Michelle Miller is VP of IS at MedSolutions, Inc., a Nashville, TN, radiology-management products provider that works with large managed-care organizations to manage quality and cost related to high-end outpatient diagnostic imaging.

Miller’s department has an extremely diverse set of user requirements: The utilization management product requires a highly scalable, highly reliable transactional system to support a precertification call center that runs from 7 A.M. to 7 P.M.; the data management and analysis product requires highly customizable reporting on large amounts of clinical and financial data; the Preferred Radiology Network requires an efficient but highly accurate and flexible claims payment system; and the list goes on.

In this first installment of her CIO Journal series, Miller’s notes illustrate how a current CRM project and staff management meetings pack her schedule.

Monday, 8 A.M.: Check in with users
My first order of business is to “swim a lap” during the first coffee run to ask users how things are going with the CRM system. We implemented PeopleSoft’s CRM Support early this year and are still in the absorption phase. The product is 100 percent thin client, and users have had trouble adjusting to the look, feel, and response of a Web-based application vs. a client-server application.

The implementation included a migration to a paperless environment. Our medical staff reviews detailed clinical information in order to make recommendations about appropriate diagnostic imaging, and it has been an adjustment to do that sort of cognitive review online vs. having their hands on paper clinical reports they can read through, mark up, and shuffle.

As committed as I am to the paperless process and the efficiencies to be gained, I agree that some things are just harder to do online. I like the feel of paper when I’m trying to absorb a large amount of written information. However, the adjustments being made by our medical staff are well worth the benefits we will gain as a company in terms of accuracy, record keeping, reporting opportunity, and automation. Easy for me to say, I suppose.

9:30 A.M.: Catching up with communications
I delve into the 44 unread e-mails in my inbox this morning. The only thread requiring rapid follow-up is related to reporting. The absorption of CRM in January is now beginning to register in our reporting environment—report data is changing, things are missing, etc. All of it is buried in our databases somewhere—we just need to start a project to determine what has been affected and where its new source is. We did cover this in implementation, but there are always a few details that slip by.

10 A.M.: Handling candidate interviews
I conduct an interview for a new technical support position. We’ve doubled our number of employees in a matter of months and must build out our Support organization with the addition of a dedicated hardware tech to support that department.


Michelle Miller

Miller’s first IT gig was an IBM internship as a hardware test engineer on the then-new RS600. The 33-year-old says she most enjoys the variety and pace of her job, as it’s never boring. Yet there are inherent drawbacks as well, as it’s nearly impossible to become an expert in any one initiative, she admits. Miller advises wanna-be CIOs not to underestimate the amount of leadership, people-management, and time-management skills needed to serve as an effective CIO. “Knowing the technology bit is not enough,” she said.

1 P.M.: CRM project meeting
I attend the Service Task Force Meeting, where we continue to brainstorm and, as a team, make system and process enhancements to get us to our preimplementation goals. When we implemented CRM, two things happened. First, productivity plummeted, resulting in longer turnaround times in our call center and unhappy customers. Second, we were able for the first time ever to track in mind-numbing detail just what our productivity situation was. The jury is still out as to whether the perceived productivity drop was a result of the system implementation itself or was a result of new awareness of and focus on productivity measurement.

The system implementation was not smooth. We had performance issues, some design issues, and a learning curve for which we were not prepared. However, I also am certain that we uncovered process issues long entrenched in our environment that simply flew under the reporting radar. January and February were difficult. We had planned for a huge productivity gain as a result of CRM, yet we were facing some severe productivity hits. We even talked about pulling the plug on the project. There was not an attractive Plan B, however. As difficult as things were, the option of reverting back to a paper-based environment where we could no longer “count our widgets” was even more unsettling. We elected to move forward and have made huge improvements in a short amount of time. We will get there. We have the right tool and the right people to do it.

3-5 P.M.: More CRM project work
The rest of the afternoon was spent doing follow-up from the task force meeting and having one-on-one meetings with senior staff. First up was my implementation/production lead, who has been tasked with developing a CRM Testing and User Group team. Our objective is to push ownership of testing and usability more towards the business users in order to ease the implementation of changes—a valuable lesson we learned during the first implementation.

My second meeting was with my CRM development lead, where we discussed the upcoming release of system enhancements. We have found the PeopleSoft environment very conducive to rapid application development. However, rolling out releases is somewhat complex. It is easy to make many changes very quickly, only to fail to implement them well. Another valuable lesson learned.

Today’s journal installment illustrates how the CRM implementation is receiving much of my focus these days. This is changing, however, and as things begin to return to steady-state, projects that have been pushed to back burners begin to heat up.