From: https://www.ama-assn.org/practice-management/digital/digital-health-implementation-playbook-step-12-scaling

Digital Health Implementation Playbook Step 12: Scaling

Overview

As you scale, focus on growing smart, not fast. Leverage your success metrics to position your program for expansion. Consider other areas remote patient monitoring can improve your practice. Is there a new patient population you’d like to reach? Another department or location? Once you identify your target for expansion, circle back to Step 7 (Designing the Workflow). Evaluate possible workflow changes to accommodate a larger program, then proceed through the remainder of the steps, modifying your program as needed.

Goals to accomplish

  • Resolve any improvement opportunities identified in the initial implementation

  • Socialize the success of the RPM program throughout your organization to generate enthusiasm

  • Select your next scaling prospect (i.e., new disease state, new department, more patients, etc.)

  • Budget and secure financing for growth

  • Negotiate the next phase of your partnership with your vendor

  • Adjust workflows to account for program growth

  • Retrain staff or train new staff to account for program growth

  • Engage, enroll, and train new patients

  • Continue tracking key success metrics for ongoing impact

Why scaling is important

Don’t allow your initial implementation to die in the “Pilot Graveyard.” Adopting an organized scaling process maintains the momentum you’ve generated with RPM and provides the opportunity to:

  • Negotiate better pricing on RPM devices and services due to higher volume

  • Apply initial implementation learnings to continuously improve the program

  • Improve management of chronic disease, patient engagement, and resulting health outcomes

  • Reduce cost through more efficient patient care

  • Improve organizational performance against quality and patient satisfaction metrics

Best practice

“You can't achieve impact without scaling a solution across all relevant patients. This type of iterative scaling allows you to roll it out responsibly across the organization.”

—Niko Skievaski, co-founder and president, Redox

Avoiding a misstep

Scale in small, manageable batches. Develop an iterative scaling approach that allows you to re-evaluate your process as the program grows. It may take several rounds of gradual expansion before RPM is integrated throughout your entire organization. However, the iterative Plan, Do, Study, Act* growth process allows you to address any remaining challenges for an efficient and effective expansion.

Practice spotlight

Following a successful initial implementation, the team at Massachusetts General Hospital took a "hiatus," or a pause, to thoroughly evaluate lessons learned and gather evidence to generate a strong use case for scaling the program broadly. While the vendor had been a strong collaborator to date, institutional knowledge and internal credibility, not a sales pitch, was needed to appeal to the executive team for approval and funding. Therefore, they presented their proposal and use case among an exclusively internal team. Once approved, initial results distributed to the organization via email garnered excitement among other departments and helped identify the next wave of participation. Finally, a streamlined pricing structure and security assessment were negotiated into an organization-wide contract to diminish remaining barriers to implementation. As a result, four additional departments have integrated the use of this technology into their daily operations.

—Michael Pandolfi, Project Manager at Massachusetts General Hospital

You have completed all 12 steps of the AMA Digital Health Implementation Playbook. You can also go back to Step 11: Evaluating Success, or visit the playbook main page to review all 12 steps..

AMA Digital Health Implementation Playbook

Download the Playbook to review all 12 steps to implement and scale remote patient monitoring in practice.