An Implementer's Notes

This article was originally published in the JHU Global mHealth Initiative’s Digital Roundup (April 2015)

An implementer’s task is to assess a situation, match technology and stand up a robust information system that sustainably meets the needs of an organization and their clients. Over the past decade, I have implemented small-scale projects at small businesses, NGOs and the government. Each of these positions have allowed me to innovate as an entrepreneur, implementing technology to make business run a little more efficiently. I aim to share a number of implementer’s notes that help me get from idea to product in an efficient manner.

##Early Work
A major component of implementing is selling the idea to the individuals within the organization. Demonstrating value of a new technology presents a challenge as there’s a lot of time between initial conversations and actually getting value from the information system – many gains are often incremental and build upon each other over an entire system. The typical conversation resembles…Our outcome ‘x’ can be achieved with system ‘y’. The system capabilities are often touted as being a near fit for the organization to reach its outcomes, with an unclear roadmap to turn those capabilities into action. In my experience, I find more success using a more transparent route. System capability ‘a’ allow us to collect data points ‘b, c, d & e’ that can then be aggregated into report ‘f’ that’s submitted to manager ‘g’ who can then choose to do ‘h’ or ‘i’ toward outcome ‘x’. This granularity affords us a greater understanding of a particular system and its ability to achieve the outcomes of the organization.

##Where’s the IT team?
The investment in an IT team shows if and how an organization values their information. Technology, and the teams that support it, are a means to an end. They enable streamlined business processes, information and communication. The technical team doesn’t just maintain computers and networks, they ensure the organization is connected so information can flow through an organization’s systems and people can act on the right information at the right time. A good IT team is proactive in nature, seeking problems and performing preventive maintenance to ensure our organizations operate with maximum uptime. My first request is to be introduced to the IT team so I can develop a strategy toward implementation. Some of my main concerns are : Is this IT team proactive? Are they ensuring uptime? Are they documenting their work? How is this reported to the management and what actions does the management take? These questions are key to identify how involved the management is in the functioning of their information systems and their integration into the organization as a whole.

If an organization doesn’t have an IT team, I may be faced with a number of hurdles before I can begin an implementation. Do I need to convince the management that information is valuable, or do I need to convince them that a specific system is valuable? How do they intend on using the new technology and/or the data it produces? However, If there is an IT team on site, actively managing the technology and information systems, I can focus on implementing the specific system, using the existing foundation as a building block. I made many erroneous assumptions in my early career, I didn’t realize the importance of identifying a true starting point and determining how organizational information is valued before getting started. Great information systems rely on a foundation of excellent people and services. For example, a typical Software as a Service (SaaS) mHealth deployment relies on solid training of front line workers (FLWs), access to electricity, a mobile network provider, organizational management and a deep stack (an organized data collection from which information enters and exits) from the SaaS provider. Every piece in this complex puzzle has it’s own strengths and weaknesses. We can research and compensate for known issues like electrical outages, 3G reception problem areas and the like. However, the success of an implementation is most reliant on the organizational management and how they value information.

##Information vs. Technology
Unlock your phone and check your email. This simple act of accessing the information in your email requires a great deal of technology. The technology in this case includes the phone and email application. The information is the content of the email message that you read and act upon. Again, the technology is a means to an end. The end is successful access and action on information.

I find that this point is a differentiating factor between the full adoption of an implementation and only adopting the technical component of the implementation. For example, many agree that a FLW can perform their job better with a mobile phone. The FLW is often thrilled just to have a device. Training ensures that they have the necessary skills to add and receive value from the device as a part of their normal job function. This training must ensure that the FLW understands how their data contribution helps them, their clients and system as a whole. Simply put, the FLW isn’t getting a phone, they’re getting access to contribute and receive actionable information. If this isn’t clear at the FLW and line management levels, the phone becomes a phone and the information system isn’t as valuable as intended.

##Technology -> Data -> Actionable Information
After assessment, the implementer’s workflow involves standing up technology, customizing it to the implementation and going live. The go live date is just the beginning of a much bigger project that will eventually add value to the organization. Next we start to get data in to the technology. Once we have data, we’re able to retrieve actionable information out of the system. However, this information is only as good as the data that’s entered, the old adage “Garbage in, Garbage Out” still applies. That’s when we get to the management’s role in information.

##Management’s Role in Information An implementation’s success relies on the buy-in from management at all levels of an organization. Human systems must be in place to ensure good data is collected and aggregated that is then acted upon. The information system is only as good as the data that’s entered and the data that’s entered is only as good as the human that manages it. Front line managers must have the responsibility and authority to ensure their team is engaged, contributing to and receiving value from these information systems. High-level managers must also receive actionable information that adds value to their work, ensuring that the implementation flourishes. The implementer must consider multiple levels of reporting to ensure that management receives value. For example, a daily snapshot of FLW work is perfect for the front line manager so they can ensure the work completed by a team member is accurate and in line with the organization’s goals. Additionally, weekly snapshots that aggregate the week’s activities are incredible for executives to see the progress of the team’s work.

These are standardized reports that can be generated by the system. The real value arrives when managers get their hands on live data. This point is critical because the information has finally arrived and management can start to make decisions based on the information. The implementer shifts roles to data analyst and sees how they can slice the data to maximize management’s value received from the information system. Unfortunately, it’s a trial and error task where the implementer presents their perspective and management returns with further requirements. The good news that this is a short-term exercise and standardized reports are created that really adds value to the management of the organization.

I hope you enjoyed these notes. If any points resonate with you, I’d love to hear about your experiences. Please feel free to contact me.

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