitals at the time. That they were able to just click a button each time they needed that, and to get that sent out into a way that, since we didn't have the technology for everyone to be logged in to Power BI, they could still get the reports.
Justin Burnett: They've got to ask. I mean, we're in the business of change almost everywhere that I've ever worked. It's there because there needs to be a change. But a common pitfall I see people, find is that they want to recreate exactly what they do today, but just a new tool, which seems like an expensive process without a lot of value there. So how do you convince people? Is it easy? Do you have any tips on how you tell people? I know that's what you do today, but I think if you accommodate a little bit of change, we might be able to do this better in the future.
Kevin Flannagin: I think that's where that trust comes into play. If you've built trust with your stakeholders, they're more, willing to listen and to hear about alternate ways of doing things. I also try to identify what is a minimum viable product that we can produce. What's a proof of concept we can throw together? Can we, you know, develop a wireframe to show how something will happen to get that buy-in before we put effort into a full-scale transition.
Justin Burnett: You’ve got to prove it.
Chad Garrett: So, question about that Kevin. So, this organization didn't use Power BI before you brought it in for this specific purpose to deliver these reports in a more optimal way? Do you know if the organization then leveraged Power BI across their organization or did they keep it siloed just to this unique purpose?
Kevin Flannagin: Were in a situation where the pharmacy department, the actual operational side, had begun using this for some of their needs, and figured out that they could build out and replace some, some vendor solutions with Power BI. And so, it became part a large part of what we did on the inpatient pharmacy team that I was a part of. But we did see that Epic started, promoting their slicer dicer tools, which brought a lot of visualizations. And that organization put a lot of effort into building out custom slicer dicer models, adding columns, adding reports. We saw a lot of success with that, and I was a big part of promoting the use of slicer dicer. And upskilling our power users that were used to reporting workbench or used to working in Excel to say, hey, you can do a lot of this. You can add it to your dashboards. And so, we did not move forward to Power BI, but we did, identify gaps in self-service reporting and then used and promoted in Epic.
Chad Garrett: Oh, fantastic. So, with all of this knowledge, like I said in the intro that you have and things you've learned over the years and found opportunities to help clients move forward. How do you help, without sounding kind of weird, how do you help yourself to move forward? How do you help yourself to continually improve and stay on top of the latest trends and look for what might be after Power BI, for example, in terms of reporting, how do you stay ahead of the curve and help clients?
Kevin Flannagin: Yeah. So, I try to stay on top of my clinical knowledge. I have a number of certifications that keep me sort of on top of that continuing ed. But I have always been sort of a lifelong learner. Now, instead of playing a game on my phone, I'm often, you know, reading an article about some obscure thing. I just have to know. So, it kind of happens naturally because I'm just. I've got a curiosity about things. But constantly being presented with new opportunities, particularly in consulting, the role that I'm in now. We're using a lot of Google Cloud Platform. And I had not really done any cloud computing work. I had not worked in Big Query. So, there were some a lot of new tools that I needed to learn. And the client has been fantastic in that they provide some Coursera courses like partnered with Google to offer, offer some, some courses. They're on a learning platform. And so yeah, I just look for opportunities to engage and make sure that I'm, I know enough to, to be able to participate with our, with our clients and with the stakeholders. I’m interacting with.
Katy Ptaszynski: Kevin, we talked earlier about building trust but taking it even a step further back. Can you just talk a little bit about how you build and maintain relationships with your clients? Obviously, establishing trust, but what other pieces of advice could you give for building a strong relationship?
Kevin Flannagin: I think it's important to come in and listen like really, truly listen. I'm, you know, as a pharmacist, there were very clear boundaries around what I could do and what I couldn't. And oftentimes I knew the right way to do something, or I knew the right thing to do. But I just wasn't allowed to. And so when I come into a new client, I want to really take time to listen and understand the environment that they're in. What are their policies? What are their procedures? How is this different than places I've worked in the past and then ask permission? You know, coming in and making assumptions and doing things, without clear guidelines is, it can erode trust. And the first time you make a change to something in Epic security, and you find out that, the policies are different here than they were where you came from. It's an embarrassing situation. And so, I really try to just ask, hey, who should I be talking to about this? And what are the processes? What should change approval? Who do I need to get signoff from?
Chad Garrett: Yeah, that's so key. Understanding is key because. Because, like you said, everybody or every client, let's say, let's phrase it like that. Every client does something differently. You know, there are thousands of hospitals around. And no two of them are alike they're their own special flower. So, they all do things, slightly differently. So, whether, like you said, whether it's security or just policy actually drives a lot of what we do in, in EMRs, as well.
Justin Burnett: Kevin, I mean this sincerely, even outside the podcast. It's great talking to people like you because you have a personal passion for what you do. The interest that you have is not just about saying, I showed up to work, I was asked to do something. I get it done. But you're pursuing things that you find interesting, and I think probably some of your customer accomplishments as much as they would. So, I'm curious if we've already covered this example. Maybe. But is there a past change or experience that you have where you really felt like you rose to meet that challenge and you were proud of, that you think about often?
Kevin Flannagin: I implemented the antimicrobial stewardship model module for Epic early in my career. It's actually my first project I did and so I really liked having a second pass at that and doing it again. And so it was exciting to bring all those lessons I learned to the table and feel like, hey, this one. We knocked it out of the park. We hit, we hit all the goals. We did. You know, I had 11 months to do that project. We optimized every day of it. And so that was that was exciting.
Justin Burnett: And that's great. So as much of a jack of all trades as you are, it's nice to repeat some things and apply some of that experience, directly.
Kevin Flannagin: Yes. It can be a little tiring to, to always be doing something new, but, you know, it’ll be with the job.
Justin Burnett: I suppose that's the key to delivering superior service, doing what's needed. Is there anything else, Kevin, through this conversation or through the questions that we sent, you responded to those? Is there anything else that comes to mind? If you were having to lead this discussion or you were talking to some others about what that takes, where would you go with the conversation? What would you like to ask?
Kevin Flannagin: You know, I think some of the things that I've seen from, interactions with other Nordic consultants is, hearing about not just like a focus on how we implement this technology or this module exactly right. Or exactly successfully, but bringing those like long term successes, oh, we saw this work really well at this other, this other side. And it improved patient care in this way. And we really brought an ROI on this that those type of like longer things, those are things that I want as, as a consultant like to be able to bring to the table. And it's I've been so in the weeds with like the little configurations and the stakeholder meetings that sometimes I don't have that, that step back level. And so, if I were interviewing someone else, those are the things I'd want to hear about. How do you develop that experience? How do you get that? Katy, I know you've got, you know, a lot of more of those types of experiences.
Katy Ptaszynski: Yeah. But I think it's great to have the experience, but it's also important to come in and not be the consultant with tunnel vision that says, this is how we did it before. We need to do it like this. Here, it's being able to recognize the differences between sites and definitely bringing that knowledge in and bringing the experience, but also listening, like you alluded to earlier, listening to the current customer and understanding how can you take your experience and apply it? It might be slightly different. It might be very different based on their practices.
Justin Burnett: But I think the difference between my first implementation and my second was not that I found out there's a second way to do things. It highlighted that there's many more than just one, and I don't know them all. And so I think some of that breadth of experience comes with that. There's that old adage about wisdom that it's, something about that you can be smart if a lot, but to be wise, you recognize how much you don't know. I feel like that comes a lot. That's the humility. It enables us to listen to our customers better. I think that's a really key component that probably continues to grow with each year that I, have experience with each contract that I take.
Katy Ptaszynski: And also, just our knowledge with the EHR itself, when I first learned Epic, it was like the ice ages. And now, every release, every upgrade, there's something new. And keeping on top of that so that you're not always building exactly the same way. Living in, in, some systems that, are living in, in certain habits that some of us have that could be more efficient. So just kind of understanding how the software itself is changing and keeping up on that.
Justin Burnett: Kevin, I think that tees it up well, that you talked about the fact that you're a continual learner. You're always reading articles. I want to ask, so based on what you're reading, what do we need to be prepared for so that we're heading in the right direction and not always a step behind? What do you see as a a future trend either in IT or consulting. How can we better anticipate our client needs and serve those? Is that something you feel comfortable speaking to?
Kevin Flannagin: Yeah. A few, a few things come to mind. You know, the client I'm with right now, they're making big investments in AI, they're making big investment to integration and interoperability. You know, where we're currently ingesting, data and really standard formats, but we want to get it into the latest fire standards. And it amazes me how fast things are going. You know I hear about something, I'm like, oh, that'll be cool. And then I find out, like, oh, we're actually already doing that. It's reality today. And so, I think keeping an open mind and an open ear for what? What are your clients doing? What are our other clients doing? It is a good way to position yourself so that you're not falling behind in old ways of working, but you're, you're staying on top off what's new.
Justin Burnett: I feel like that's an interesting way of saying the future is here. We just have to find it.
Kevin Flannagin: Yes.
Chad Garrett: You know, and that was, a good question, because I think maybe we'll make AI a future podcast episode. We'll have to see, and maybe Kevin, you might be an ideal person to invite me back for that panel.
Kevin Flannagin: I'd love to.
Chad Garrett: Awesome. All right guys, so I think that wraps it up for this episode. I want to thank my co-hosts Katy and Justin, as well as our special guest, Kevin, for joining us on today's call, I think we all learned a little bit more about you and your best practices for delivering superior service to our clients, and I want to thank you.
Kevin Flannagin: Thanks for having me, I had a good time.