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Risent and Cone come together, we take this as an opportunity to discuss your M&A playbook.


 Today in health, it Ryzen and cone health come together. And we're going to use this as an opportunity to talk about a health it M and a playbook. My name is bill Russell. I'm a former CIO for a 16 hospital system. And creator this week health set of channels and events dedicated to transform health care. One connection at a time. We want to thank our show sponsors who are investing in developing the next generation of health leaders.

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The story that prompted this was cone health to become part of Ryzen health. Ryzen health obviously is the combination of Kaiser and, um, Geisinger. And really it's driving Kaiser. Kaiser's well, and guys are they, if they'd similar care models, but mostly the Kaiser model. Which having competed with them in Southern California works pretty well.

It's a pretty effective model. It was interesting when they founded the model. W it was before my time at St. Joe's, but here's how the story was related to me when they founded the model. Their quality measures were not anywhere near what ours were at St. Joe's. And so the doctors scoffed at them and oh, that model doesn't work and that kind of stuff.

It turns out over the years, it's a very prescriptive model. It's very based on health and keeping people healthy and it's very regimented. It's almost of the mindset. That healthcare is a science, not an art. And not open to interpretation. And so we follow these protocols.

They're very prescribed and you follow them every time somebody comes in, you ask them a certain series of questions you recommend certain. Tests and those kinds of things based on who they are. And so that kind of a managed care model over time, their outcomes grew to be better than ours at St.

Joe's, which was a very fascinating and humbling for those docs, who looked down their nose at it. And and now that model is expanding while they have tried to expand this model before, and it didn't quite work. The model that they tried now, they are trying a little. Little different model coming together with Geisinger and forming rise it as the foundation.

Now they are bringing you on cone health. We're not going to talk specifically about the merits of M and a or growth, or even this specific deal of Ryzen and cone health. What we're going to do is we're going to take this as an opportunity to talk about MNA strategy. We hear this. In our 2 29 project meetings, quite often of we're either being acquired or we are acquiring, I'm going to give this one from a, an acquiring company perspective.

I could give it from the other perspective, because I lived the other perspective. I've lived both perspectives, actually. Pretty interesting. And until you've lived the other side of it, where you are the one being acquired, you cannot appreciate the value of a company that has a good health it M and a playbook. So my first thing to you is to not try to write a novel.

Don't try to write war and peace here. Keep it into five high level categories. And that is a pre-merger prep planning, execution. Post-merger integration. And then compliance and monitoring. Those are the five categories. Now you do it at a high level for the entire it operation.

And then what I would encourage is each individual group, each individual. Specialty or area do the same thing. So your networking operations team should have a pre-merger prep, planning, execution, post-merger integration, compliance, and security. Think of it as you have the umbrella. And then you have individual short stories for each one of the groups that are going to be going.

One of the mistakes that people make is they try to write step one, do this step two, do this. Step three, do this. That's not really what you're trying to do here. You're trying to identify the high level. And the reason is because if you've done one merger, you've done one merger, right? You don't know what you're going. Find on the other side, you don't know what the challenges are going to be.

You want the high level things identified so that you don't miss anything in the process. The high-level categories and the metrics that you're looking for. So pre-merger prep. You are. You're evaluating the target company. If they give you that opportunity to evaluate the company ahead of time, that's even better.

A lot of times that doesn't happen. Still. In healthcare. And you will come in at a later time, but still you have to do that evaluation. What are you connecting into? What other data security practices. How are they with regard to compliance? With regard to healthcare regulations. What's their selected technology and platforms and those kinds of things.

So you have as an assessment and due diligence phase, and that's an important phase. To do. And you're including people from both sides, right? So you're giving them information about you. They're giving you information about them. In fact, that's one of the ways you can model to them. What you are looking for is to give them information about you, be ready to give them information.

You might be, Hey, we're the acquiring company. Why do they need information about us? Because they're connecting it to you. And hopefully if your it operation is in good shape, you can provide them that information relatively easily. And it will serve as a model to them of how they can do that.

What you're looking for here in this process. And by the way, throughout the entire process, what you're looking to do is bring the teams together. So you're trying to help them to work together to identify things together. But you also want to drive into the organization and it ethos an it strategy and it culture. That aligns with what the ongoing company is going to be.

The surviving company is going to be, you're trying to build culture from the minute this comes together until the minute it does not come together. So you are aligning with the business goals, you're identifying synergies, but most of all, you're building a culture in this process. Having again, having been on the other side of this, I can tell you how not to do it. It's very easily. But with that being said this is an important opportunity for you if you're the acquiring organization.

So pre-merger preppers preparation. That's what you're doing. Then you start the planning process. Now you're developing more detailed plants. Again, don't try to, don't try to boil the ocean by writing this ahead of time. You can't, you don't know what you're connecting into, but high level, what are you going to be doing?

What are you going to be doing around active directory? What are you going to be doing around communication? What are you gonna be doing around file sharing? What are you gonna be doing around? Communication and sharing and that kind of stuff. Leave room open for, talk about the categories, but leave room open for the fact that they may do something better than you. It might make sense for you to use this as an opportunity to migrate to something else. As you're acquiring a company, it depends on how big that company is.

And it depends on those kinds of things. But anyway this is the point what you're developing those detailed plans. You're covering timelines, resources, integration, tasks. If you try to do this as waterfall, I think it's not the best. In fact, I know it's not the best. This is a point at which if you're doing agile, this is great.

If you're not doing agile, this might be a point at which you implement at least parts of it, right? It's daily stand ups, that kind of stuff. And and be able to identify roadblocks as they were coming up. Cause they're going to come up quite often. And you need to be able to handle them very quickly.

So standing up that partial agile, if you don't have, it really makes a lot of sense. Again, involve key stale stakeholders. This isn't just an it project alone. It is an entire organization project. You have key decisions to be made. During this planning phase, what's your EHR gonna be? What's your email going to be?

What's your director going to be? How are you going to do physician credentialing? How are you going to, it just. The thing about healthcare has always just shocked me as the complexity of it. It is, it's 110 businesses being run as one. And so you have a lot of different balls that you have in the air.

You have to engage key stakeholders. So that's the second is planning. So pre-merger prep planning. Third thing is execution.

Okay. Clearly you're during the planning phase and all that, you're setting the foundation for security. You're setting the foundation for data and data migration. You're setting the foundation. Four systems. You're setting the foundation for identity. You're setting all those things. People are gonna say, oh, you didn't put security in here.

I didn't put security in here because it's not a high level category. It is part of your pre-merger prep. It's part of your planning as part of your execution, as opposed to your part of your post-merger integration as part of your ongoing monitoring. So security is just a part of this. So when you're getting into the execution there, there's probably an order that this goes in, which is set the security foundation set the identity foundation. And then start to do the data and application migration. I'm not going to touch on this.

This is the area that people know pretty well and your individual teams know and understand pretty well. The thing I will drive home here is that. Do not add tech debt. This is a great opportunity to erase tech debt. If you have you either do it at the beginning of the merger, or you will have a big lump that you have to take care of at some point in the future. Try to eliminate as much tech debt as you possibly can.

And in some cases, this will mean that the acquiring organization step away from something that they are doing today. There should be a ton of politics in this as well. Try to keep an eye on architecture. And simplification of the architecture as you move forward. This is one of those opportunities. Post-merger integration.

So this is where you are. You're just constantly looking at. And putting together processes and mechanisms for ensuring that the systems have come together. You're doing a lot of testing. You're doing a lot of validation. You're obviously, checking in on on the organizational change management, how did this go from a culture standpoint?

Are people getting the services that they need are things functioning? Your help desk ticketing system is one of the. Just a treasure trove of information during this surveys can help during this as well. It can also bring people into a way of communicating with you as an it organization, if they are coming into your organization for the first time. The last thing is just the compliance and monitoring.

So you have to monitor. Just constantly monitoring how things are going. You can do that through. Tickets, you can do that. Through a tools. How's the security functioning, how's the network functioning and what's the latency. What's the I, you name it. There's a million ways to monitor. You already have a lot of these in your existing network. You're going to make sure that the entire entity, once it comes on board has those same kind of monitoring capabilities.

You want to find issues quickly. Again, you're establishing culture. You're establishing norms for how you're going to operate as a larger organization. So it's going to be important. That that you have those things in place on day one, or as close to day one, as you possibly can. So that's how I'd write the playbook.

And by the way, I'd have my teams write their individual playbooks so that the network and operations team pre-merger prep, planning, execution, post-merger integration, compliance, and monitoring. I'd have them. Give an outline of what those things look like. And pull those together again, not trying to write war and peace, more bullet points, make sure you do this, make sure you do this kind of stuff.

You, if you're a CIO listening to this I would focus on an awful lot on people, culture structure processes. Those things that tend to break down when you bring two teams together for the first time. That's your role? Lots of communication. All right. That's all for today.

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