Success Plan Reset at a Regional Hospital System
You take over as CSM for a 12-hospital regional health system four months after signature. The deal includes Webex meetings and calling, ISE for wired and wireless access, and DNA Essentials across 38,000 users. The original business case justified the purchase as license consolidation and avoiding a competitor renewal, not as a clinical or operational outcome. The CIO who sponsored the deal has left; an interim CFO now chairs the steering committee. Webex meeting adoption is 61% of licensed users, but calling is only 22%, and ISE profiling is enabled in just 3 of 12 hospitals. There is no documented success plan, no agreed health score, and the first QBR is in three weeks. The account team says renewal is nine months away and wants a positive story. You have one customer success associate and no budget for new training.
1. What foundational gaps should you close before the QBR, and in what order? Explain the risk of presenting adoption metrics first.
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The gaps are not cosmetic. The account lacks an agreed success plan, an executive outcome owner, a stakeholder map, a health definition, and a baseline for value. I would close them in this order:
- Outcome discovery with the interim CFO, the IT operations lead, and a clinical informatics owner. Without an agreed problem statement, any metric is arguable.
- Stakeholder map covering influence, interest, and attitude. The interim CFO controls budget scrutiny; security and compliance control ISE expansion; clinical leaders control calling workflow.
- One-page success plan with two or three outcomes, measures, owners, and dates. License consolidation can be an outcome if it is framed as avoided duplicate spend and audit readiness.
- Health score definition tied to those outcomes, not just logins.
- QBR story built backward from the plan.
Presenting adoption first is risky because 61% meeting adoption invites the question 'so what?' The CFO hears cost, not value. Worse, calling at 22% and ISE at 3 of 12 hospitals look like poor performance before the customer has agreed what good looks like. Adoption metrics should appear as leading indicators beneath an outcome the customer owns.
2. Draft the stakeholder and outcome map you would use. Which stakeholders must be engaged before the QBR and why?
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I would map five groups by influence and interest.
- Interim CFO: high influence, high interest in cost and risk. Outcome: avoided duplicate licensing and audit-ready access control. Needs verified savings, not anecdotes.
- IT operations director: high influence, high interest in stability. Outcome: fewer access incidents and faster onboarding.
- Security and compliance lead: medium influence, high interest in ISE. Outcome: profiling coverage across all 12 hospitals and evidence for access reviews.
- Clinical informatics lead: medium influence, high interest in calling and meetings. Outcome: reliable care-team coordination and reduced travel.
- Procurement: medium influence, interest in renewal timing. Needs a clear value story before negotiation.
Before the QBR I must engage the CFO and the security lead. The CFO sets the value test; the security lead can convert ISE from a stalled deployment into a compliance outcome. The IT director must validate the operational baseline, and the clinical lead must confirm whether calling adoption is blocked by workflow or training. I would not walk into the QBR with only the account team and the IT director. That would repeat the original sponsor-dependent mistake.
3. The interim CFO asks: 'Why should we keep paying for adoption tooling and CSM time when we have not seen hard savings?' Write your response.
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I would not defend the tooling or the CSM time. I would reframe the question around evidence and risk.
Response: 'You should not pay for activity that cannot show value. Today we have three unproven areas: license utilization, ISE coverage, and calling adoption. I propose a 30-day baseline and a 90-day value review with you. The baseline will show duplicate licenses by department, ISE profiling coverage and audit findings, and calling usage in two revenue-cycle units. The value review will compare those numbers to the original consolidation case. If we cannot show a credible path to savings or risk reduction, we should change the scope rather than defend the current program.'
I would also separate cost avoidance from hard savings. Avoiding a competitor renewal is real, but it is not the same as reducing current spend. The CFO needs both categories labeled honestly. Finally, I would ask for one executive sponsor and one business owner for the 90-day review. Without them, the account will keep measuring activity instead of outcomes.