Summary: This article discusses the differences between healthcare software implementations at one healthcare facility or as part of an enterprise stakeholders. It covers the differences between: stakeholders, their goals, pricing, IT differences, and ROI.
Over the years that we’ve been implementing Assign, our patient assignment software, to hospital medicine teams around the US, the question has come up: Should you embark on one facility implementation or implement Assign as an enterprise endeavor across your entire organization?
Let’s take a look at these difference implementations specifically for our Assign software:
- The different stakeholders
- Needs and goals
- IT differences
- Pricing differences
- Benefits of enterprise implementations
- An example from a recent enterprise implementation at Texas Health
Overview of Facility Implementations vs. Enterprise Implementations
A facility-level implementation focuses on a single hospital or department, tailoring Assign to that group’s needs. An enterprise healthcare software implementation, on the other hand, creates a standardized, integrated approach across the entire health system. When we work with enterprise organizations, we typically follow a phased approach – the agreement covers the implementation across the enterprise health system but they start with one facility pilot and roll out from there.
Enterprise Stakeholders
When we are working with an enterprise organization considering implementing Assign at multiple sites, the stakeholders typically look like this:
- We’re working with a program manager or director that is overseeing operations of multiple facilities
- They have a great holistic understanding of the burden that’s happening to hospitalists across multiple sites
- Operationally, they understand the morning assignment process is a big cost
- Typically, they are a physician who is now in a leadership or business role and may not be practicing anymore
- They are familiar with the enterprise IT and vendor procurement policies; typically they have already received approval to reach out to a vendor and understand the steps involved in vetting software and going through contracting
Enterprise Needs and Goals
Large healthcare organizations may want to implement the same software across their entire network of facilities to ensure consistency, the same workflows, and have standardized processes across all facilities. Their goals are:
- Efficiency: Streamline workflows and operations across multiple sites
- Standardization: Consistent patient assignment rules and processes
- Scalability: Easier to expand or adjust as the organization grows
- Efficiency: Shared workflows and data visibility across facilities
- Better outcomes: More equitable assignments, improved provider satisfaction, smoother patient flow.
Single Facility Implementation – Stakeholders
When it comes to a single-facility site, the stakeholders and needs vary accordingly.
Stakeholders:
- A hospitalist on the rounding floor who knows first-hand the pain point of making the assignment list in the morning
- A hospitalist medical director or chief of hospital medicine who has heard complaints from hospitalists about patient balancing and workloads
- May not be aware of their internal policies regarding IT processes or budgetary approval for new software
Their goals are more focused on the immediate benefits of no longer having to do the manual work of assigning patients to providers every morning:
- Fewer complaints: Hospitalists are burnt out and complaining about workloads – they want something that can automate the process so there are no complaints
- Fair workflows: Lists are unbalanced causing workload issues
- Reduce admin work: One less administrative task for a hospitalist to do so they can focus more on patient care
It may be the hospitalist’s first time buying software, so we often take the opportunity to guide them and help them understand what they need to do on their end, to move this forward if they like the software. We guide you step-by-step in the process to help you:
- Understand the ROI and present it to your leadership team
- Review the pricing and explain how to get budget approval at your organization. Budget is usually not coming from the hospital medicine department so we help you advocate for your budget with senior leadership
- Understand your IT structure and how to get IT projects vetted and in the queue
Pricing
Our single facility pricing is a set price per bed, per year (based on your average annual census). However, our enterprise agreements come with much more pricing flexibility with significant discounts for rolling out multiple facilities.
Integrate continuity logic into provider assignment tools and ensure EHR handoff notes reflect prior treatment history and discharge rationale. Systems that track prior attendings and trigger continuity logic within a configurable window (e.g., 7–10 days) can support revenue and care quality goals.
IT Differences
Working with IT teams is a part of any healthcare software implementation. We are very familiar with assisting you in getting the information you need to your IT teams, such as security questionnaires and other processes.
When we work with enterprise IT teams, there are a few differentiating features:
- They are much larger IT teams that manage thousands of projects every year
- They prefer fewer vendors – easier to manage from a logistics and security perspective
- They want to know how we can get the data from them as streamlined as possible so they can scale it systematically
Benefits of Enterprise-Wide Implementations
Ultimately, we can implement Assign in whatever model works best for your organization.
By rolling out Assign at the enterprise level, organizations achieve consistency in workflows, reduce duplication of effort, and gain visibility across the system. This leads to smoother operations, improved equity in workload distribution, and ultimately better patient outcomes:
When I work with our enterprise customers, they are invested in becoming development partners and working on new features with us, or they ask for custom development based on their workflows and how their patient assignment process works. We can do all of that for any customer, but when it’s for a large enterprise, it’s easier to get the teams on board and develop it together, quickly.
Our customers have told us that they see significant ROI from using Assign – in the form of labor savings, efficiency, and also hospital-wide metrics like reduced length of stay, improved discharge rates, and workload balancing. Our enterprise customers find it much easier to justify and quantify the ROI when they are implementing at scale because the benefits are larger. For example, one customer of ours was looking to implement Assign at 15 facilities. They were spending over $5 million on salaries for their hospitalist group, so just looking at time savings alone, implementing Assign meant 30 hospitalists could spend 2 hours less a day making the list, which was a significant savings.
Assign Enterprise Roll-Out at Texas Health Resources
Texas Health Resources chose to implement Assign across their entire network. They started with one of their larger sites – a 600-bed facility, which had complex rules regarding how they assign patients (balancing geographic rounding, plus evenly balancing workloads, and they also have a lot of new patients with a large number of transfers from ED and ICU).
When implementing, we also learned that Texas’ outbound interface didn’t use the common attending and consulting model in Assign, they use a hospitalist relationship model. This new relationship model is how the hospitalist tracks the patients for whom they are responsible. We developed this for Texas and now it’s part of our Assign software for any other future customers that assign patients this way.
Once they saw we could master their complex site, they were ready to roll out at additional facilities.
We just completed their fourth facility, Texas HEB – with more to come. The implementation at Texas Health HEB addressed several unique challenges in provider assignments:
- Geographical Assignments: Optimized for 8 rounding teams across the facility.
- Balanced Workloads: Providers now receive evenly distributed patient loads.
- Pending Admissions & NP Patients: Custom flagging ensures fair distribution of pending admissions and patients already seen by NPs.
- Nocturnist Coverage: A rotating team of two nocturnist NPs (7 on/7 off) drives consistency in overnight assignments.
Their Results:
- Process Efficiency: The assignment process was reduced to 15 minutes, an 80% labor savings compared to manual workflows.
- Fairness & Transparency: Balanced teams and workloads foster clinician satisfaction.
- Enterprise Consistency: Another milestone in standardizing operations across the Texas Health system.
Final Notes
While we work with both single facilities and enterprise health organizations, if your facility is part of a larger healthcare organization, there are numerous benefits to implementing Assign across the entire enterprise. In the end, you’ll see:
- Consistent assignment practices
- Better workload balance across the system
- Enterprise-wide reporting and visibility
- Scalability for growth and expansion
- Improved provider satisfaction and patient care
Want to learn more about our consultative approach to healthcare software implementation? Check out my other blog on the topic, here.
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