Do I Trust Me? http://ping.fm/nszDT
This is default featured post 4 title
Go to Blogger edit html and find these sentences.Now replace these sentences with your own descriptions.
This is default featured post 5 title
Go to Blogger edit html and find these sentences.Now replace these sentences with your own descriptions.
Wednesday, December 1, 2010
Good Consultants, Bad Consultants
In 1998 when I became CIO of CareGroup, there were numerous consultants serving in operational roles at BIDMC and CareGroup. My first task as CIO was build a strong internal management team, eliminate our dependency on consultants, and balance our use of built and bought applications. Twelve years later, I have gained significant perspective on consulting organizations - large and small, strategic and tactical, mainstream and niche.
There are many good reasons to hire consultants. One of my favorite industry commentators, Robert X. Cringley wrote an excellent column about hiring consultants. A gold star idea from his analysis is that most IT projects fail at the requirements stage. If business owners cannot define their future state workflows, hiring consultants to implement automation will fail.
I've been a consultant to some organizations, so I've felt the awkwardness of parachuting into an organization, making recommendations, then leaving before those recommendations have an operational impact. Many of my friends and colleagues work in consulting companies. Some consultants are so good that I think of them as partners and value-added extensions of the organization instead of vendors. From my experience, both hiring and being a consultant, here's an analysis of what makes a consultant good or a consultant bad.
1. Project Scope
Good - They provide work products that are actionable without creating dependency on the consultant for follow-on work. There are no change orders to the original consulting assignment.
Bad - Consultants become self-replicating. Deliverables are missing the backup data needed to justify their recommendations. Consultants build relationships throughout the organization outside their constrained scope of work, identifying potential weaknesses and convincing senior management that more consultants are needed to mitigate risk. Two consultants become four, then more. They create overhead that requires more support staff from the consulting company.
2. Knowledge Transfer
Good - They train the organization to thrive once the consultants leave. They empower the client with specialized knowledge of technology or techniques that will benefit the client in operational or strategic activities.
Bad - Their deliverable is a PowerPoint of existing organizational knowledge without insight or unique synthesis. This is sometimes referred to as "borrowing your watch to tell you the time".
3. Organizational Dynamics
Good - They build bridges among internal teams, enhancing communication through formal techniques that add processes to complement existing organizational project management approaches. Adding modest amounts of work to the organization is expected because extra project management rigor can enhance communication and eliminate tensions or misunderstandings among stakeholders.
Bad - They identify organizational schisms they can exploit, become responsible for discord and cause teams to work against each other as a way to foster organizational dependency on the consultants.
4. Practical Recommendations
Good - Recommendations are data-backed, prioritized by relative value (cost multiplied by benefit), reflect current community standards, and take into account competing uses of the organization's resources and time.
Bad - Recommendations lack depth. They are products of uncorroborated interviews. They lack factual details and are a scattershot intended to create fear, uncertainty and doubt. They focus on parts rather than systems. Implementing these recommendations causes energy to be drained away from more strategic and beneficial initiatives.
5. Fees
Good - Consultants use markup factors (amount they charge verses the amount they pay their staff) such as the following:
Staff augmentation / placement only, with no management oversight = 1.5
Commodity consultants, largely staff augmentation, but with "account management" = 1.5-2
Consulting / systems integration, project-based = 2-3.5
Management consulting / very senior and high-demand specialists = 3.5-4
Bad - The engagement partner becomes more concerned about billing you than serving you. Meetings appear on your calendar weeks before the end of a consulting engagement to discuss your statement of work renewal. You begin to spend more time managing the consultants than managing the project. Consultants justify a markup factor of 5 or 6 by saying "We're so good that we have high overhead".
6. Balancing Priorities
Good - Complex organizations execute numerous projects every year in the context of their annual operating plans. Although consultants are hired to complete very specific tasks, good consultants take into account the environment in which they are working and balance their project against the other organizational priorities. In this way, the organization can adapt to the changes caused by the presence of the consultant while not significantly disrupting their other work.
Bad - Meetings are consistently scheduled with little advance notice that conflict with other organizational imperatives. Any attention paid to organizational demands outside the consulting engagement are escalated to senior management as being "uncooperative".
7. Quality of deliverables
Good - The deliverables are innovative, customized to the organization, and represent original work based on significant effort, due diligence, and expertise.
Bad - Material is reused from other organizations. The volume of deliverables is increased with boilerplate. The content seems unhelpful, general, or unrelated to the details of your organization.
8. Managing project risk
Good - Risk is defined as the likelihood of bad things happening multiplied by the impact on the organization. Real risks to the project are identified and solutions are recommended/developed collaboratively with project sponsors.
Bad - There is greater concern about risk to the reputation of the consultants than the risks to project success.
9. Respect for the org chart
Good - Work is done at the request of the project sponsors. The chain of command and the hierarchy of the organization are respected, so that consultants do not interact directly with the Board or senior management unless directed to do so by the project sponsors.
Bad - Governance processes are disrupted and consultants seek to establish the trust of the organizational tier above the project sponsors. Sometimes they will even work against the project sponsors to ensure organizational dependency on the consultants.
10. Consistency
Good - Transparency, openness, and honesty characterize all communications from the consultants to all stakeholders in the organization.
Bad - Every person is told a different story in the interest of creating the appearance of being supportive and helpful. This appearance of trustworthiness is exploited to identify weaknesses and increase dependency on consultants.
I'm the greatest ally of good consultants. Per Robert Cringely's article, we'll bring in a few "Consulting Type A" experts each year for specific well-defined tactical projects requiring deep expertise.
If survival of the fittest applies to consultants, then the good ones should thrive and the bad ones should see fewer engagements over time. However, I'm not sure Darwinian selection pressures apply to consultants, since organizations may have short institutional memories about consulting experiences due to their own staff turnover.
The best you can do for your organization is think about the good and bad comparisons above, then use them to evaluate your own consulting experiences, rewarding those who bring value added expertise and penalizing those who bring only "powerpoint and suits".
There are many good reasons to hire consultants. One of my favorite industry commentators, Robert X. Cringley wrote an excellent column about hiring consultants. A gold star idea from his analysis is that most IT projects fail at the requirements stage. If business owners cannot define their future state workflows, hiring consultants to implement automation will fail.
I've been a consultant to some organizations, so I've felt the awkwardness of parachuting into an organization, making recommendations, then leaving before those recommendations have an operational impact. Many of my friends and colleagues work in consulting companies. Some consultants are so good that I think of them as partners and value-added extensions of the organization instead of vendors. From my experience, both hiring and being a consultant, here's an analysis of what makes a consultant good or a consultant bad.
1. Project Scope
Good - They provide work products that are actionable without creating dependency on the consultant for follow-on work. There are no change orders to the original consulting assignment.
Bad - Consultants become self-replicating. Deliverables are missing the backup data needed to justify their recommendations. Consultants build relationships throughout the organization outside their constrained scope of work, identifying potential weaknesses and convincing senior management that more consultants are needed to mitigate risk. Two consultants become four, then more. They create overhead that requires more support staff from the consulting company.
2. Knowledge Transfer
Good - They train the organization to thrive once the consultants leave. They empower the client with specialized knowledge of technology or techniques that will benefit the client in operational or strategic activities.
Bad - Their deliverable is a PowerPoint of existing organizational knowledge without insight or unique synthesis. This is sometimes referred to as "borrowing your watch to tell you the time".
3. Organizational Dynamics
Good - They build bridges among internal teams, enhancing communication through formal techniques that add processes to complement existing organizational project management approaches. Adding modest amounts of work to the organization is expected because extra project management rigor can enhance communication and eliminate tensions or misunderstandings among stakeholders.
Bad - They identify organizational schisms they can exploit, become responsible for discord and cause teams to work against each other as a way to foster organizational dependency on the consultants.
4. Practical Recommendations
Good - Recommendations are data-backed, prioritized by relative value (cost multiplied by benefit), reflect current community standards, and take into account competing uses of the organization's resources and time.
Bad - Recommendations lack depth. They are products of uncorroborated interviews. They lack factual details and are a scattershot intended to create fear, uncertainty and doubt. They focus on parts rather than systems. Implementing these recommendations causes energy to be drained away from more strategic and beneficial initiatives.
5. Fees
Good - Consultants use markup factors (amount they charge verses the amount they pay their staff) such as the following:
Staff augmentation / placement only, with no management oversight = 1.5
Commodity consultants, largely staff augmentation, but with "account management" = 1.5-2
Consulting / systems integration, project-based = 2-3.5
Management consulting / very senior and high-demand specialists = 3.5-4
Bad - The engagement partner becomes more concerned about billing you than serving you. Meetings appear on your calendar weeks before the end of a consulting engagement to discuss your statement of work renewal. You begin to spend more time managing the consultants than managing the project. Consultants justify a markup factor of 5 or 6 by saying "We're so good that we have high overhead".
6. Balancing Priorities
Good - Complex organizations execute numerous projects every year in the context of their annual operating plans. Although consultants are hired to complete very specific tasks, good consultants take into account the environment in which they are working and balance their project against the other organizational priorities. In this way, the organization can adapt to the changes caused by the presence of the consultant while not significantly disrupting their other work.
Bad - Meetings are consistently scheduled with little advance notice that conflict with other organizational imperatives. Any attention paid to organizational demands outside the consulting engagement are escalated to senior management as being "uncooperative".
7. Quality of deliverables
Good - The deliverables are innovative, customized to the organization, and represent original work based on significant effort, due diligence, and expertise.
Bad - Material is reused from other organizations. The volume of deliverables is increased with boilerplate. The content seems unhelpful, general, or unrelated to the details of your organization.
8. Managing project risk
Good - Risk is defined as the likelihood of bad things happening multiplied by the impact on the organization. Real risks to the project are identified and solutions are recommended/developed collaboratively with project sponsors.
Bad - There is greater concern about risk to the reputation of the consultants than the risks to project success.
9. Respect for the org chart
Good - Work is done at the request of the project sponsors. The chain of command and the hierarchy of the organization are respected, so that consultants do not interact directly with the Board or senior management unless directed to do so by the project sponsors.
Bad - Governance processes are disrupted and consultants seek to establish the trust of the organizational tier above the project sponsors. Sometimes they will even work against the project sponsors to ensure organizational dependency on the consultants.
10. Consistency
Good - Transparency, openness, and honesty characterize all communications from the consultants to all stakeholders in the organization.
Bad - Every person is told a different story in the interest of creating the appearance of being supportive and helpful. This appearance of trustworthiness is exploited to identify weaknesses and increase dependency on consultants.
I'm the greatest ally of good consultants. Per Robert Cringely's article, we'll bring in a few "Consulting Type A" experts each year for specific well-defined tactical projects requiring deep expertise.
If survival of the fittest applies to consultants, then the good ones should thrive and the bad ones should see fewer engagements over time. However, I'm not sure Darwinian selection pressures apply to consultants, since organizations may have short institutional memories about consulting experiences due to their own staff turnover.
The best you can do for your organization is think about the good and bad comparisons above, then use them to evaluate your own consulting experiences, rewarding those who bring value added expertise and penalizing those who bring only "powerpoint and suits".
Register for Food Allergy Teleseminar This Wednesday
Gina Clowes, of Allergy Moms, is offering a free workshop via telephone to discuss the holidays and food allergy issues. The workshop is being held today, Wednesday, Dec. 1 from 2-3 pm EST (11 am Pacific). Gina encourages everyone to register, even if you can't participate in the call as all registrants will receive a link for a recording of the call.
Register here!
Register here!
Tuesday, November 30, 2010
10 Tips for Reducing Sugar Intake
The average American eats more sugar in one day than our ancestors did during an entire lifetime. They prized sugary foods for their abundant calories and quick energy spike. Thus, now we are wired to reach for the cookie jar over and over and over – even though we have no lions to outrun.
Sugar has a very high caloric content and virtually no nutritional value. Besides causing weight gain, it also encourages inflammation and infection, compromises the immune system and raises insulin levels. Insulin encourages the storage of fat, elevates triglyceride levels and promotes cardiovascular disease, asthma, mood swings, diabetes, gallstones, hypertension and arthritis. Still want that piece of cake?
We all know that sugar can cause health problems, however our eating culture revolves around sugary, salty, fatty, unhealthy foods. Even those without a raging sweet tooth will find that it's almost impossible to avoid eating refined sugar these days, as grocery manufacturers routinely add it to everything from bread and pizza dough to spaghetti sauce and salad dressing.
Eating less sugar is one of the best actions you can take to improve your current and future health, but saying "no" to sweets isn't as easy as it seems. If you can't cut out sugar completely (who can?), then try the following tips to quickly and painlessly reduce your sugar intake. It seems this becomes increasingly handy during the holiday season...
1. Cut down on processed and packaged foods. Salad dressings, spaghetti sauces, soups and even pizza crusts contain sugar. If you make your own soup, you will unlikely be adding a cup of sugar to the stew pot, however this is exactly what manufacturers do. Try to purchase groceries with the least amount of packaging as possible.
2. Indulge in the highest-quality sweets that you can afford. You will get more satisfaction from enjoying one divine chocolate truffle than you will from six crappy little sandwich cookies. Resolve to only eat sweets that you really, really like. Forget the rest, and then don't beat up on yourself when you have a sugary treat that you really enjoy.
3. Free sweets aren't free. Many work sites, businesses or offices always have on hand candy, doughnuts or other sweets to snack on. It is human nature to grab these cheap calories and ingest them, however you will pay for the free treats later with poor health and a belly roll.
4. Banish the candy jar. Do you have a candy jar on your desk at work, school, or some other handy and convenient place? Remove it, and you will reduce your sugar intake. Even just moving a candy dish from your desk to a table across the room will drastically decrease the amount that you eat.
5. Know your sugars. Fructose, glucose, lactose, maltodextrin and dextrose are all types of sugar masquerading under their scientific names. Read grocery labels so that you know what you are putting into your body.
6. Don't drink liquid candy. Soda is basically that – liquid candy. Most Americans think of soda as a beverage, and most Americans are overweight. Think of soda as a special treat rather than a daily occurrence, and you will enjoy it even more and avoid all those empty calories. Besides, we've got the Top 10 Reason to Banish Soda.
7. Watch your breakfast. Deep-fried dough topped with icing and candy sprinkles isn't anywhere near healthy, but doughnuts are a tried-and-true American breakfast. Just say no. Also passing as breakfast: giant muffins (muffins = cake), frappuccinos and smoothies – these are basically milkshakes. Starting your morning off with a sugar overload like this will offset your energy and unbalance your system for the rest of the day.
8. Indulge your sweet tooth naturally. Fruits, honey, maple syrup and molasses all contain natural sugars. Although these foods are no health superstars, they are a better option when the sweet tooth strikes and you are craving some sugary action. An apple will give you a sweet burst of flavor along with beneficial vitamins and fiber. Check out our Guide to 10 Natural Sweeteners.
9. Go black and never go back. Resolve to drink your coffee and tea without sugar and milk; this small change of mind can save you several sweet teaspoons every single day, and you will most likely find that you do not miss it. And besides, ordering a straight-up black coffee or espresso is infinitely cooler (and cheaper!) than ordering the triple-no-fat half-caramel grande Flufficino with whip and chocolate drizzle. Don't let your daily caffeine requirements become an excuse to load up on sugar.
10. If you just have to have something sweet at the end of every meal, keep a pile of your favorite gum on hand and enjoy a piece for dessert. This will give your brain the sweet sensation it desires and will keep your mouth occupied from chewing other more high-calorie dessert options. Of course, conventional gum isn't healthy either, but you can find natural and even organic gums at your local health food store.
Medical transcription outsourcing: Acting as a catalyst for change
Medical transcription is a vital component of the healthcare process; creating patient records which can be used as a point of reference as required. Patient records are invaluable as a decision making tool in planning care for patients, as the basis for coding and billing, as evidence in case of litigation. Documenting the healthcare service provided to patients also prevents duplication of efforts and helps saving on resources.
The process of medical transcription requires inputs in the form of personnel, infrastructure and technology to be able to create accurate and speedy patient records. Having an in-house medical transcription department can lead to dilution of focus of time, attention and other resources from the core business of providing quality healthcare. Outsourcing medical transcription on a turnkey basis to a professional service provider helps the healthcare facility focus on the core business.
Availing professional transcription services from the outsourced medical transcription service provider can act as catalyst for change in focus and provides strategic advantages.
How does outsourcing medical transcription act as a catalyst for change?
Outsourcing medical transcription to a professional service provider helps increase focus on core business, by providing services with the following benefits:
- Savings on cost of transcription: One of the main and obvious benefits of outsourcing medical transcription is that of savings on direct and indirect cost of transcription. Not only that quality medical transcription services also help speed up the reimbursement process.
- Renewed focus on improving services: Outsourcing medical transcription frees up a lot of resources including key personnel, information technology infrastructure, real estate etc. This helps the healthcare facility renew their focus on improving the quality of services in their core business utilizing these resources.
- Helps cope with expansion plans without diluting quality: Outsourcing medical transcription ensures that the quality of transcription, that is; accuracy, turnaround time and security are not compromised irrespective of the quantity of services required. Healthcare facilities can add on additional specialties and services without fear of dilution of quality in patient records
- Access to a talent pool and the right technology: Outsourcing medical transcription basically provides access to a trained pool of transcriptionists without adding on to the payroll of the healthcare facility. Another benefit of outsourced medical transcription services is that of access to technology used by the service provider for the transcription process. Technology is a major part of the medical transcription process requiring huge amount of investment, maintenance and up gradation costs.
Outsourcing provides access to technology without any of these hassles. The benefits of technology used by the medical transcription service provider helps in improving speed, security and ease of use by providing:
- A system that enables automatic upload of audio files for transcription at predetermined intervals
- Flexible modes of dictation
- Different modes of document delivery like automatic printing, faxing, delivery to specified folders, access of transcripts to multiple users etc
- Facility for electronic signature
- Secure technology like data encryption, multi tiered application architecture, firewalls etc.
- HL7 interface for EMR adoption
- System for keeping track of dictation, transcripts etc
Outsourcing medical transcription to the right provider enables healthcare facilities to leverage on the experience, expertise, manpower and technology of the service provider. Outsourcing medical transcription to the right service provider can help act as a catalyst for positive change.
TransDyne, a leader in the outsourced medical transcription industry has utilized their extensive background in information technology and their experience in providing medical transcription services to come up with medical transcription solutions that help healthcare facilities save on time, money and effort. TransDyne offers quality medical transcription at reasonable prices, executed by experienced and qualified medical transcriptionists with a very quick turnaround time executed through secure HIPAA and HITECH compliant channels, with very high levels of accuracy and all this with technology that is advanced but easy to use!
To avail complete outsourced medical transcription services from TransDyne, click here.
