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5 Steps to Achieve System Integration

Posted by Matthew Smith on Nov 17, 2016 4:03:24 PM

By Brandon Klar, MHSA, Senior Manager, GE Healthcare Camden Group

integration.pngAn effective integration plan not only aligns operations and maximizes the collective system resources, it also serves as a roadmap and a vehicle to cultural integration. Recognizing the need to balance both quantitative and qualitative inputs in the identification of the ideal strategies for each unique system integration plan, leadership should follow a proven5-step methodology to create a plan that is realistic, achieveable, and sustainable for the system.

To position the system integration planning process for success, an effective governance structure and Integration Management Office (“IMO”) should be established to guide and facilitate integration initiatives.  Capitalizing on the organizational knowledge and expertise from operational, clinical, and medical staff leaders throughout the system, the governance structure should be positioned to make critical system decisions and be nimble to adjust planning efforts in an uncertain world. With the support of an unbiased IMO to facilitate and manage integration initiatives throughout the system, communication surrounding planning and implementation should be frequent and broad band.


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Step 1: Vision for System Integration   

The vision and design of an integration plan should reflect the system’s core strategic goals and objectives, and be grounded in the unified mission of the integrated healthcare delivery system. Balancing meaningful integration initiatives that are designed to enhance value with the system’s tolerance to culturally accept and adapt to change, leaders should establish clear guiding principles to harness decision making.

The integration vision and associated guiding principles will become the foundation for departmental and service line integration efforts. When organizational or personal bias arises, the guiding principles will focus leadership and their teams on the system as a whole, break down both organizational and departmental silos, and position teams to be innovative and progressive as they plan to drive quality and control costs throughout the system’s administrative, support, and clinical services.

Steps 2: Efficiency Opportunity Assessment

Opportunity to improve operational efficiency, enhance quality, maximize existing resources, and control varies within each system. Factors including the geographic distribution of care sites, the scope and scale of operations, and community needs will all impact integration opportunities. To effectively identify integration opportunities, individual functional area work teams should be established to assess current performance both quantitatively and qualitatively. With the help of the IMO, these work teams will assess historical and projected data, utilize industry benchmarks, and gather team operational insight to catalog operational variation.

Capitalizing upon industry experience and their own internal analyses, the work teams will identify a range of integration opportunities available to the system. These opportunities should be organized by the IMO and shared with the integration governance team to ensure the opportunities have been properly vetted and do not conflict with the mission or vision of the system.


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Step 3: Operational Efficiency Plan Development

Once a preliminary listing of integration opportunities has been identified, the work teams will commence building operational efficiency plans to drive system integration. Utilizing a blend of proven horizontal and vertical integrations strategies, the work teams should build tactical plans with clearly defined action items, potential barriers, necessary resources, financial impact, implementation timeframes, and interdependencies with other departmental plans. 

Recognizing that individual departmental and service plans may conflict, the governance committee and IMO will serve as a central repository for draft plans and must identify integration plan interdependencies as well as potential strategic and political complications with implementation. Once plans have been reviewed and refined, the IMO will develop a master system integration plan for approval and adoption.

Step 4: Implementation and Communication

As the system begins implementation, broad and frequent communication to both internal and external stakeholder is essential. Communication of the overall integration plan at a system level and open dialogue regarding departmental plans with their respective teams will provide the best chance for the plans to be accepted and adopted by the workforce and the community.

Implementation of the integration plan should commence upon final approval of the plan or when permitted by regulatory agencies. With the governance committee and IMO team coordinating initiatives system-wide, both positive and negative feedback should be monitored closely. With the proper mechanisms in place, work teams can modify their plans as needed to ensure the successful achievement of the system’s integration goals.

Step 5: Plan Monitoring and Refinement

Concurrently with plan implementation, the IMO should establish an integration dashboard to monitor progress and barriers to implementation. The dashboard will serve as a tracking tool for the governance committee and system executive leadership, in addition to a communication mechanism to the system to illustrate progress and success.

It is also during this step that the governance committee will identify barriers to implementation. As all healthcare systems operate in an evolving market these changes are to be expected. It will be up to the governance committee and the work teams to adjust their plans to overcome the impediments and stay on course.

This is Part 2 in our 4-part System Integration blog Series. Parts 1 and 2 may be found here and here. Part 4 will examine common challenges experienced during a system integration process and solutions to overcome those challenges.

For more details surrounding health system integration planning, please download our PDF via the button, below:

Health System Integration


B_Klar.jpgMr. Klar is a senior manager with GE Healthcare Camden Group with over 12 years of experience in healthcare management. Mr. Klar specializes in strategic and business planning advisory services, including service line planning, master facility planning, and transaction work (e.g., mergers, acquisitions, affiliations, joint ventures). He has extensive experience in the creation of strategic partnerships, the facilitation of inaugural health system strategic plan development, as well as the creation and implementation of business plans of operational efficiency, system-wide integration plans, and clinical programmatic alignment plans. He may be reached at brandon.klar@ge.com.

Topics: BPOE, Hospital mergers and acquisitions, Brandon Klar, Mergers and Acquisitions, Health System Integration

New Download: "Stay Focused While Developing Your System Integration Plans"

Posted by Matthew Smith on Oct 29, 2016 9:20:58 AM


Brand-Strategy-Mergers-Acquisitions.jpgSystem integration plans fall short and occasionally fail to achieve their desired outcomes most frequently because they lack effective solutions, fail to consider the impact of system operations on the community, and don’t have the necessary support from the workforce.

As much as a well-orchestrated integration planning process and an invested leadership team can work to position a system for integration success, a system integration strategy must be grounded in value creation, risk management, and employee engagement to ensure any integration plan to reach its goals.

This new download from GE Healthcare Camden Group details the importance of focus when developing an effective integration plan and includes information such as:

  • The value creation equation
  • The 3 pillars to effective health system integration planning
  • A sample listing of functional areas for integration consideration

To download this PDF file, simply click the click the button below.

Health System Integration

Topics: Health System Efficiencies, Health System Integration

Stay Focused While Developing Your System Integration Plans

Posted by Matthew Smith on Oct 20, 2016 4:00:21 PM

By Brandon Klar, MHSA, Senior Manager, GE Healthcare Camden Group

3 Pillars.pngAs the healthcare industry continues to experience consolidation and health systems evolve to meet industry challenges, operational integration initiatives present great opportunities to enhance system-wide performance.

Many health systems speak to the integration goals as they design their strategic partnerships, but only a portion develop realistic, achievable, and sustainable integration plans and even fewer accomplish the goals set forth in those plans.

System integration plans fall short and occasionally fail to achieve their desired outcomes most frequently because they lack effective solutions, fail to consider the impact of system operations on the community, and don’t have the necessary support from the workforce. As much as a well-orchestrated integration planning process and an invested leadership team can work to position a system for integration success, a system integration strategy must be grounded in value creation, risk management, and employee engagement to ensure any integration plan to reach its goals.

Value Creation

To achieve success in a value-based world, health systems must actively seek to enhance the value of their clinical services. Defining value as healthcare outcomes per cost, a health system’s pursuit of value creation will involve enhancing the quality of its services while reducing the per unit delivery cost.

Value creation through health system optimization can be achieved through both horizontal and vertical integration strategies. Horizontal integration strategies are focused on reducing unnecessary duplicative resources, enhancing system operational performance, and aligning/optimizing clinical programs and resources. While duplication of select resources and clinical services may be warranted to maintain access in select geographic areas, plans must carefully balance community needs with efficient resource distribution to deliver high-quality cost-effective clinical programs.

Conversely, vertical integration strategies are focused on enhancing the value throughout the continuum of care by effectively positioning access points, redesigning the care model, and promoting information technology and data sharing. As systems form and evolve, seamless handoffs between system providers and multidisciplinary care plans will reduce unnecessary resource utilization and provide for the efficient navigation of patients through the system with high quality and high satisfaction outcomes.

Risk Management

Risk is inherent within every system integration initiative. The term “system integration” can often trigger employment uncertainties and high employee and physician anxiety which heightens the internal challenge to achieve a successful integration. Community resistance or concerns for the planned integration efforts are also possible based upon the drivers that prompted the system to take action. While identified risks may become realities and unanticipated challenges can arise with little warning, effective risk management planning is essential.

Identification and analysis of the integration risks by the system integration leaders and their teams are foundational to the planning process. Balancing the benefits of integration initiatives against the probability of the risk may prompt either the development of preventative and contingency plans, or the abandonment of the integration initiative all together. Regardless, every risk should be thoughtfully analyzed in the context of the benefits of the system integration plan and weighed carefully.

Employee and Physician Engagement

The third pillar to effective health system integration is employee and physician engagement. While system integration planning is overseen and led by senior system leaders, it is imperative that employees and physicians have a voice within the planning process to foster effective integration results.

Solicitation of ideas, involvement in plan development, transparency in the planning process, and frequent communication will provide systems with the best chance for developing an effective integration solution, and fostering acceptance, accountability, and alignment among the stakeholders. This planning approach will also provide the system with the platform to accelerate the change process, and achieve and sustain its integration goals and objectives. While some confidentiality is warranted in the integration planning and implementation process, employee and physician engagement is necessary for success.

As health systems take on their integration planning and implementation process, a focus on the three pillars will provide the foundation to strategically position themselves to be nimble and efficient in a value-driven world.

This is Part 2 in our System Integration blog Series. Part 1 may be found here. Part 3 will examine the 5 steps in a successful system integration planning process.

For more details surrounding health system integration planning, please download our PDF via the button, below:

Health System Integration  


B_Klar.jpgMr. Klar is a senior manager with GE Healthcare Camden Group with over 12 years of experience in healthcare management. Mr. Klar specializes in strategic and business planning advisory services, including service line planning, master facility planning, and transaction work (e.g., mergers, acquisitions, affiliations, joint ventures). He has extensive experience in the creation of strategic partnerships, the facilitation of inaugural health system strategic plan development, as well as the creation and implementation of business plans of operational efficiency, system-wide integration plans, and clinical programmatic alignment plans. He may be reached at brandon.klar@ge.com.

Topics: Business Plan of Operational Efficiency, BPOE, Mergers & Acquisitions, Health System Efficiencies, Brandon Klar, Health System Integration

Health System Integration: You Need a Plan!

Posted by Matthew Smith on Oct 3, 2016 1:25:10 PM

By Brandon Klar, MHSA, Senior Manager, GE Healthcare Camden Group

Health System Integration PlanSuccess within population health is grounded in a health system’s collective ability to improve the health and wellness of those in its communities, and other patient groups it may serve. With a goal of achieving the Triple Aim, systems are restructuring their operations to strengthen the value proposition of their clinical services. With a desire to enhance access, improve quality, and control costs, many systems are looking towards formal strategic partnerships as a means to attain the necessary scope and scale to be successful.

As systems expand, they have the opportunity to achieve system-oriented efficiencies. Through both horizontal and vertical integration strategies, systems desire to position themselves within the market as high-quality and cost-effective providers to attract patients and payers. While many systems pursue these objectives, some fail to achieve full integration due to a lack of effective planning, poor management collaboration, or subpar implementation. Regardless of the reason, a sound integration plan focused on the goals of the system and dedicated true integration will increase the odds of success.  

System Integration plans can be developed both pre-transaction and post-transaction, as well as by systems that have been operating for some time, but in more of a “loose federation” model than as a truly integrated system. Below, you will find an overview of system integration plans, the critical factors in developing them, and associated benefits and limitations.

Pre-Transaction Integration Plans

The development of pre-transaction integration plans provides the aligning entities a road map to achieve their partnership goals and objectives once the transaction is final. Developed prior to the signing of a definitive agreement, these plans serve to lay the foundation for administrative, support, clinical, and service line integration across the continuum as it relates to the location of services, management and staffing, and the optimization of non-salary resources and contracts.

Pre-transaction integration plans allow the entities to build upon their shared strategic vision and construct a newly integrated operating model by which the two entities can optimize their individual strengths and maximize their collective resources. Recognizing that each entity brings with it their unique resources and capabilities, pre-transaction planning is focused on:

  • Cataloging the collective resources and capabilities of the newly proposed system
  • Understanding the existing operating models and functional area interdependencies
  • Framing a new operating model for the integrated system functions
  • Selecting horizontal and vertical integration strategies to align operations
  • Developing action plans with clearly defined goals, resource requirements, barriers, accountable parties, and quality and cost impact analyses
  • Designing an implementation governance structure to oversee the capture of short-term wins post-transaction while coordinating for long-term integration

In addition to preparing the system for operational integration, pre-transaction integration plans can also serve a role in supporting regulatory approval of the proposed transactions by Departments of Health, Attorneys General, and the Federal Trade Commission. While the burdens of proof and detail required may vary by state and regulatory agency, these plans illustrate that the transacting parties are committed to the transaction, have a roadmap to integrate operations at a systems level, and possess a plan to reduce overall system costs. These plans have been proven helpful in demonstrating the value that can be derived by a transaction for a community, but are limited in their detail as the parties are unable to exchange competitively sensitive information prior to the transaction.

In the preparation of these pre-transaction integration plans, parties have utilized both anti-trust counsel and a system integration consulting firm to prevent undue disclosure of sensitive information and support in the development of a more meaningful integration plan.

Post-Transaction Integration Plans

Post-transaction integration plans seek to enhance the integration of entities with a system both horizontally and vertically outside of the confines and limitations of the transaction process. These plans are developed to support system operational integration at two points in a system’s journey: (1) Immediately following a transaction, and/or (2) Years post transaction to optimize a system’s operational performance.

As systems pursue integration post-transaction, they should build upon their pre-transaction plans or previously completed integration initiatives. As the parties are now able to share competitively sensitive information, the integration plans can be further refined, enhanced, and validated. To efficiently drive system integration planning and implementation, the newly formed system should:

  • Activate a system integration governance structure to oversee operational integration
  • Establish an Integration Management Office (“IMO”) in line with an integration governance structure to manage processes, team collaboration, and track progress
  • Convene functional area integration teams to drive integration plan refinement and implementation
  • Engage employee and physician stakeholders to keep them informed and solicit ideas
  • Construct a community communication plan to highlight benefits and any changes to care design and delivery

Integration plan refinement and implementation immediately following a transaction can both position the system for success, or doom it for failure. While integration planning and implementation will drive efficiency, attention must be paid to cultural alignment. Individual functional plans and strategies should have their benefits objectively weighed against the cultural or political turbulence that could result. This process requires collaboration between the integrated management teams, and will require input from both internal and external system stakeholders if the plans are to successfully drive acceptance, accountability, and alignment within the system.

Many systems fall short of achieving full integration immediately following a transaction, and thus have opportunity to further optimize system performance years later. These systems may have either decided not to pursue specific integration opportunities in fear of cultural turbulence, stakeholder resistance, or a lack of guidance, will-power or resources to do so. Regardless of the reason, systems should reassess their degree of integration at least annually to identify new opportunities that may have arisen or determine if previous barriers to implementation or resistance to change have been mitigated. It is not uncommon for systems to achieve between 5 to 10% in sustainable, operational annual cost savings years after a transaction as a direct result of future integration plans.

As consolidation trends and cost pressures accelerate, the keys to a successful integration initiative are to focus on value creation, risk management, and employee and physician engagement in order to develop a realistic, achievable, and sustainable plan that positons the system for success.  

For more details surrounding health system integration planning, please download our PDF via the button, below:

  Health System Integration


B_Klar.jpgMr. Klar is a senior manager with GE Healthcare Camden Group with over 12 years of experience in healthcare management. Mr. Klar specializes in strategic and business planning advisory services, including service line planning, master facility planning, and transaction work (e.g., mergers, acquisitions, affiliations, joint ventures). He has extensive experience in the creation of strategic partnerships, the facilitation of inaugural health system strategic plan development, as well as the creation and implementation of business plans of operational efficiency, system-wide integration plans, and clinical programmatic alignment plans. He may be reached at brandon.klar@ge.com.

Topics: Business Plan of Operational Efficiency, BPOE, Mergers & Acquisitions, Health System Efficiencies, Brandon Klar, Health System Integration

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