The ongoing drive to save time and money drives organizations to look into content management. As the costs of software and implementation range from almost free to millions of dollars and choosing the right vendor or system is vital, this decision can be daunting.
The term content management: What does it mean?
Content management is a phrase you hear everywhere these days. Companies claim they "do content management" and vendors say that they sell content management software. People who hear about content management often think about how to create a web site. The text, images, movies, etc., that are shown on web sites are the actual content indeed, but content management entails more than meets the eye.
Prior to explaining what content management is, it is useful to define the word content. Content is essentially any type or "unit" of digital information that is used to populate a page. It can be text, images, graphics, video, sound—or in other words—anything that is likely to be published across an intranet, extranet, or the Internet.
Where does content management come from?
Currently, information, communication, and digital networks have made a major impact. In this society, there is much information available. A company needs to acquire and structure information that exists both within and outside of its own four walls.
Where does this need for information or this need for content come from?
It can be said that the buzzword of this era is content. Before content, the hype of the late eighties and early nineties surrounded documents. As companies were producing large volumes of information by the end of the eighties, and while business boomed for products like Word, WordPerfect, Excel, and Lotus 123, organizations faced an increasing need to organize documentation. Rather than printing and storing hard copies, the documents required digital storage. The market responded with the creation of a powerful software tool to manage this process. These solutions became known as document management systems (DMS).
By the end of the nineties, the terms changed from document management systems to content management systems (CMS). A lot of DMS vendors suddenly called themselves CMS vendors since the main difference between document management and content management is the fact that document management deals with the document in its entirety, while content management focuses on the individual parts that make up a document or even a web page.
Both systems follow the same basic rules, workflow and processes. However, due to the evolution of the Internet, companies began to be more focused on managing the web site at the content rather than document level. This caused the market to shift from document management systems to content management systems.
Content management is more than just a software tool. It is very much about the individuals involved, and the processes and the organization as a whole.
The content management process entails collecting, managing, and publishing the content by combining rules, processes, and workflows. It is a discipline that manages the timely, accurate, collaborative, iterative, and reproducible development of a web site.
Why use a content management system?
Web sites were, in the past, built and maintained by a handful of persons within a company. The process of publishing text was a fairly simple process. Most web sites were simply electronic versions of a company brochure and understanding HTML was necessary to make even simple changes to single words on the web site. This process of maintaining web sites was labor intensive and not only made it difficult for other IT departments to publish content, but interfered with the use of other IT skills and products.
Nowadays the Internet, intranets, and extranets are dynamic with internal and external information about the company and its products, business solutions, and services. This information cannot be maintained by only a few people, moreover maintaining it would take too much time to deploy as new content to the Internet.
Content within organizations and on the web continues to grow exponentially. Organizations are struggling with maintaining their web sites and locating, and sharing a variety of content. Today organizations need more than simple content delivery. Businesses need to maximize their processes and optimize their value. Improving business efficiency, reducing costs, and operating risks motivate the implementation of content management systems.
Enterprise content management helps organizations accomplish this by enabling better access to the content, optimizing their business processes, and connecting database applications with the actual people.
A CMS allows a company to realize several benefits; it
- Improves customer satisfaction by having correct information
- Maintains a high level of quality and consistent information on the web
- Enhances productivity by permitting for content to be re-used over multiple web sites
- Enhances productivity of webmasters in the areas of redesign and functionality
- Results in faster response time
- Facilitates controlled workflow, built up around the company's processes and policies
- Leads to increased productivity among employees
Meet the business goals with the requirements
Before one looks to investing in a CMS, it is important to clearly define business goals. Defining what is important to meet immediate business needs, as well as long-term goals is often cited as the most challenging of tasks for an organization. What does the business want to accomplish by implementing a CMS? The answer to this needs to reflect the long-term strategies of the organization.
To define the business goals, the organization should perform a thorough analysis and ask itself some questions that well define its requirements. You need to understand what goals and expectations you have that drives the need for a CMS. What problems will the CMS solve? What is the cause of these problems in the first place and what is the anticipated impact of the CMS on your organization?
The scope of the CMS will need to be well defined also. Boundaries for the business goals will need to be set. If the scope is too broad, too many vendors will meet the criteria. This only hampers the selection process.
After defining the business goals, the requirements need to be gathered. Your business goals should provide a clear view into the requirements. Each and every single requirement should reflect a specific business goal. It is important that not only short term requirements are met, but also future requirements should be taken into consideration when selecting a CMS.
Make sure you structure your requirements into categories, such as content creation, content management, and content delivery. This will make the list more manageable. It should cover all aspects of the CMS life cycle.
What makes up a CMS?
A CMS can improve content publishing, efficiency, and productivity significantly. Specifically, a CMS offers a range of benefits and tools including
- User-friendly, web-based access and use
- Decentralized authoring, allowing many authors in multiple locations
- Document version and time controls
- Content approval workflow
- Database and template creation
- Dynamic page generation
- Link management
- Document conversion
- Access control and built-in security
- Usage analysis
- Template and design standardization
Vendors will offer a variety of these or other benefits. It is definitely in the company's best interest to determine which system and vendor suits the organization best.
Selecting a CMS can run a company millions of dollars. It is therefore very important that the right software package is selected to meet your business goals and needs. That is why it is crucial to set up the business goals and make sure all stake holders are involved in the process.
Spending enough time on the initial phases will reduce the business risks inherent in selecting the most appropriate CMS.
There are several factors to consider when selecting the appropriate solution for your organization. If you want to maximize the chances of choosing the most appropriate solution for your organization, be sure to speak to inScope group to get the best advice.
Beat them or love them. It matters not. Vendors bombard financial institutions with advertisements for all sorts of software and hardware, often claiming to revolutionize some aspect of banking. Some products meet and exceed expectations. Other products plainly fail to do anything of value for the bank.
To complicate the divide between good and bad, the way a bank selects, implements, and monitors a technological product significantly contributes to the final effect on the bank's environment. An auto owner may find a fantastic deal on diesel fuel, but if his car only takes unleaded gas, anything else will clog the engine. Similarly, many technical products for banks are incompatible with existing systems or simply unnecessary.
Project managers and other delegates responsible for technology in an organization should approach these projects with a clear procedure for analysis and decision-making. A strategic slant helps control indiscriminate upheavals of systems and work processes.
Each project has unique factors. A five-step process can draw a clear picture for everyone involved in the venture, and increase the likelihood of a successful outcome for the bank. They are:
- Start. Someone needs to recognize the need for a project, define it, and initiate the process.
- Plan. At this point, project managers structure a proposal that accomplishes the tasks required to conclude the project.
- Execute. Project managers coordinate the people and resources required to implement the plan.
- Supervise. During this phase, the progress of the plan is monitored and adjusted, when necessary.
- Finish. People need closure. A formal ending to the project brings satisfaction and a reallocation of resources.
All types of projects require these five phases of development. Because of the complexities and fluidity in the technology marketplace, certain aspects of this type of project management are more nebulous, requiring special insight and experience. Most certainly, they require management by individuals who understand the products, services, and vendors that will decisively impact the final effect of the project. Technology can raise many questions for even the most knowledgeable IT personnel.
Defining the Project
Clearly define the project. Project managers should elicit input from staff within the bank who will be affected by the proposed technology. The end users face some of the greatest daily impact, and their psychological buy-in is valuable to the bank. Project managers need to describe in detail:
- The technology system and processes to be implemented or changed.
- How the bank will use the application.
- The benefit the technology will provide to the organization.
Record this information on a form standard to these projects. A lucid, unambiguous definition goes a long way toward controlling the outcome of the project.
Determining Organizational Impact
A positive impact is clearly the goal. Although that seems obvious from a step back, there is often an unavoidable, interim impact of new technology on an organization. During this time, frustration may develop for many reasons, including system glitches, lack of knowledge, and user downtime.
Project managers can mitigate the prospect of frustration by reviewing the big picture. Some changes required for a new IT component might be work process reengineering, staffing levels, training and more. The changes may initially inconvenience some departments, but are required for the eventual greater good.
Some questions to ask are:
What business processes and functions should be changed?
What resources are required to support the operation of the new technology?
- Identify staff requirements
- Identify the impact on current training resources.
- Describe new hardware or use of existing hardware.
- Describe new software or use of existing software.
- Describe interface requirements.
- Describe network requirements
What is the impact on the current network infrastructure, IT policies, and standards?
Can the new IT solution be applied to other areas of the bank?
Could any redundant or duplicate system be used, modified, or eliminated?
At this point, it may be determined that the project will drain resources, or perhaps, profit the organization more than previously anticipated. Either way, the evaluation helps assess whether the bank has the means to attain its goals. The final success of the project relies on the bank's ability to maintain the technology, including support, training, and maintenance.
Project managers can ask several questions, in conjunction with assessing the project's effect on the bank, to determine the value of the new technology. The bank's long-term strategic plan comes into play at this level (assuming that the strategic plan is up-to-date, and in line with current bank goals). The following facets of the project should be addressed:
What strategic goals does the IT project help meet?
What prioritization ranking does this project mandate in the current project schedule and use of available resources?
Describe the intangible benefits.
Describe the tangible benefits.
- Increased revenues
- Decreased costs
- Revenues maintained
- Costs avoided
Describe IT project costs.
- Up-front hardware, software, and installation costs.
- Ongoing vendor maintenance and support fees.
- Ongoing internal maintenance and support costs.
Develop five-year ROI analysis and/or net present value when comparing alternatives.
This level of analysis helps management and staff gain enthusiasm for the benefits of new technology, and understand the cost in time and money involved in implementation. A common disappointment in technology projects is misconception of long-term costs and benefits. Project managers and certain members of IT personnel may thoroughly understand the functions and capabilities of a new software application, along with its total cost of ownership. At the same time, management and users may have completely different expectations. Creating a tangible document with full descriptions of the outlined information may help avoid these adverse situations.
The risk factors involved in a technology project should be carefully assessed. The bank can minimize the danger by carefully assessing it, and forsaking a project that provides evidence of unacceptable risk. Project managers should assess the risk of:
- Failing to implement the project on time
- Not implementing the system
- Foregoing the intangible benefits
- Foregoing the tangible benefits
- Exceeding estimated project costs
The caution used at this level will considerably help the bank avoid unacceptable conditions. The flip side of risk is security. Project managers can secure the bank's technological investment by prudent inquiry into all conceivable outcomes of the project.
And Finally . . .
A bank can use technology to grow. More than that, technology oils the wheels of progress in some areas. But, an organization cannot take on everything presented to it. When a decision is made to examine new systems and products, the project should have a dedicated system of management and prioritization. This system requires that its participants possess knowledge, insight, and a determination to use a uniform project management methodology. The level of thoroughness and competence that project managers use to manage a project will mold the ultimate result for the bank.
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Product lifecycle management (PLM) software vendors are consistent in their belief that PLM applications software is well worth the investment because the life cycle costs of new product design and initiation (NPDI) are inherently weighted at the front end. Therefore the better job a company does in managing an efficient process toward NPDI will imply considerable cost savings over time. After a product launch, there are additional and significant gains that can be achieved by properly and efficiently managing the product life cycle through product retirement, but the real nugget for most manufacturers lies in the front-end of the product design and development cycle where an average (over multiple long NPDI industries) of over 80 percent of the costs resides.
Life Cycle Costs Over Time—Efficiency Starts with Design
Current global market forces are driving the need for manufacturers to re-examine their ways of conducting business, and are, in turn, driving PLM applications initiatives. These global market forces include
- Mergers and acquisitions
- Outsourcing and off-shoring
- Globally distributed manufacturing operations
- Broader supply chain networks
- New product market opportunities
At the same time, the recognition of inefficiencies and complexities across comprehensive business processes throughout a companies' design, engineering, manufacturing, marketing, and support organization are driving interest in PLM:
- Market assessment including segmentation and demographics
- Forecast demand and market window
- Conceptual design and product definition
- Detailed design
- Manufacturing release and change management
- Parts selection and sourcing
- Production process planning
- Market rollout
- Aftermarket support
- Portfolio management
The dynamics of these global market forces coupled with existing but inefficient product development business processes are opening the door to increasing PLM software adoption. Manufacturers are achieving better time-to-market improvements from the adoption of NPDI techniques and technology, but there are still bottlenecks during execution of these processes. Global design teams are becoming more commonplace due to mergers and acquisitions and outsourcing, dictating a more dispersed cross-functional team to collaborate on NPDI. Global expansion is also seeding collaborative NPDI activities. At the same time, regulatory requirements and other compliance initiatives are increasing the data capture requirements as new products go to market. Studies show that NPDI cycles are shrinking, indicating that collective PLM targeted processes and technology are paying off.
Demand for PLM and recognition of value can be translated by the fact that key vendors like PTC, Dassault Systems, Agile, MatrixOne, and UGS are experiencing mixed to healthy growth in revenues for both design tools and broader PLM capabilities. PLM vendors, as a group, are meeting or exceeding market growth expectations, and the bar has been set high. The CEO of Compaq was recently quoted as saying that PLM offers "more pure ROI" than any other business application. So where does the value come from? Many of the subjective revenue gains and objective cost reductions lie in
- Improved new product design innovation
- Coordination across multiple product design and development locations
- Improved design quality while reducing design cost
- Reduced product time-to-market cycle times
- Better support for customers located worldwide
- Opportunity recognition via portfolio management
- Improved custom product development
- Enabled patent management
- Improved channel management
- Enabled intellectual property management
The Business Case for PLM Varies by Industry and Timeframe
Each industry has its own view of how PLM can improve efficiency, and what drives the business case for initiating PLM projects. Industries with short NPI and short product life cycles, like electronics and apparel, are "manufacturing" driven. Their focus is on the advantages gained through PLM concept adoption from design to mass production product launch. At the other end of the spectrum, industries like automotive, aerospace and defence (A&D), and pharmaceuticals have long product life cycles and long NPI cycles. They are "program" driven, and stand to gain from PLM initiatives focused on collaborative design, project management, portfolio management, and product retirement.
Total cost of ownership (TCO) is a holistic way to view the true costs of IT investment throughout an applications' life cycle. TCO is a way to understand and analyze the costs, efficiencies, and economic impacts associated with procuring, using, and maintaining IT application components over time. In short, it is the "cradle to grave" costs associated to IT investments. TCO of a PLM environment is the total cost of procuring, operating, and maintaining PLM applications including hardware, software, training, peripherals, servers and local area networks (LAN) equipment including hidden and indirect costs like training and support throughout the life cycle of the PLM software assets.
Consulting firms that specialize in TCO assessments for software acquisition embrace a TCO philosophy based on the best practices surrounding application life cycle management including acquisition, deployment, service, and support, as well as revision control. TCO benchmarks exist for detailed analysis of current expenditures related to hardware and software, operations, administration, as well as end user operations and downtime. Topics such as staffing information, outsourcing fees, service desk metrics; dispatched support calls can all be included in a thorough TCO analysis.
PLM, as a strategy, is as much process definition as it is technology. Any TCO analysis examining the costs associated with a PLM application must as well examine the scope and level of best practices you have implemented in your company today as well as in the future. This requires a sharp view of both the "as-is" and "to-be" state of a companies' product design and development cycle.
But this type of analysis can be time consuming, laborious, and expensive and is most likely not warranted if one takes a more simplified approach. A considerably more simple yet logical approach for manufacturers initiating a PLM project involves developing a process flow schematic of product design and development processes, determining estimated or average durations by process, and comparing the reduction of product life cycle design and development time versus the over all product design and development costs. A mere percentage of savings in life cycle time can result in big dollar savings. Hacking off a week or two of product development time, and the resulting ripple effect throughout the product life cycle, can result in considerable savings that far exceed the TCO of a PLM application.
There is no need to succumb to analysis paralysis when it comes to justifying a PLM applications investment if you understand the nature and specifics of your product development life cycles. Appraisal of cost savings based on incremental reductions of product design and development times in most cases will far outweigh the TCO of a PLM package. To date, most companies have adopted an incremental approach to implementing PLM and have been directing immediate attention to projects that solve tangible problems with short term paybacks.
Long term, the benefits can be substantial, albeit subjective, in terms of measurement. Senior management needs to trust in instinct and common sense at times when forces are colliding to warrant prudent but immediate investment in PLM.
Call us to find out how inScope PM's can help your organization.
A key challenge in software implementation is getting the end users up to speed with the new system. My experience has been that training is more often a failure than a help. At my last job, I found people doing astounding work-arounds to get their work done because they didn’t know how to use the system.
There is a surprising but valid reason that managers skimp on training of all types. They don’t think training works. In many cases they are right. Just think about the number of people you know who have gone off to training, but showed no change in behavior or outcomes when they returned. You might even have been one of those people! Why would a rational manager repeat that.
Of course, the training gurus tell managers that “you just didn’t train enough”; in other words, you need more of the same medicine. But from the surface, it is virtually impossible to distinguish one training supplier from the next. So picking a “good” trainer is very tough for the non-expert. And in the software world, the trainers usually come with the implementing firm, so you may not even have much choice.
In the face of all this, it seeems there isn’t much to recommend training; however, much we might think that it is a good thing in principle.
Or is there? Maybe it isn’t training in and of itself, but how we do it. After all, Olympics athletes aren’t born doing what they do—they learn their skills. It turns out there are some pretty consistent practices that help those athletes improve.
What, then, if we could find a set of practices that seemed to make a difference?
A program called Training Within Industry (TWI) was developed during World War II (WWII) to help boost the production and productivity of the nation. They were dealing with bringing large numbers of unskilled people (women and those who had been unemployed during the Great Depression) into factories that hadn’t existed, making products that had just been invented. For example, the labor force in shipbuilding went from under 50,000 in 1939 to over 650,000 in 1943!
This program developed an approach to training that was proven effective time and again. The training time to get people productive on a new task went down at least 25% for every company that used it, and often much more. For example, the time to train a competent lens grinder went down from 5 years in 1940 to 5 days in some plants in 1944.
Interesting. But how does that make any difference in 2012 in the world of software?
There are two reasons to think it might be effective.
First, this method is still used today by some of the very best companies, such as Toyota. The TWI approach is still at the core of how Toyota trains its workers, and the company expects new plants to produce at full run rates within the first shift of start-up!
Second, we have seen it applied by a software vendor with remarkable results:
- A client installation of a module that had historically involved several support calls happened without a single call, and compliments on-the-job instructions.
- A group of sales people who had never used the application before learned to do sales order entry in two sessions, and were doing it with high confidence, with virtually no errors, and were excited about their new contribution to the sales process.
- A module installation that previously had taken a day and with lots of support was done flawlessly in just one hour without any questions by a junior person.
This company is now using this approach whenever it trains clients, and the consultants are excited about how fast the training is to develop, and how quickly the learners master the skills.
What makes this method work? There are five key reasons it is effective.
- Starts with context
Most people like to know why the work they are doing matters. How does it affect the customer? The TWI approach starts by preparing the worker, figuring out what his/her existing experience is, how that experience might relate to the work at hand, and explaining why the work is important—how it matters to others in the company and, ultimately, to the customers. Letting the learner see the big picture helps his/her interest in learning.
- Distinguishes between three types of information
One of the challenges in most instruction is that the presenter wants to get across not just what to do, but how that step needs to be done and why it has to be done that specific way. In most cases, these different kinds of information get all mixed together. This makes it hard for the learner to follow the flow of the work. It also makes it harder to remember. By carefully distinguishing between Important Steps, Key Points, and Reasons, the TWI approach makes it easier for a person to learn and remember the steps of the operation.
- Demonstrates in stages
If you think about someone who has taught you to use a piece of software, the single biggest challenge is following where the teacher’s cursor is. If you are not familiar with the task, then you don’t know what fields matter, and where they are located on the screen. By doing repeated demonstrations (four) and layering on new information each time, the learner gets familiar with where to move his/her eyes on the screen, and doesn’t get overwhelmed with information all at once. The “bite-size” pieces of information make it easier to swallow.
- Learners repeat the process
Too often people learning software are shown the process once, and then allowed to do one practice try before moving on to the next task. The problem with that is that humans learn well through repetition. So the TWI process asks learners to repeat the process several times, with specific activities during each repetition, so that before they leave the training session they have demonstrated not just ability, but also understanding.
- Only shows the current best way
Most software offers many ways to achieve the same result. Think about how many options there are for aligning text in any word processor. However, when you are learning, choice is NOT your friend. Those who have used an application for some time also know how to get the desired result with the fewest clicks and screens. In the TWI approach, you teach only the current best method. You also start with the core task that will cover 90–95% of all cases. Let the learners master that. Only then do you layer on the exceptions. Don’t give the learners unnecessary options. It makes it far easier for them to learn.
Fortunately, the TWI method for job instruction is easy to learn. The instructional time is just 10 hours, not weeks.
Of course, practice is needed to master this training method, just like anything. But the evidence is that this training model can be as effective today with software as it was in WWII with shipbuilding and aircraft manufacture, or as it is today at the very best companies.
As you consider the training needs for an installation, look for a vendor who uses this proven method—a method that reduces the learning time by at least 25%. And if you can’t find one, ask us and we'll help.
If you’re a small to medium business looking to purchase a learning management system (LMS), you may not be fully aware of the standards out there for e-learning.
Many of us take for granted the fact that we can simply sign up for an e-learning course, whether it’s an online course, or a course offered through our own company’s LMS: We log in, start our training, breeze our way through the content and questions, and everything works smoothly and seamlessly. But what’s going on behind the scenes? Plenty! And it all starts with the way the learning content (or learning objects [e.g., videos, questionnaires, glossaries]) were written and compiled, as well as the way the course content is delivered.
This article is for you if you are
- looking to purchase an LMS or learning content management system (LCMS) for the first time, or
- looking to update your legacy LMS.
I'll help you understand the basics about e-learning standards and how they need to be applied in the context of your LMS purchase.
Why Are E-learning Standards So Important?
To help you understand e-learning standards, here's a great analogy provided by Rustici Software:
When you buy a new movie on DVD you don’t need to check to see if it works with your brand of DVD player. A regular DVD will play on a Toshiba the same as it will on a Panasonic. That’s because DVD movies are produced using a set of standards. Without these standards a studio releasing a new movie on DVD would have a big problem. They would need to make differently formatted DVDs for each brand of DVD player. This is how online learning used to be before SCORM [a set of e-learning standards] was created.
It’s important to note that some LMSs are not compliant with any content standards. Any content created in such LMSs will not be reusable for other LMSs.
Standards You Should Know About Before Buying
Depending on your e-learning initiatives, it’s important to know how the various existing standards will affect your company's LMS purchasing decision.
SCORM, or Sharable Content Object Reference Model, is a set of technical standards for e-learning software products. It was originally developed based on the US Department of Defense's (DoD's) technology specifications for e-learning supplies. The DoD's goal was to define the smallest possible units of learning content that would allow consistent classification, "shareability," and wide reusability.
SCORM is important because it makes Web-based training content and the applications that control and display that content to learners interoperable in a standard way. If you have a SCORM-conformant LMS, you can be certain that any learning content that is also SCORM-conformant will integrate successfully with your system.
When SCORM 2004 (the most up-to-date version of the standard at the time of writing) was established, it introduced a complex idea called "sequencing"—a set of rules that specifies the order in which a learner may experience content objects. In other words, these rules constrain learners to a fixed set of paths through the training material, allow learners to bookmark their progress during breaks in learning, and assure that the test scores achieved by the learner are recorded.
SCORM also defines how to create sharable content objects (SCOs) that can be reused in different types of systems and contexts—i.e., it tells software programmers how to write code so that it can work properly with all types of e-learning software. More specifically, SCORM governs how online learning content and LMSs communicate with each other. All online or Web-based training needs to be SCORM-compliant: Your e-learning initiatives may be in serious jeopardy if your users can’t count on your LMS to deliver content well and consistently.
It’s important to note that SCORM governs online training only, and only interactions between a single user and an LMS. Offline or group training is not governed by these standards.
The advantages that SCORM compliance brings to e-learning are the following:
- Portability: When your courses are SCORM-compatible, you can rest assured that they will "play easily" with most LMSs, and transfer between multiple LMSs when necessary.
- Compliance: Many LMSs require that your courses meet the SCORM standard. In other words, non-SCORM-standardized courses just won't "play" on a SCORM-standardized LMS.
- Tracking: SCORM compliance ensures that your courses can track learner performance, and enables managers to view that information.
Among all e-learning standards, SCORM has gained the most traction in the LMS industry, and I'll be referring to SCORM as the de facto e-learning standard throughout the rest of this article. That said, other standards exist, and you should be aware of them as well.
In the context of e-learning standards, AICC stands for "Aviation Industry CBT Committee," an international association of technology-based training professionals. The AICC develops guidelines for the aviation industry for the development, delivery, and evaluation of computer-based training (CBT), Web-based training (WBT), and related training technologies. AICC specifications are usually designed to be general-purpose specifications (as opposed to being specific to aviation training) so that learning technology vendors can spread their costs across multiple markets, which in turn allows vendors to provide products to the aviation industry at a lower cost. This strategy has resulted in AICC specifications gaining broad acceptance among non-aviation and aviation users alike.
The standards developed by AICC have influenced SCORM standards, as well as those of other organizations such as IMS Global, IEEE, and Ariadne. While learning content creators generally prefer the SCORM format for creating e-learning content (since importing and deploying SCORM content is a one-step process), deploying AICC content is a little more difficult and requires a bit more overhead, as the import and upload of content is a two-step process.
Although some argue that AICC is a more reliable, robust, and unambiguous system specification, the more widely supported SCORM standard seems to be a better choice with some LMS applications for technical reasons (e.g., authoring tools, sequencing, and navigation). On the other hand, there are certainly valid reasons for using courses and management systems based on AICC specifications. For example, AICC allows content to exist on separate servers, and supports secure information transfers with HTTPS. With SCORM, the content and the LMS must be on the same server. This is just one of the reasons you might want to choose AICC over SCORM.
LETSI RTWS stands for "Learning Education Training Systems Interoperability Run-Time Web Service." In a nutshell, LETSI RWTS is an enhancement to SCORM that came about through research related to scripting issues under the SCORM standard. Click here for more information on LETSI RTWS.
How Do These Standards Affect My LMS/LCMS Purchasing Decisions?
LMSs allow instructors to create and deliver content, monitor learner participation, and assess student performance. LMSs also allow learners to use interactive features such as threaded discussions, Web conferencing, discussion forums, and other methods of communication. If you're looking to buy an LMS for the first time, there are certain things you’ll want to verify before you buy. A comprehensive and SCORM-conformant LMS should be able to do (but should not be limited to) the following:
- centralize and automate administration
- provide self-service and self-guided services
- assemble and deliver learning content rapidly
- consolidate training initiatives on a scalable Web-based platform
- support portability and standards
- personalize content and enable knowledge reuse
Today, SCORM has been widely adopted by many large organizations. Besides the US DoD, other industries are following suit, and the standard appears in the majority of today’s requests for proposal (RFPs) in the procurement of both training content and LMSs. It is generally recommended that all e-learning content and LMS purchases include SCORM-conformant products in the submitted proposals. If these standards aren’t mentioned as part of your RFP, make sure you add them.
Technology Evaluation Centers (TEC) offers RFP templates for companies that are looking to compare LMS products. Our LMS RFP template includes all the relevant e-learning standards to ensure that prospective software buyers cover the bases when gathering information from LMS software vendors.
What Can I Do to Ensure that the Content I Produce Or Deliver Is Compliant?
E-learning standards assure learning content developers that their content will connect to almost any LMS on the market. They also promise learners that the content they purchase in the LMS marketplace will be seamlessly delivered. These standards also provide organizations with the ability to analyze their return on investment (ROI) in learning through SCORM and AICC’s tracking features.
Sticking to one standard allows organizations to mix and match course providers and deliver all courses to their employees through a single LMS. With compliance comes the opportunity to buy off-the-shelf training packages, hire a consultant to write specific programs, and create content yourself (or any combination of the above).
Bottom line: If your LMS is compliant with SCORM, AICC, or other standards, learners can use the standard packages inside the LMS instead of your company having to create native LMS course content. This can be very convenient if users don't want to tie themselves to using one particular LMS. Moreover, courseware vendors often provide their course content in some of the widely used standards, so you can purchase ready-made courses instead of creating your own. Be sure to verify standards compliance before purchasing any courses.
What If My Existing LMS or Learning Content Is Not Compliant?
If we go back to the DVD analogy, one thing is for certain, if your LMS (or the content you produce or attempt to access) do not both conform to the SCORM standard, your employees/learners won’t be able to properly access the courses you’re providing.
Whether you want to be able to export content from your system, or import other people’s content into your system, you need to make sure you’re covered in terms of SCORM standards. Period!
It’s important to note that conforming to one standard does not necessarily mean that you automatically conform to the others. Do your homework and ask your content and LMS provider if they’re up to date with these e-learning standards—before you buy!
For insightful subject specialists and leading project managers that can help you scope, define features, select a vendor and implement your LMS, call inScope today.
The success of an e-learning initiative depends as much on the people and culture of the organization as it does on the technology used.
So what is culture? One of American comedian and pop icon Jerry Seinfeld's favorite show business stories goes something like this:
One cold winter's day, the members of the Glenn Miller Orchestra are on their way to a gig when their bus breaks down. So the musicians grab their instruments and start walking. Before long, they come across a cozy little house. Inside, a family is sitting around the dinner table, talking, laughing, clearly enjoying each other's company. The band members are damp and shivering as they gaze at this idyllic Norman Rockwell scene. Finally, one of the musicians turns to another and asks: "How do people live like that?" [source]
That is a story about culture.
There are many definitions of culture, however, including the following ones.
- The "customary beliefs, social forms, and material traits of a racial, religious, or social group" (Merriam-Webster Online Dictionary)
- The "set of shared attitudes, values, goals, and practices that characterizes a company or corporation" (Merriam-Webster Online Dictionary)
- Learned and shared human patterns or models for living
- Day-to-day living patterns
- The shared knowledge and schemes created by a set of people for perceiving, interpreting, expressing, and responding to the social realities around them
- The "basic pattern of shared beliefs, values, behaviors and assumptions acquired over time by organizational members" (Daryl Conner, O.D. Resources Inc.)
Whatever the definition, all social organizations—nations, industries, corporations, churches, social clubs, etc.—have characteristic cultures.
There is also quite a diversity of definitions of e-learning. One goes as follows:
E-learning: Covers a wide set of applications and processes, such as Web-based learning, computer-based learning, virtual classrooms, and digital collaboration. It includes the delivery of content via Internet, intranet/extranet (LAN/WAN), audio- and videotape, satellite broadcast, interactive TV, and CD-ROM.
E-learning is one methodology and technology for delivering and enabling learning. In most organizations, an e-learning initiative is an implementation of training and collaboration that is made available to employees over the corporate intranet, and is thus readily available to people at their convenience. While e-learning may partially replace classroom training, in most cases it is designed to enhance training and extend it to a broader audience, while saving costs.
This paper looks at the impacts of organizational structure, behavior, and culture in the context of an e-learning initiative. National and industrial cultures do impact the culture in a specific company, but that is not the primary focus here.
Corporate culture can help or hinder an e-learning initiative, sometimes both. E-learning can also be a tool to support cultural change.
We can study a corporate culture by observing the way it does things in order to identify its core values and beliefs. Organizations do not always behave the way they say they do. There are also subcultures within organizations that can differ greatly. By knowing the corporate culture, we will be better equipped to work with it, rather than against it.
Cultural factors can appear in many places, including the organizational structure, support from the top levels, the environment for innovation and change, the human resources situation, administrative procedures, budget, the training and learning history, the relationship with the information technology (IT) department, and the existence or non-existence of an enterprise resource planning (ERP) system.
Cultural stories can be very revealing, so here are a few illustrations.
A few years ago, before the term e-learning had been coined, someone at Cisco decided to videotape a presentation and put it on their intranet. When they showed it to a vice president, he got so excited that he sent out a message to everyone saying that they should have a look at it. Hundreds did so and it nearly brought down Cisco's network—probably the most advanced network in the world at the time.
Many companies still have strong prohibitions against video. In fact, Cisco itself still does. They continue to use video extensively, but they have figured out ways to keep it off their backbone by distributing it on local area networks (LAN). Their fascination with technology led them to experiment—moving them towards e-learning. However, their technology innovation was contrasted with a very traditional view of training—videotaped presentations are very passive ways to learn, but they are a way of getting information out to employees quickly. Nonetheless, the environment for implementing e-learning was obviously right in Cisco, since it is one of the most visible corporate e-learning success stories.
A corporate culture that supports innovation is more likely to embrace e-learning.
Human Resources and Administration
In a unionized company, the director of training consulted with the labor relations group about e-learning and was told it couldn't be done. The reason was that managers would complain about it. Why would managers complain about people getting additional opportunities for training? It turns out that the problem was the instantaneous nature of e-learning. Employees would be able to sign on and take the training without the manager's approval and the manager couldn't control what the employee was doing.
There were several things at work here, one of which was an administrative procedure—when employees registered for a classroom course, the manager was sent a letter, and the manager could advise the employee not to take it. To some extent this was a control issue, but it was also legitimate because managers want employees to take courses that are part of their plan or will contribute to their job, especially if they are doing it on company time. The other was a perception issue on the part of the labor relations people—they were afraid of possible problems. Later when e-learning was rolled out without consulting with them, this problem never occurred.
It is always wise to consult with all the stakeholders in an e-learning initiative, but the Human Resources (HR) people may prove to be one of your biggest challenges, even though the training department is often part of HR. HR people are good at anticipating all kinds of labor relations problems and other issues.
Learners and Training
Some say that the greatest challenge in an e-learning initiative is the learners themselves. It may not be the biggest challenge, but it is something to consider. If people are used to going to classrooms to learn in an instructor-led social environment, then they may not understand the concept of learning while sitting at their desks in front of their computers. After all, we have been conditioned all the way through our school system to believe that being in a classroom is how we learn. So if there is a strong tradition of instructor-led training in your company, then you will need to deal with this.
In addition, in organizations with strong internal training departments, the trainers themselves may view e-learning as a threat to their jobs. This fear needs to be addressed.
In one company, some e-learning courses on communications and management were made available to people and they gobbled them up with comments like "Finally the training department is doing something for us." As it happened, although there was a strong tradition of classroom learning, it had become a perk that was provided only for a select group of people. They got to travel to the big city, do their shopping, and have time off the job—all at the expense of the company. All of the others—the ones who in many cases really needed the training—were being denied access to training. They were hungry for almost anything.
E-learning is about more than saving costs, it is about extending access to the entire organization.
Central Training Organizations
A central training organization is usually the best place to initiate e-learning because it can reach most people in the organization, and be cost-effective. While such a unit is most likely to have the necessary budget, that budget is visible and vulnerable to the whims of senior executives.
The Gartner Group's total cost of ownership (TCO) studies showed that computer support is a fairly constant cost regardless of how it is organized. Training is a lot like that too. There is a natural cycle of central training organizations. As corporations grow, each department recognizes the need for training and starts to deliver and manage its own training. The cost of this is largely invisible to senior executives. At some point in the growth cycle, a smart new vice-president sees an opportunity to save money by centralizing training. After this happens, companies often do save money, but the budget for training is now more visible and is subject to senior management approval each year. It then becomes a target for executives who don't recognize its value especially in times of fiscal pressure. It tends to be one of the first budgets to get cut. When the central training unit is downsized, the departments begin to increase their in-house training resources again. Once again, the cost is relatively hidden but the total cost to the organization is greater. And so, the cycle repeats itself every few years.
E-learning can save an organization a good deal of money in the long run, but there is an initial investment required. Therefore, to implement e-learning, you need to know the budget culture of your company.
Whether to Buy or Build a Learning Management System
One company worked hard to identify a learning management system (LMS) to suit their needs. They already had some e-learning in place and they wanted a system that would manage both classroom training and e-learning. After extensive work, it was decided that they would build it themselves—reinventing the wheel. The decision was made for political, budget, and process reasons. There was no budget in place to obtain the LMS, and there was an internal IT group who had developed some related applications. It was easier in this company to generate a project to build a system than it was to find the money to purchase a system.
You need to understand the peculiarities of the budget system in your company.
- Why, when, and by who are budget decisions made?
- Is it a capital or expense budget?
- What is the best time for a proposal?
- Are the key players drivers of the budget or driven by the budget? The ones who are driven by the budget will never find any money for you if there isn't some already in place.
Return on Investment
Budget requests require justification. If your company is very return on investment (ROI)-oriented, as most are today, you will need to justify e-learning on an ROI basis. In a study issued in September 2002, Nucleus Research stated:
Customers implementing these solutions have quickly recognized first-tier benefits, including reduced costs for travel, human resources overhead, regulatory compliance and customer support costs; and eventually received second-tier benefits, such as increased employee performance that directly impacts profitability. Nucleus found most companies could gain significant returns from even modest investments in e-learning technology.
This has not proven to be true for all companies, so the decision making along the way needs to be carefully done and a plan should be in place.
The IT department and the support of its people are key to the success of any e-learning implementation. Be sure to include them in the discussions from the beginning.
In one company's initial e-learning offering, there were three delivery or hosting choices—host the courses on their own server, have the parent company host them, or have the supplier host them over the Internet. These choices raised several issues.
- Bandwidth. Do the courses use too much bandwidth? Do the courses contain any video? Even if they do not, courses may not be allowed to run over the backbone to the parent company because critical operational applications run there. Even in companies that have very sophisticated intranets, there are rules about the applications that run across backbones and key networks.
- Internet access. Does everyone have access to the Internet? In some companies, access is a choice made by local managers, some of whom may believe that the Internet access is a waste of time. In a meeting with customer service managers in a major communications company, eight out of ten supported Internet access because their people needed to be able to see what their customers were being offered by the competition. Two managers, however, would not support it and one of them said, "Over my dead body". This resulted in inequitable distribution of Internet access throughout the company and meant that access to courses outside of the intranet would not be possible for some.
- Corporate firewall. If a choice is made to have someone outside the company (like the vendor or another application service provider [ASP]) host the courses, you need to test the corporate firewall to see if the courses can run through it. If they don't, approach the IT department to see if it can be done. If it can't be done, then you will have to run the courses internally. Again, you will need the support of the IT people to provide the necessary server space. You may find that the firewall issues will change over time. Whether you think so or not, the IT and security people are your friends and it is important to enlist their support from the beginning.
Unions can be supportive of the idea of e-learning because more of their people will get easier access to needed training. Some unions may be resistant because they cannot control it. One company tried to provide people with an opportunity to telecommute—to work from home—but the union resisted it because then they couldn't monitor the managers while at work to make sure they were not doing union work. In another company, the union and management had been trying to negotiate a new contract for nearly two years and were getting nowhere. A union leader was quoted as saying that having to have personal development plans in place put additional stress on people. However, the personal development plans which had been initiated by senior management were the key to the success of their e-learning program.
In 2001, Sun Microsystems was moving into the e-learning business as a vendor and had purchased an LMS to use and sell. It had a major presence at the 2001 Online Learning conference in Anaheim. During the conference, another LMS supplier was approached by someone from Sun. The other vendor responded with, "Why are you talking to us? You have it all in house." The response was that the Sun representative was from a different department and they were going to do things their way. Sun now appears to have abandoned the idea of becoming an e-learning vendor.
In many organizations departments are sufficiently autonomous to make these kinds of decisions. On the one hand, this presents an opportunity for suppliers; on the other, a single department may not have the critical mass to make e-learning cost effective, leading to its ultimate failure.
What Kind of Organization is Yours?
You want your e-learning venture to work with the culture not against it. There are at least three kinds of companies. The type of company you have will determine the most effective path for an e-learning strategy, as follows.
- For top-down, task-oriented organizations, a straightforward curriculum of courses is your best bet.
- For democratic, people-oriented companies, collaborative e-learning systems are the way to go.
- If your company is a true "learning organization", you will need a broad program of collaborative e-learning and knowledge management.
Different divisions may require different treatments. Where do you fit on this spectrum?
E-learning is a significant change event and needs support at the chief executive officer (CEO) level—get him or her to actually take an e-learning course so that they know what they are talking about. It also needs a high level champion who will do the work to see it through to success, but beware of e-learning champions who believe it will replace all forms of training. Such a person can do as much damage as someone who does not believe in it at all. The reality is that instructor-led training is not going to disappear. There are things that e-learning doesn't do very well, for example, laboratory work and face-to-face interactions. There are some people who will never get used to the idea of learning at their computer. To them learning is a social event. The best solution is a multi-option, blended solution like that offered by North West Airlines, which provides people with computer-based training, classroom training, mentoring, personal training plans, and a checkout library with books, magazines, videos, and audiotapes.
Executive Computer Literacy
How computer literate are your executives? Many are quite technology challenged—even in technology companies. This can work against you because they have no idea what you are trying to do. Educate them. How often do the senior executives visit the intranet? Typically it is a rare event. This can work for you because you can use the intranet as a marketing tool without being seen as wasting money.
The existence of any of the following conditions may present an opportunity to implement e-learning.
- Mobile workforce. A mobile and widespread workforce is an opportunity to save a good deal of money for training, because travel costs are reduced.
- Training not meeting needs. What training department can meet all of a company's needs these days? E-learning is about extending access to training.
- Knowledge management. Knowledge management is about collecting and sharing corporate knowledge; thus it is part of e-learning and vice versa. Get your people to see the connection.
- New products. Many companies introduce several new products per month. It may take weeks to train people on one new product, by which time there have been several more introduced. E-learning can train people almost instantly.
- Highly regulated industry. Regulation compliance training is a good place to start. Large numbers of people have to get it and be regularly retested for certification. E-learning is faster, better, and cheaper than training that requires travel.
- Sales people. Sales people need quick access to information because knowledge impacts their income. Moreover, they are highly mobile and computer literate. If it works for them, they will sell it.
- Change. If your company is going through some significant change—anything from a merger, to a new product line, to a downsizing, to a new ERP—you can leverage e-learning to support that change. In the previously mentioned example of the initiative requiring everyone in the company to have a personal development plan, when people discovered that there were e-learning courses available for "free", they built them into their plans and started taking the courses. The personal development plan and e-learning each contributed to the success of the other.
Factors that Support E-Learning
The following factors support e-learning.
- A CEO who believes
- Corporate change initiatives
- A central training organization
- A supportive IT department
- Regulatory requirements
- Budget reductions
- A geographically dispersed company
- Having a strong network (intranet) in place
Factors that Work against E-learning
Conversely, the following factors work against e-learning.
- A CEO who doesn't care or believes that e-learning will replace all training
- The learners themselves, perhaps
- Trainers who feel their jobs are threatened
- Managers whose control may be threatened
- Conservative HR people who are nervous about anything new
- A lack of a long term view of cost savings
The following are some tactics that may be used to market e-learning within a company.
- Matching the culture
- Linking with change initiatives
- Department meetings
- Door prizes
- Rewards for participation
- Intranet announcements
- Guerilla or underground tactics
If you need help drawing up your LMS requirements, or need assistance with vendor selection - call inScope today.
Seth Godin's post today - The map has been replaced by the compass - says to it all when it comes to project management:
The map keeps getting redrawn, because it's cheaper than ever to go offroad, to develop and innovate and remake what we thought was going to be next. Technology keeps changing the routes we take to get our projects from here to there. It doesn't pay to memorize the route, because it's going to change soon.
The compass, on the other hand, is more important then ever. If you don't know which direction you're going, how will you know when you're off course?
And yet we spend most of our time learning (or teaching) the map, yesterday's map, while we're anxious and afraid to spend any time at all calibrating our compass.
Do you have any questions now about why project management exists?
There are many stats on why IT project management exist... basically, if you average out all the good stuff you come to:
- 75% miss deadlines
- 55% exceed budget
So get that project delivered on time and on budget - call in a professional PM.
Applications trends can have a serious impact on the enterprise. Fight the hype!
- Major trends in Social Computing, Cloud Computing, Rich Internet Applications, and Mobility are driving businesses quickly towards the future, and for those businesses not ready to move with the wave of emerging trends, many are being left in the wake of their competition.
- Generally speaking, the earlier a trend is adopted, the riskier it is to business due to the unproven, untested, and volatile state of many emerging trends.
- Businesses that choose to wait too long run the ever-increasing risk of being swamped by the cresting wave and falling well behind the competition.
- Understand the hype surrounding trends, where it comes from, and recognize the bias when you hear the hype.
Our AdviceCritical Insight
- These topics, trends, and areas of concern are top of mind right now in many discussions about future directions in applications and app development. But does the reality match the hype, and if they do have value who, what, when, and where are these developments appropriate?
- Choosing the right wave to ride wisely can propel your business to the forefront. Alternately, choosing the wrong wave can leave your business languishing in the wake of your competition.
- Trends, like waves, have a way of swamping you if you wait too long to get onboard.
- Help Application Managers understand the trends and where they fit in the larger context.
- Highlight any tangible benefits such as cost savings, increases in productivity and business opportunities, more efficient and improved business agility.
- Explain the steps required to facilitate and ultimately implement the trends.
- Explain how Application Managers should sell the benefits to their boss.
Get to Action
Understand application trends
Get a summary view of each application trend based on the current experience of application professionals.
Evaluate the social trends
Leverage a wide range of expert talent and assistance.
Assess the development trends
Provide a richer, more interactive experience for business users.
The main problem for the majority of vendors appears to be one of marketing. These examples were chosen not only for their actual software solutions but for the clarity with which the solutions were explained. Most IT managers and vendors fail to understand that the end-users want some analytics on the savings in time and money presented to them prior to the on-site test. There is still a tendency to be vague and ephemeral assuming that doctors will adopt EHR solutions because it’s a really good idea for patients.
EHR documentation and database systems are generally perceived as a new technology that may or may not provide efficiencies with little or no tangible increase in patient care. A study entitled “Electronic Medical Record Systems in Critical Access Hospitals: Leadership and Perspectives on Anticipated and Realized Benefits” shows that, at the time of publication (spring, 2010), there had been no benefit seen at hospitals that had adopted EMR. This makes EMR/EHR a poor investment when compared to specialized equipment, such as MRI machines, which quickly pay for themselves and have tangible increases in patient health (CDC, NAS, and Stats Canada).
As an example, to install an MRI machine costs $2M. In most US states the average cost for an MRI examination is $2200, which means that the cost of installation requires only 1000 patients or approximately one year of average use for a machine that has a 10-30 year useful life (data from Pennsylvania health care cost containment council). In addition, the CDC reports that MRI is now considered a standard of care and therefore is a must-have item for hospitals to maintain and upgrade in order to remain competitive. Diagnostic equipment has a tangible return on investment to the frontline users (i.e. Doctors, nurses) and also can be a marketing tool in competing for niche patients (i.e. high yield patients). Since EHR does not have a readily apparent short term benefit to either the administration or doctors, there is little incentive for either of these parties to assist in moving EHR adoption forward.
Doctors are looking for three features from EHR:
- Easy to scan fields with user controlled input and output. The documents have some kind of quick
- Completeness of dataset for historical purposes. These patient records are meant to be shared between physicians and are a guarantee against malpractice.
- HIPAA compliant database solution with user controlled access. Control and security of the patient data is a paramount concern to hospital administration as well as doctors who are ultimately responsible should the data be lost.
For EHR implementation to go smoothly, and maximize cost efficiencies, IT managers need to take the initiative and follow these three steps:
- Ensure that the selection and approval process of the EHR solution involves care providers and administration in the same room. These meetings cannot be for show, all decision makers must be involved.
- Get to know who the key decision-making doctors are in each department and develop relationships. Some doctors are in favor of EHR, find out who they are in your hospital/clinic, and involve them in building a strategy for how to tackle the implementation.
- Get care providers on-board during the demonstration phase. Take your key decision makers through the products, and ask questions about the mundane parts of the software (e.g. first impressions of the GUI, how to access the records, etc.) not just the big-picture items.
Adoption of EHR/EMR has lagged behind the rate expected in the US market. This appears to be largely due to low end-user adoption. IT managers need to understand the end-user needs and get them on board during the adoption process to fix this problem.
What Are Users Looking For?
End-users want an easy product that looks and feels like traditional charts.
Doctors want control of who has access to the data and where it is stored.
EHR documents in the US exist as a series of fragments with each hospital’s or doctor’s patient database existing in a proprietary encryption and filing system. While from the individual doctor’s point of view, this should provide them with control and peace of mind; it does not have the interoperability that will drive cost efficiencies or long term viability in mind. Long term viability is an important aspect of any infrastructure project, which is how most hospitals view EHR. Convincing doctors to adopt a single solution is difficult without convincing them that data security and cost concerns will be mitigated. Surveys performed over the last five years suggest a strong bias against allowing control of their life blood by IT or any other outside entity.
Remember, patient records are vital to doctors from a malpractice point of view in addition to patient care. Since malpractice insurance is a large expenditure for doctors (or the hospital in some cases) this aspect of cost control weighs heavily in their decisions. The CIO/IT managers need to understand that the doctors carry a great deal of weight in the decision process today at most hospitals, according to end users interviewed.
The problem is that the vendors’ EHR solutions are not based on what the end-users are asking for or what governmental agencies (e.g. NAS, US HIT program) are outlining as optimal models. The lack of direct compatibility of these solutions with government models reduces the ability of hospital administration to find outside funding for the cost of EHR adoption and maintenance. This combined with the fact that most doctors prefer paper records and older diagnostic machinery, according to interviews with a number of doctors and nurses as well as published surveys.
The majority of current EHR software is not built for back compatibility with these very specific legacy machines thus decreasing any enthusiasm for these products. This coupled with a lack of clear return on investment for EHR, particularly when compared the newest diagnostic machine, means the doctors, who have a great deal of leverage, are not pushing for EHR adoption. Therefore, vendors need to be clear about how their particular solution can minimize costs to doctors in a tangible way. Since many of the EHR documentation and database systems are generally perceived as a new technology, most medical staff are reluctant to endorse or even take the time to understand what they consider a speculative venture. IT managers need to speak directly to the end user with a message that speaks to the reliability and ease-of-use of the software that is being selected.
Why Early Commercial Solutions Are Being Adopted by End Users
The solutions with the highest adoption rates are self-made and have been driven by the physicians and IT departments working together to build the infrastructure and pick the solution from scratch.
Currently, the most successful commercial software solutions fall into one of three different types:
- Integration of multiple real-time devices for acute care (e.g. operating room visuals, medication reminders for scheduling of patient care).
- Horizontal integration of various records (e.g. prescriptions, procedures, diagnostic tests).
- Vertical integration of multiple service places (e.g. emergency room, family practices, orthopedics).
While there are several vendors, each one of them has their benefits and drawbacks.
The healthcare industry is currently adopting EHR to take advantage of potential long term cost control programs. There are two separate forces shaping the current state of digitization:
- The need for healthcare providers and anyone handling patient data to comply with HIPAA and similar health data privacy acts worldwide.
- The push by governments and patients to increase sharing of patient information between care providers (i.e. nurses, doctors, pharmacists), which causes tension with patient privacy.
IT managers must convince the various other stakeholders; hospital administration, doctors, nurses, and patients that EHR serves each stakeholder’s individual needs. While all of these stakeholders must be mollified in order for a smooth adoption, you must identify which stakeholders, in the decision making hierarchy, are blocking adoption and understand how this group can be brought on board. The various stakeholders have unique and discordant wants and needs from digital records. In this report, we will limit the discussion to the over-arching drivers of change, and the main source of slow adoption of digital records.
The main push for digitalization of patient records, i.e. EHR or electronic medical records (EMR) is based on the assumption that this will trigger a number of widespread efficiencies throughout the system. Although there are subtle differences between EHR and EMR, for the purpose of what is slowing adoption of digital records they can be considered as a single type of product.
The main driver of widespread adoption of EMR will be overall cost savings to hospitals and/or physicians. However, the stakeholder beliefs on potential societal benefits cannot be overlooked. Anecdotal evidence from catastrophic events, such as 9/11, hurricane Katrina in New Orleans, and the California house fires, suggests those individuals that have EMR records had better healthcare outcomes; timely prescription refills, care of chronic conditions, etc. This data is a key reason that consumers (i.e. patients), large insurers, and governments are pushing for a quicker adoption of EHR/EMR, which can migrate easily between healthcare providers. Hospital administrators are pushing for IT managers to quickly source and implement EHR to take advantage of government programs to cover the costs. Early adopters of EHR/EMR have seen ineffective and unused solutions due to end-user resistance. This leads to reassessment by administrators on how to proceed with EHR implementation. These same administrators are now cautious to proceed without the consent of the end-users while still pushing IT to quickly implement a solution.
- There is no direct connection between doctors and IT departments at most hospitals.
- Doctors feel that the solutions offered do not meet their needs and refuse to participate.
Why Are Doctors so Reluctant?
It is important to note that doctors, of all the end-users, are the single biggest obstacle to adoption of EHR, as discovered by over thirty-five separate surveys performed between 1998 and 2011. While cost of investment was an issue for this group, the single largest obstacle cited by these doctors was a perceived difficulty of use. Their reluctance is due in part to a belief that it will cost them time and increase their staffing requirement to use EHR. Since doctors do not feel that EHR will benefit them directly, they are reluctant to take on the cost and are not willing to be flexible about taking staff away from patient care to receive the proper training. For this reason it is vital that IT managers have a direct relationship with key care providers to understand what they are looking for in EHR/EMR solutions.
A meta-analysis of twenty-two studies by Boonstra and Broekhuis in the journal BMC Health Services Research shows that physician resistance to EMR is complex but is largely based on cost-related factors. The essential problem for physicians is integration of the different data sources into a legible document that fits the needs of doctors and nurses. For example, in a critical care environment doctors and nurses need access to patient data. While the nurse needs a quick way to look at up-to-the-minute vitals and care schedules, the attending doctor needs timely access to treatments given and the patient response. This information is readily available in the patient charts, which both groups are accustomed to scanning for the pertinent information.
While vendors have a variety of solutions that are IT optimized, the end-users have not felt that these have met their specific needs thereby decreasing the adoption of these solutions.
The two terms, Electronic Medical Record (EMR) and Electronic Health Record (EHR), are used interchangeably by many stakeholders. However, IT leaders in healthcare should realize that these terms define two different ideas. A clear understanding of the fundamental differences between the two concepts will equip IT leaders with the tools necessary to face the implementation challenges of EMR and, in the near future, EHR.
EMR Is Different from EHR
EMR is a comprehensive electronic record of a patient's health-related information, including pathological, radiological, and pharmaceutical information that is shared and managed by healthcare practitioners via a secure network within a Care Delivery Organization (CDO).
EHR is an environment that connects a subset of EMRs from different CDOs within a community, state, or region via a secure and nationally standardized network. The network allows authorized clinicians and healthcare staff access to patients' health-related information across more than one healthcare organization.