Technology can sometimes seem like the right way to address issues but most people do not know about the extra problems it can create. You may get a short-term win with technology but end up suffering in the long-term.
If your hospital or organization in on a Lean journey, technology can sometimes go against your philosophy and management system.
Here are some things to consider if you are looking at technology:
- Never automate a bad process. Eliminate waste and understand what the process really needs before you find a way to make it faster. Quicker waste is still waste.
- IT systems should fit the process, not the other way around. In The Birth Of Lean, there was an early Toyota document with the following: “It is not a conveyor that operates men…it is men that operate a conveyor…” So often people change processes to meet the rigidity of the technology. Ensure the technology does not force standardization that has waste, lowers quality, or makes no sense.
- Be able to make changes after it is implemented. So often organizations are stuck with wasteful systems because nobody has knowledge to make iterative improvements or the cost to bring someone in is so high that nobody fixes it until it is totally broke.
- Trial first instead of piloting. Pilots usually happen after you buy the system. I have rarely seen organizations stop implementation if a pilot does not work out like they expected. Organizations usually just change their messaging and training to fit what the technology can do instead of ensuring it does what they wanted it to do. Trialing is part of PDCA thinking and will help ensure the IT system meets the needs of the process without being financially committed to rolling it out.
- Know the problem you are addressing. With today’s technology, there are all sorts of bells and whistles that seem great. Although impressive, the added features may be more than needed (overprocessing waste) and can sometimes distract from why you were looking for technology. These ‘extras’ can also add complexity to your processes.
I think technology can be embraced in Lean organizations but it is important to ensure it is thoroughly tested, reliable, and improvable before you commit to implementing.
Any other tips?
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Great post!
Not really a tip, and not really technology, but I always encourage folks to look at paper forms with suspicion before automating them with a technical solution. More often than not, I’ve found they embody bad or outdated processes, but because there is so much momentum behind them it’s difficult to look past the form to the actual outcomes it’s intended to achieve.
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Brian,
Love this post! This is an excellent list. I just had breakfast with someone on Tuesday who gave me my new favorite phrase–“Don’t automate the mess”–which is your first bullet point. As much as I love tech, I often try to steer people away from either a) taking a bad process and applying tech or b) taking a perfectly good manual/visual process and applying tech when it wouldn’t apply any additional value.
Your second bullet is also one of my favorites. I blogged about this a few years ago and reference a Baseline magazine article (links below). It is unfortunate how many times a business system either hinders a great process or creates additional waste.
http://leantech.com/blog/2007/06/06/one-massive-size-cant-fit-all/
http://www.baselinemag.com/c/a/IT-Management/Solving-ITs-Biggest-Challenge/
Great post!
Great list. I see a lot of instances in healthcare, sadly, where technology and automation lead to higher labor cost and slower performance. It ain’t supposed to work that way! Pharmacy pill picking automation…. requires a person to run another machine to repackage pills. Lab automation that add physical conveyors to a bad physical layout… less they got labor savings, but turnaround time was way longer than it needed to be if they used a truly lean cellular layout.
Technology is a tool. It’s hardly ever (never?) a silver bullet solution.
I type this as I prepare to spend two days at the HIMSS conference… something I’ve only half-jokingly referred to as the “silver bullet show.”
Healthcare needs to do better…. following the Toyota Way mantra:
Principle 8
Use only reliable, thoroughly tested technology that serves your people and processes.
How much of our 18% of GDP is being wasted on ineffective software and automation implementations? I’m not saying the software is to blame, necessarily, but if technology and process aren’t aligned, you get trouble.
Nail on the head. Especially point #3!
I like to say, “The problem is knowing what the problem is.” Someone with the authority to procure tools usually believes they know how to fix the issue, and spends money on a new gadget. They then have to drive use of the gadget, to verify their idea was a good one. With no effort to step back and appreciate the processes and identify those bugs, expensive solutions get pushed onto others, often with the end of making the project initiator look good, rather than improving the organization as a whole.
I’ll add to your ‘Trial first…” tip, and say “Don’t stick with broken technology.”
I really wish more poeple understood the concept of sunk costs. What you already spent on a system that doesn’t do what you want is irrelevant to the decision about what to do next.
When I started to use lean principles, we learned from a Schonberger book. The lessons of Simplicity. He pointed out that althought technology is sometimes helpful it can ihibit further improvement due to not wanting to “lose” the tech… “We spent so much on the !!! system, and now you say there is a better way”
Tech is good when you have to use it… key word being “have”
You ask, “Does technology really provide solutions?”
I think the best answer is, “it depends”.
A hammer and nail is a great fastening tool. A nail gun is a technology wrapped around a hammer.
A paper and pen is a great communication tool. Email is technology wrapped around delivery of the message.
A bike is a great transportation tool. A motorcycle is technology that takes you farther and faster.
Yes, it really provides solutions, assuming one is skilled and knowledgeable enough to know which tool to select for the job.