Paragon: A New System – A New Culture

Paragon culture shiftKatlyn Graham:  Hello, I'm Katlyn Graham here with Andy Cole, the Director of Financial Implementations at Community Hospital Advisors. Welcome, Andy.

Andy Cole:  Thank you.

Katlyn:  Thanks for joining us, today.

Andy:  You're welcome.

Katlyn:  We're discussing, Paragon, your system that you bring to hospitals and with that you bring "A Brand New Culture."

That is the title of this podcast. We're going to be digging into the culture of Paragon. Andy, in your opinion, what is the largest challenge a hospital faces when they migrate to this new system? Actually, maybe we should start off just explaining what Paragon is for those, who may be unfamiliar. What is Paragon, Andy?

Andy:  Paragon is a complete financial and clinical information system that hospitals purchase and install.

These systems will usually take around 14 to 16 months to be installed. The project is that long and touches that many areas. It is a complete hospital information system.

Katlyn:  And there is a lot of information at a hospital. This process of implementing Paragon takes more than a year...

Andy:  That's right.

Katlyn:  ...to get everyone on board.

Andy:  To answer your question about what's the largest challenge during that year, in my opinion, it is the actual cultural shift that the employees who will end up using the system go through. There are so many new processes.

Folks are very scared when they see a new system coming in. They're afraid of losing their job. They're afraid of not knowing how to do something. They're unsure of how this is all going to play out. Guiding these employees who have those fears and getting them to realize it's not the end of the world, in my opinion, is the most challenging part of the project.

It's not how to get the system to work properly or to train them which button to click or which software to use. It's moving to that cultural shift.

Katlyn:  I see. And it is a huge cultural change. I would imagine, could you give an example of how a billing, or administration person in a hospital, how one workflow might change with this system?

Andy:  A good example is, charging, how a hospital charges for its services. A lot of times, hospitals have been putting off tough decisions for years.

They realize, "We're losing charges on this system. We're not capturing all the things that we incur during an MRI," for example. Implementing Paragon will actually bring all those departments together. The Radiology Department, and the Billing Department, and Administration, and Finance.

It brings them all together is a room and says, "OK, Let's figure out what our costs are. How can we bill for this appropriately? How are we going to get reimbursed for this appropriately, as well as deliver the care that we need to deliver?

Normally, those four departments that I mentioned have never seen each other before. They may have never spoken to each other before. Bringing in Paragon actually gets them in front of each other to define their workflow better, tie up any loose gaps, close the circles, and make sure their charges aren't flying out the door. It's the point where the software brings people together.

Katlyn:  I would think that more communication between Billing and the more clinical side could not only improve workflows, but also, patient care if everyone is on the same page and know what's going on. It is quite a process to undertake. You know how hospitals do this successfully.

Andy, what are the keys to a successful Paragon implementation?

Andy:  In my eyes, there's four definitive keys. I call them the four ships. Ownership, comradeship, partnership, and leadership.

Ownership meaning that the hospital will, in their minds, own the software. They have a say in how it's going to be rolled out. They have a say in how folks are going to use it, and how they are going to be trained on it.

It's different than some software they've used before where they just take what the vendor gives them and that's just life. Paragon is such that where it allows them to be involved in that design, that rollout, that workflow discussion. They need to get into that process early, and that's one of the things that we help them with.

Understanding, you can design this. You can be a huge part of it's success. Owning the software and realizing ownership is important. Comradeship. What I mean by this is bringing historically adversarial departments in the hospital together. Much like that Radiology and Billing example I gave earlier.

Typically, those departments butted heads a lot of times. They were unaware of what the other one did day‑to‑day. Designing Paragon, they have to come together, because each part of their system will affect the other. Another key is partnership. What I mean by this is the hospital, actually, becoming partner with Paragon. They need to not have a chip on their shoulder. If something doesn't work, not be mad with the vendor.

They need to realize that they can drive change within the vendor. Being an enemy with each other will not get you anywhere. They need to become partners. Lastly, leadership. Leadership at the hospital is huge. The executive team, the administration team. They need to be involved in the implementation.

They need to be part of the design meetings, part of the rah‑rah meetings to inject enthusiasm in the project. Without that, the end users who end up building it and using it just feel like it's something that was imposed upon them. If there's leadership presence, they don't feel that way.

Katlyn:  I like that concept of the four ships. Ownership, comradeship, partnership, and leadership. You're saying that a hospital needs to make sure they have all four ships there.

It doesn't work without them. I'm sure you've seen examples where not all four of these ships are there. After you go through this implementation, Andy, what does a hospital look like after they've successfully brought on Paragon?

Andy:  It usually takes a few months after the dust settles, after they go live.

A successfully implemented Paragon hospital will look totally different from the hospital before they installed Paragon. You'll have multidisciplinary meetings throughout the week, again, where clinical and financial teams will come together and review workflows.

There's just a breath of fresh air almost throughout the hospital where a lot of bad habits are broken. Silos between departments are broken down. Folks have this attitude of not accepting how things are. They'll say, "OK. I know this process is not optimal. What can we do to fix it?"

They've had this mind shift from, "Oh, this is how it works. This is just our lives now" to "All right, I don't like the way this works. Let's do something about it and fix it." It really changes their mindset and really changes their lives to give them that strength and to empower them to make the system their own.

Katlyn:  And to become more proactive about how the hospital operates.

Andy:  Exactly. And to know that they have a big hand in it. They know that what they do on a day‑to‑day basis can make or break the hospital. It's a good feeling for them once they get it and once the system is stable.

Katlyn:  I hope you go back and visit once they get to that point.

[laughter]

Katlyn:  You've helped their hand through the tough part. To see the result, that this has worked out for them.

Andy:  It does. It makes it all worthwhile.

Katlyn:  Definitely. Thank you so much for explaining all this, Andy.

Andy:  You're very welcome. Thank you.