WHAT IS CLINICAL SYSTEMS?

Business Systems is a Collective of all the information technology at the Hospital level that facilitates Clinical Operations. Sometimes referred to as “Patient Corridor” or “Brand Experience”. Clinical Systems automate the processes from the time the customer (pet owner) decides to consult with a veterinarian to the time they are back at home with a treatment plan and scheduled follow-up appointment for their pet (if needed).

Most Common Clinical Systems that facilitate Patient Corridor:

  • Get Information About Pet Care
  • Find a Veterinarian
  • Book an Appointment
  • Check in (if Physical)
  • Connect (if Virtual)
  • Electronic Health Records
  • Imaging
  • Lab Work
  • In-house or Online Pharmacy
  • Apply Insurance
  • Apply Wellness plan
  • Payment Processing
  • Compliance
  • Recheck

Creating a standard Clinical System Stack is an ideal situation, and depending on the strategy of the organization, it may be required at the time of the integration process.
In case there is a commitment not to change anything, then the systems need to be connected through a Data Integration process.

This is a less than ideal situation due to lack of standards in the veterinary domain across various clinical applications.

There is a hybrid version of the strategy which is to acquire practices, connect the clinical systems through a data integration process and slowly migrate the hospitals to one system when the team. The lower hanging fruits of margin expansion are achieved through application of various growth levers.

While brainstorming on what systems to use for the clinical operations, one needs to take two criteria into the account:

Workflow Integration
Data Integration

Workflow Integration is a process of transitioning from one system to another without a loss of important data/documentation or information. It is usually achieved through integration between the various components of the Patient Corridor.

Data Integration is how the systems produce the metrics that are vital to process assessment.

The Clinical Tech Stack selection is a much more complicated process than Business Systems. The reason is because there is a much broader user base to satisfy and a significant resistance to change. It is important to note that after clinical systems change it is not uncommon to see 10-15 percent drop in both revenue and EBITDA which then recovers after a quarter or two. The better coordinated the change is, the sooner the recovery phase will end,
The Clinical Stack systems selection is better performed by a Chief Medical Officer with significant experience with Technology.

POTENTIAL RISK

Not having a well-articulated Clinical Systems strategy is a significant risk since it creates a disruption at the revenue generating center — the hospital. If not enough experimentation is conducted before the Tech Stack is implemented then it is better to not initiate a Clinical System change.In addition, system change is a significant disruptor to front line staff and when the change happens several times after the acquisition process, staff can go into a change fatigue state.
There are many other initiatives that could be executed prior to changing Clinical Systems to increase revenue or expand the margin.

CONNECTED PROCESSES

  • HR Process/Onboarding
  • Knowledge Accumulation
  • Strategic Filter
  • Talent Acquisition
  • Training
  • Recruiting at the Hospital Level
  • Change Management
  • Data-Driven Change Management

BURNOUT PREVENTION

If the Clinical Systems are changed at the early Levels of Maturity, multiple problems can arise from the process. While the teams in the newly-acquired hospitals are vulnerable to multiple changes, throwing a change in the process that they developed themselves and are comfortable at executing creates significant stress and triggers: Lack of control, value conflict, insufficient reward, work overload, and breakdown of the community.

DE-NOVO AND FRANCHISE

One major advantage of franchise and de-novo model is in the ability to select systems upfront and lead the recruitment with the clinical stack as a buy-in feature, in addition to providing detailed training on all the systems before the opening. A training module is one of the most important assets of both types of consolidation.

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