Most systems today have become more complicated and sophisticated so the inability to fully use them shouldn't be surprising. "What needs to happen is that we should make systems more user-friendly," said Richard Perrin, AdvanTech president. "Many of them are needlessly complex in trying to link process flow with systems. Many automated systems are not set up to facilitate their capabilities and require specialized interfaces with multiple sign-ons and screens to access other systems."

Rudomin noted that users can be impatient for results, too. "People want to get a system up and running fast," he said. "They want their data now and they want to file purchase orders without going through 18 different screens."

When software implementations become complicated in materials management, particularly with an ERP system selected by senior level executives (such as the CFO and CIO), materials managers retreat to their comfort zone.

"They make the mistake of saying all we want to do is get it live and get it to do what our previous system did," Wyatt said.

Indeed, one of the biggest problems is that many merely want to replicate their old system, Fernandez noted. "If you want a good typewriter go to a legacy system," he said. "You should take advantage of automation to reengineer your processes."

"People tend to use automated systems that mimic what they've done with their previous legacy system or the way they did it manually," Perrin said. "They continue to work in their silos and are not cross-trained to understand what others using the system do."

That's part of the problem, Wyatt noted. "Materials management is not an island," he said. "They are a service provider to customers. An ERP system gives you the ability to draw on what other departments are doing to simplify your efforts and impact the whole organization. This is not off-the-shelf boxed software. ERP focuses organizations to make decisions on how they want to do business. It takes a lot of work but that's a short-term inconvenience for a long-term benefit. It will take time and resources on the front end but over time it will free you up to do different things. ERP focuses you to be very disciplined and holds you accountable and responsible for what you do. Some mistake that for a lack of flexibility."

Dan Sougstad, healthcare supply chain product manager for Lawson Software (St. Paul, MN), called it an "apples to oranges" comparison, indicating that ERP integration works to eliminate that island mentality typified by an MMIS. "Departmentally-focused MMIS, while containing many key features and functions, actually reinforce silos and naturally result in 'departmental sub-optimization (i.e., optimizing one department at the expense of the overall process)," he said. "When you cobble together systems that toss data between 'islands of automation,' information gets lost in translation, the process breaks down and ultimately the customer of the process suffers."

Materials managers either don't know what to do because they lack the training, the resources in terms of staff and time, or they simply don't see the need because the growing number of online e-commerce capabilities offers a seemingly simpler route, according to Majors.

"If I could wave my magic wand, I'd like everybody to know all of the capabilities and use as many of them as possible," Wyatt said. "We'd have happier customers. I have four days of stuff I can show you but if I'm only given two hours chances are you're going to leave things on the table. You need to take time to learn. The amount of effort upfront will definitely determine the value of the benefits you receive later. People need to understand why it's going to be better at the end. They just need to see the light at the end of the tunnel."

The blame game

When materials managers run into trouble with their MMIS or ERP software packages it's almost instinctual for them to point fingers at the vendors for making promises and not delivering.

"Most materials managers are realistic in what they want," Bohon said. "I think it's the vendors' understanding of materials management needs that falls short. The vast majority of materials managers don't have overblown expectations. They just want the system to do some basic stuff. They want the basic functions to work and keep them out of trouble."

Majors argued that software vendors are "very often less informed" than their customers about what's needed. "They tend to be very vague or unrealistic in their responses to our direct questions relative to features, capabilities and components of their system," he said. "This is especially true with standard reports, installation time line, required installation resources from the hospital, and industry penetration of their product. And then it is too late when you're in the middle of an installation before you find out that you were misled or you misinterpreted a vendor response to your question several months earlier."

It's a matter of trust, according to Buehner, and eliminating confusion. "If you're not a technical person you have to believe in your vendors and trust them," she said. "I don't think we're being unrealistic. We just want to know the facts."

Bohon concurred with the need for trust between materials managers and software vendors. "We're looking for companies that will work with us to solve problems and not just sell software," he noted.

Some are unwilling to condemn the vendors without passing equivalent judgment on the providers. "Both ends of the equation have unrealistic expectations," Rudomin said. "Vendors want to sell products so they're going to oversell and tell you it's the latest and greatest and will fix any problems. Hospitals are only too willing to believe it because they've exhausted other possibilities, such as reducing inventory, cutting staff. They also underestimate the resources they need, in terms of time and people. Many will say it's harder and costlier than they thought it would be. They'll spend thousands upfront and still be putting bandages on it later.

"Often, senior management is reluctant to throw any more resources into it because they figure it's you who's not doing your job right," he continued. "Some hospitals just have bad operations that a new system won't fix. Sometimes they think the system will save the day so they spend a lot of money on it and still don't get results. You want to believe the product is as good as the vendor says it is and you want to believe implementation is going to go as smoothly as you expected and neither is true."

Don't blame the vendors, Fatholahi insisted, because they aren't doing anything wrong. "They're just trying to sell the strong points of their systems," he said. "If you believe every one of them without testing the software then you're at fault. It's our job to understand these systems. We need to do our due diligence and planning ahead of time." He urges materials managers to develop a detailed checklist covering system demands. Bohon also agreed with testing but cautioned against relying on the sample database the vendor provides. Instead, hospitals should input their own data, which have more relevance to their operations.

Integration testing is important, Fernandez emphasized. "Every step in the process has to be tested thoroughly, from the point of demand to the point of paying invoices--from req to check. At some point everything impacts the general ledger. Data integrity for building files and relational databases is critical for ERP implementations in a multi-entity organization."

In addition to a checklist, hospitals need a roadmap showing where they want to go and how they plan to get there, according to Wyatt. "In many cases, there's no operational plan," he said. "Keep in mind that an implementation of any system never ends. You always continue learning and expanding capabilities. Those organizations that see the most value are those that don't stop."

"We've met the enemy and they are us," Abramson said. "We as users all want a system that will make our work life better and easier with higher productivity. Suppliers will play to these needs. As a result, the decisions made have an emotional base to them and are built on what [the vendor or hospital IT department] can make the technology do for you, which can be expensive. Sometimes real financial gains aren't recognized because they don't come fast enough for our expectations. We think that since it's electronic it's going to save the employee from any kind of physical execution with the keyboard or the mouse. Well, we haven't seen the brain wave interface yet."

In with the IT crowd

If anything, a software implementation project reinforces the need for materials management to collaborate with the hospital's IS or IT department. "You have to develop and maintain an integrated working relationship with IT and keep the organization's big picture in view," Parker said, "because you're seeing materials managers getting more connected with finance and billing."

Abramson echoed that effective partnerships are needed. "IT people need to keep their eye on the business goals," he said. "It's not just about installing technology but helping to change processes and getting business goals accomplished. People should be able to see their own needs and simultaneously see the bigger picture affecting the whole organization."

When TMC switched to the PeopleSoft ERP system, Bohon admitted that his department's relationship with IT could have been better with clearer communication. "With our implementation we needed better coordination between the two departments," he said. "We felt we were at a disadvantage because we felt we understood IT better than they understood materials management so [the relationship] started off poorly and never seemed to improve."

What worked for Fatholahi was a dedicated systems administrator on staff to make sure the software runs effectively for more efficient day to day operations. "Materials managers don't really understand all the capabilities of an ERP system, such as drawing meaningful reports," he said. "But a systems administrator can help you alleviate any shortcomings and deliver the information you need."

The systems administrator can keep track of how frequent upgrades affect department-specific customizations programmed into the software and how those customizations impact data ports, he noted. "It's a chain reaction that can leave you with a hodgepodge of information and data discrepancies," Fatholahi said. "Ideally, it's better to have an IT person as your systems administrator but if you have one that understands materials management, too, then that's great. He's a resource that helps us show our value to administration."

COPYRIGHT 2004 Healthcare Purchasing News
COPYRIGHT 2004 Gale Group