KPI mad or not?

by | Nov 25, 2018 | Book reviews - business, Management

Is business now KPI mad?  In fact are organisations KPI or metrics mad? Just finished reading ‘The Tyranny of Metrics‘ by Jerry Z. Muller.  And it does give reason to think again about the curent obsession with KPIs  and ‘if you can’t measure it you shouldn’t be going it’.

Muller provides a good background – why we have seen the focus on KPIs.  And it’s not a new phenomenon.  It seems attractive to professional managers – if we can figure out what’s important to the performance of the organisation or company why not measure that?  To some extent the various reporting processes – annual inancial statements, monthly management accounts, variance analysis against budget and/or forecast – are all part of this measurement process.

Key performance indicators

Key Performance Indicators (KPIs) seem attractive – capture the essence of performance in a discrete set of numbers (preferably calculated automatically).  But unfortunately some of this attraction is the weakness.  Selecting a KPI which is calculable – but which may be too simple to measure what si actually a moe complex process.  And lot’s of important activities may not lend themselves to trasditional KPIs at all.

Cross industry challenge

Muller does a good job of  looking through different industries and sectors – be they health, policing, univestities, etc.  Ineach case he points out eamples where the metric is not comprehensive or causes people to game the metric. Almost more worrying, he lists lots of exampels where the metric causes sub optimal behaviour.

Conclusion

So what’s the answer? Do we stop measuring – because it’s too hard, demotivates people, encourages the wrong behaviour.  The balance of the book is so critical of metrics that one could find oneself headed that direction.  I do not believe this is the intent – and I do not think it the right conclusion.  Rather we need to review again the strategic and operational objectives (in a more holistic way) and determine whether there are appropriate measures in respect of each of these.  We need metrics which will motivate performance in line with organisation or corporate objectives.


Great Managers and Great Leaders

by | Nov 10, 2018 | Leadership

Just listening to Mark Little (founder of storyful) on the radio this morning talking about the difference between Great Managers and Great Leaders.  Not sure what the source his commentary. Iw was along the following lines:

  • A great manager walk into a room and convince others that she is a great manager
  • A great leader walks into a room and convinces others that each of them is a great leader

Digital Transformation

Not too far off in this.  Now think Digital Transformation. The need is change leadership more than change management.  So we are seeking people (leaders) who can convince others of their ability to lead change.  Then these leaders will leverage the opportunities presented by new digital platforms and solutions.

Newspapers no longer a sociable experience

by | Nov 1, 2018 | Disruption

I gave up buying daily newspapers a number of years ago. I do, however, subscribe to the Financial Times and the Economist – reading one online (sometimes) and listening to the other (sometimes). We have the Irish Times delivered home on Saturday – but I do not read much (if any) of it. And for the last number of years I have bought the Sunday Times and the Sunday Business Post on Sundays. But, to be honest, find myself increasingly bored by both.

Problems with newspapers?

So, what’s the problem? Has the standard of journalism dropped so much that I am not interested? Has the content changed and become less relevant to mey tastes in news? Is my life too busy to find time to read a newspaper?

I think the biggest change is that no one else in the house is interested in reading newspapers – or, should I say, interested in waiting for the newspaper as a source of news. When I was growing up as a kid the newspaper made its way around the house – read by one, if not two parents, and different pieces were read by different kids (including myself). But now now – not in our house and not in many houses.

And whatever about paying more than €3 for a newspaper on Sunday which may make sense if read by three people not sure it represents great value if only read by one person. And there is no interaction with other household members re the Sunday paper – because they get their news elsewhere – and are online all the time.

I do not have any particular issue with the quality or content/ relevance of the newspapers. But I am inundated with other news – news sites, twitter, blogs,various aggregation sites – far more than I have time to process.

No longer setting the weekly agenda

There was a time when the Sunday newspapers were looking to set the agenda for the week – the breaking new stories which would play out over the following week. No longer any need for this – the news breaks real time all of the time.

Keep paying?

So why do I continue to pay for subscriptions to the Economist and the Financial Times? I think I am still convinced, just about, that the spend is worthwhile for the content. But it’s marginal.

Not sure the newspapers have done a lot wrong – but I think to remain relevant, they have to find a way to become part of the future social framework – which is real time, mobile and largely free.

Generating a return on investment (‘ROI’) in Electronic Health Records (‘EHR’)

Generating a return on investment (‘ROI’) in Electronic Health Records (‘EHR’)

by | Oct 30, 2018 | Healthcare

Electronic Health Record ('EHR')
Generating a return on investment ('ROI') in Electronic Health Records ('EHR') 2

Demand for EHR

Looks like the industry, the regulators, the public, science – all demand the availability of an Electronic Health Record.  We work in an industry which is highly dependent on technology  – be that radiology, robots, theatres, measuring and recording of vital indicators.  Patients are all using very powerful technology (on their mobile phones and/or laptops) all day, every day – leveraging the latest in cloud, artificial intelligence and mobility.

Increasingly providers (hospitals) are faced with major investments to provide the required electronic health record – redesigning clinical and business processes, selecting and implementing complex and expensive information systems, hosting these systems in the cloud (or, for now, on premises), facilitating secure exchange of data between the hospital and patients, insurers, labs, collaborating doctors, regulators and others.  And all the time being required to work within the context of legislation, including recent General Data Protection Regulation (‘GDPR’).

Who pays for, who owns the data?

Traditional thinking means that providers sometimes struggle to recognise that the data is really the patient’s data – even if the provider needs to make major investments to receive basic patient data, generate and record lots of data with respect to the treatment of the patient and provide this back to the patient (and her doctor as may be required).  But I think we’re not far from the idea of patients choosing providers, making data available to providers on a temporary basis, updating the data with data from the provider and then taking the data with them (potentially not leaving a copy with the provider).

So, if that is the model, how do hospitals make the investment pay?

Well, in the first instance, hospitals may not be able to play at all without the investment.  Perhaps, also,  we should see all of this as more of an ongoing opex cost that the traditional capex investment followed by annual support cost.  This may at least provide hospitals with the opportunity to match the opex cost with the number of patients being treated.

If the model is ‘provision of affordable private healthcare’ then the spend will be justified – but it must lead to economies in many areas of operation for each hospital e.g. capture of data once, effective integration of systems (eliminate rekeying and risk of associated errors), streamlined processes in interactions with patients, improved management of supply chain, etc.

Inevitably the technology will impact patient care (before, during and after hospital admission) , interactions between consultants, GPs, patients and hospitals, commercials between payors and payees.  We may also see, in the medium term, changes in the ‘relationships’/ ‘partnerships’ – between GPs and consultants, consultants and hospitals, patients and consultants/ GPs and patients and hospitals.

Achieving an ROI on EHR investment

The return on investment requires that the additional costs (be they incremental capital or operating costs) will be offset by a combination of additional revenues and reduced costs of production.  This will most likely result in redeployment of some current resources –  as technology driven solutions obviate the requirement for basic transcription, constant monitoring of devices, labour intensive accounting and administrative tasks.

The outlook should be very positive – any change whereby error prone and repetitive tasks can be automated should be a good thing.  Likewise artificial intelligence should assist in diagnostics.  Virtual reality offers opportunities for training.  And oll of the changes will provide improved opportunities for collaboration and communication between patients and their doctors and hospitals.  But it would be foolish tno to anticipate the likely initially negative impact on productivity and profitability when implementing these changes (many of the best people will need to be freed up to lead digital transformation type activity).