Benefit Management may save us all!

I just read a thesis from the University of Aarhus, about harvesting value in IT projects. The students named the area as Benefit Management (profit realization), and is a highly relevant and general area that many organizations should prioritize. Particularly in the health sector.!

I've often wondered that in such a research-heavy and evidence-based system such as health care sector, how can you introduce New Technology, new processes around technology and new skills among staff, without knowing the evidence or just the effect on productivity or perhaps quality.?

Currently there are deployed  IT in the Danish health like in a pace not seen before. In Region Southern Denmark the regional project portfolio consist of more than 50 large and small projects, so spending millions and billions on a national level - and what do we get out of it? Well to put it bluntly we often don’t know!

Benefits management is defined in the book "Benefits Management – How to increase the business value of your IT projects" written by Ward, J. & Daniel, E. 2012 as:

“The process of organizing and managing such that the potential benefits arising from the use of IT are actually realized” (page 8)

Benefits Management is all about identifying and harvesting the value that a given project has the potential to realize. Currently projects are not initiated in Region of Southern Denmark without having drawn up a business case. But how will the projects be prioritized towards each other? And do we work adequately with identifying the value a given project may realize. Maybe – but probably not.

But when the system, technology or equipment is implemented, how is it ensured that the gains that were identified in the business case is realized. ? There may have been a tendency not to make this impact assessment, evaluation, or otherwise measure whether what you thought you got out of a project. Traditionally, the value collected are invisible deep within the operation of the organization. The point is that we often do not know what the value is and therefore we cannot harvest it.


I guess benefit management has two major objectives. One is on a macro project management level to harvest the value on a organizational level. It could be to increase the effectiveness with 2 pct. or to reduce adverse events. The other is on a local level, where the individual ward or department can identify their special benefits from the implementation and then try to work towards those when implementing the system. Done right it may help on the projects implementation success rate on a local scale, because the receiving users take responsibility on the implementation and the goals/benefits regarding it.

In my organization we have used the Himss IT value suite. In short it is a framework to identify the following:

•    How do we know Health IT works?
•    How does Health IT improve patient care?
•    Can others duplicate the type of value others have achieved?

The framework is suitable both on the managerial/organisational level but also on the local level, where a discussion with the headline “what is a successful implementation in our ward” the main issue.

Benefit management is and must be our focus otherwise we invest, implement, learn and reinvest in the dark. To know the impact is crucial also because only then are we able to share our experience and help others in their efforts.

It took two very talented, hard-working and well-prepared students to get my eyes to the problem again. (I gave them the grade 12 for the rest). They introduced me to the field on an academic and structured way. The road is paved with endless amounts of benefits and value of digitization - we all have an obligation to pursue these unyielding, and the courage to harvest them  in a proper and professional manner.

Ward and Daniel is a great book by the way – and I highly recommend it.

Ownership of healthcare data is an irrelevant discussion

I have just been in Finland for the annual conference in healthcare IT where I did a speech on “From the structural reform to new hospitals projects”. It was a great experience, and the conference had over a 1000 participants and a great vendor area. On day two I was invited to participate on a expert panel arranged by the Finnish health ministry, who are finalising the national ehealth strategy.

The expert panel consisted of a group of very influential people including the CEO of Himss Stephen Lieber, Hal Wolf former of Kaiser, Hans Nielsen Hauge of Norway, Uwe Biddrus of Himss. We should comment and influence the final draft. I am rather proud to be accepted in that crowd and we did our best to comment and discuss the content and the direction the strategy described.

It is a very ambitious strategy, where municipalities, social services, hospitals, general practitioners are all covered in and end to end continuum of care strategy. I found it inspiring and the big challenge now will be to get it flying, coordinated and actually implemented within the Finnish system.

When we discussed the strategy, we landed on the subject on who will own the health data. It is the patients data, and the patient will in the future generate a lot more for themselves – we have seen a fraction on that with fitbit etc.

In the future the patient will probably meet the healthcare system with a huge amount of self-collected data, and say here you go, use it to cure me and to personalize my treatment. After a while Hal Wolf directed the conversation towards the issue, that it is not about who owns the data (strictly a legal issues) – It is who have access to the data. I think the first legal question shouts down the discussion more often that it opens it up – so the shift in paradigm was a very welcome gesture from a very knowledgeable man. In the end it is all about access and nothing more actually.

We need knowledge and information to be able to coordinate the care and bring healthcare towards personalised and integrated care. It took me a trip to Finland to truly realise that.


By the way. Finland stands on the brink on something great - I guess the magnificent vendor area is a sign to that. Investments will be huge and we should all help and look north - because a change in healthcare might come from that direction sooner than we know it.

HIMSS Continuity of Care Maturity Model - an importent patient focus acros the continium of care

In a few weeks Himss is announcing the European model of HIMSS Continuity of Care Maturity Model: Transforming Health through Effective Usage of Interoperability and Analytics in Nice in the start of April at WOHIT.

Himss is renowned for its maturity model EMRAM within the hospital sector, where 7 stages defines the maturity of digitalization within the hospital. The Nordic countries and maybe Denmark in particular have always focused on the patients journey.The entire continuum of care from the GP, to the hospital, municipality, pharmacy etc. Denmark has a widespread digital landscape that shares data as messages between the participants with the patient in the centre.  The Continuity of Care Maturity Model will address exactly that, and more importantly it will drive change into a focus around the patient and not the Hospital. You could call the new maturity model a patient centred model!

I have participated in the project of developing the model with Himss analytics as the project manager. It has been fun and very rewarding to work closely with other healthcare partners across Europe, but also to develop something different, something new and substantial important for the health services and organisations across the European Union.

The above sounds like a little flamboyant, but a maturity model is important. Not that it matters if you get a 5, 6 or 7 in an isolated perspective, but the model and the eagerness to achieve greatness will drive the business, the hospitals and partners in a certain direction. It will be a driver of change, and the model will point the direction and set out the goals – so of course it is important, that it is designed properly. Data shows in the US, that the higher grade you have in the EMRAM the greater your hospital will be within quality metrics end efficiency. So it is ultimately not about the digitalization, the grade or us bragging in the bar late at night about my hospital being EMRAM 6 or even 7! – it is and always will be about cutting costs and improving quality – it is about the patient and nothing more actually. 

I truly believe Continuity of Care Maturity Model will in the future be a factor in that equation.

Himss on the model:

HIMSS Europe is presenting the Continuity of Care Maturity Model, that evaluates various aspects of delivering continual care covering both capabilities at organization and pan-organization levels. The Model will measure the readiness of an organization to deliver continuity of care as well as the maturity of a healthcare system in the continuity of care delivery. There will only be a global model but regional specifications are possible within the model’s framework.

The model has been designed by HIMSS Europe in collaboration with a pan-European workgroup including country teams from Spain, the Netherlands and the Nordics. It comprises 32 individuals representing regional and national health authorities, strategic planning organizations, CIOs of groups or regions, industry and HIMSS consultants.