Faculty/Presenter Disclosure• Faculty: Joanne Hohenadel, Brenda Merkle, Ashley Taylor

• Relationships with commercial interests:– Grants/Research Support: Nothing to disclose– Speakers Bureau/Honoraria: Nothing to disclose– Consulting Fees: Nothing to disclose– Other:

• Brenda Merkle – employee, Plexxus• Joanne Hohenadel - employee, University Health Network• Ashley Taylor – employee, University Health Network

CFPC CoI Templates: Slide 1

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Fast Track to Business Transformation: The Journey of 10 Hospitals

E-Health 2013May 29, 2013

Presented by:

Brenda Merkle, BASc, CMA

Joanne Hohenadel, BASc, PMP

Ashley Taylor, HBA, CMA

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Agenda

Context

Plexxus

The Project

Success Strategies

Lessons Learned

In Summary and Continuous Improvement

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Purpose/Objective of Presentation• Story of a journey started in 2003 that is a collaboration

among 10 hospitals and Plexxus, their shared service provider, in the procurement and implementation of a back office business transformation enabled by SAP

• Share experiences and lessons learned about regional inter-hospital collaboration – Overview of the shared services model to gain efficiencies in master

data maintenance, procurement and business reporting and analytics

– The opportunities and challenges of University Health Network (UHN) being the first of 10 hospitals to go-live

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Background• One of the largest academic health sciences centres

in Canada• Ranks of the world’s leading providers of exemplary

patient care, innovative research and teaching• The first of the Plexxus Member Hospitals on SAP

• Largest provider of enterprise-wide business application software in the world

• 109,000 customers in more than 120 countries• 12 million users

• A not-for-profit shared services provider for 11 hospitals across the GTA, 10 of which are on SAP

• Expertise in supply chain management, information technology and business transformation

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The Plexxus Membership

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Plexxus Business Model• Plexxus was created to transform the back office of Member

hospitals, reducing cost and improving quality through:– Group purchasing

– Common and integrated systems

– Leading practices and standardized processes

• Member owned

• Not for profit shared service

• Over $75 million in purchase price savings to date

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• Supply Chain Management– Strategic Sourcing– Sourcing and Contract Management– Purchasing– In-Hospital Logistics– Distribution– Clinical Support

• And Now…Information Technology (Finance, Supply Chain)– Ongoing Support, Maintenance and Enhancement– Master Data Governance and Management

Scope of Plexxus Services

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Integrated Technology Solution (ITS) Project• What is ITS?

– Major business transformation project– Integrated “single build” SAP-based platform for 10 hospitals and Plexxus– Standardized business processes and leading practices– Delivers significant efficiencies (EDI, e-Requisitioning)

• Scope– Finance

• general ledger• accounts payable• grants and funds management• fixed assets and capital project management

– Supply chain management– Data governance and management

• Groundwork laid between 2006 and 2010. And then…

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The ITS Project• 11 organizations (including Plexxus)• 7,000 users• 1 Harmonized Chart of Accounts• 27 companies (legal entities)• 48 plants (site locations)• 7 Advisory & Validation Committees• 250 interfaces• 125,000 material and 42,000 vendor records harmonized • 350+ project deliverables• 40 training courses• 65 Steering Committee meetings• 6 go-lives

…In 2 years and 2 months from start to finish and under budget

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ITS Project Timeline

Mar 2010 Sep to Dec 2010 Jan to Aug 2011 Sept to Oct 2011 Nov 2011 to Oct 2012

All Hospitals and Plexxus participated in business blueprint and build phases

Project Launch

Individual roll-outs: 2 hospitals every 2 months

or Build

Project End

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ITS Project Governance Model

Plexxus Core Team

3rd Party Vendors

Hospitals Project Teams

Advisory and Validation

Committees

Strategic Management

Tactical Management

Operational Management

Plexxus Board

ITS Committee

ITS Steering Committee

Program Management

Office

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SAP@UHN• What is SAP@UHN?

– Project to deliver ITS to UHN• Scope

– UHN participation in the overall governance of the ITS initiative

– Collaborate with Member Hospitals on design and decisions related to standardized features across all hospitals

– Lead UHN implementation• Business process redesign• Technical (installation, integration)• Change management (communication, education and training)

• First of ten Plexxus member hospitals to go-live

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SAP@UHN Governance

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SAP@UHN – Success Strategies

Finance (Corporate

and Research)

PMO

Technical Team

• Strong commitment from senior leadership

• Authority to make decisions

• Support for UHN Finance Subject MatterExperts to participate in SAP configurationwhile maintaining Hospital functions

• Supporting UHN project management and technical teams

• Extensive ITS Advisory and Validation Committee involvement

• Internal communication and engagement (strong communication and change management strategy, daily huddles, UHN Shared Information Management Education Department support)

• Took holistic view with decisions on project – not just what was best for UHN

• Only one temporary junior staff person was hired by UHN with the result that knowledge stayed in the organization and built a very strong team post go live

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ITS Project Success Strategies• Extremely strong Board support

– Signaled importance by establishing ITS Committee of the Plexxus Board – All scope additions and customizations required Plexxus Board approval

• Clear governance down to the deliverable level• Adherence to guiding principles

– Single build – Shared service is a “compromise”

• ‘Tough love’: zero tolerance for slippage, leverage the power of the Membership

• Repeatable ‘rollout kit’

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ITS Project Success Strategies• Forums for participation, communication, collaboration,

transparency– Advisory and Validation Committees, CEO calls, project sponsor

meetings

• Choice of first Hospital to go live• Interface strategy buffered

dependency on connector systems• Two independent third party

reviews − Governance and processes− Budget, benefits, risks

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Ongoing ITS Governance Structure

Strategic Management

Plexxus Board

Resources and Audit

Committee

Plexxus Senior Mgmt & ITS

Service Delivery

User Groups

Tactical Management

Operational Management

• E-Requisition/SRM• Reporting/Finance/Accounts Payable• Purchasing/Logistics/Finance Integration• Technology

ProductionChange

Control Board

ITS Council

Functional Governance

• Material Governance• Vendor Governance• Reporting Governance• Security Forum• Security and Privacy Advisory Committee• Others TBD

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Lessons Learned• Data: quality

• Data: incremental consolidation – adding new materials and vendors for each rollout

• Data: governance, change management – Data S.W.A.T. team, quality check reports

• Importance of complete and accurate material master especially in critical patient care areas e.g. operating rooms

• Train more, train later

• More business resources on project team

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In Summary and Continuous Improvement• Continue to leverage inter-hospital collaboration and

perseverance• 6 key areas of focus for ongoing stabilization are

– Data refinement – Security – eRequisitioning ramp up– Enhancing reporting access – Configuration refinement

• Activities that transcend specific stabilization activities are communications, data quality control and governance

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In Summary and Continuous Improvement• Desired outcome - gain efficiencies in supply chain

management and ability to make more judicious and informed decisions for our healthcare organizations and our patients– Improved procurement processes and savings – Elimination of paper purchase requisitions – eRequisitioning adoption– Flexible financial reporting capabilities– Access to timely information for business decisions

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