Background
What began as a simple audit meeting quickly evolved into a full-scale operational transformation. I led a cross-functional initiative to map undocumented workflows, bridge gaps between departments, and build a real-time operational intelligence platform using Microsoft Fabric, Power BI, and the Power Platform.
The challenge was clear: a 200-person healthcare organization was operating with fragmented systems, manual processes, and limited visibility into performance across 10+ departments. Staff were relying on memory, spreadsheets, and countless status check-ins to manage patient care workflows from scheduling through billing.
By the end of the project, we had deployed performance dashboards across 10+ departments, automated critical task workflows in Microsoft Dynamics CRM, and began integrating quarterly goals through Microsoft Goals to align with the Entrepreneurial Operating System (EOS).
Key Achievements
Leadership & Strategy
- • Multi-Department Transformation: Directed strategy across ABA, PT, OT, Speech, Sales, Intake, Billing, Admin, Medical, and Compliance departments
- • Process Discovery: Conducted stakeholder interviews and BPMN process mapping to uncover undocumented workflows and identify optimization opportunities
- • Change Management: Facilitated adoption across 200 staff and patients, prioritizing quality-of-care outcomes over system upgrades
- • Strategic Alignment: Led planning sessions to align department KPIs with EOS Rocks and company-wide goals
Technical Implementation
- • Data Infrastructure: Built an Azure SQL staging layer using ODBC from the Practice Management System for reliable data extraction
- • Scalable Processing: Developed Dataflow Gen2 pipelines in Microsoft Fabric for efficient data transformation and storage in OneLake with Delta format
- • Intelligence Layer: Implemented SQL + Python logic for task audits, note quality checks, and KPI tracking across all clinical workflows
- • Visualization: Created Power BI dashboards with role-specific views for staff, team leads, and executives
- • Workflow Automation: Connected Power Platform workflows to Microsoft Dynamics CRM to automate patient lifecycle tasks
- • Cross-Department Support: Expanded the framework to cover PT, OT, and Speech while providing indirect support across all 10+ departments
- • Financial Integration: Initiated integration with Sage Intacct for financial forecasting and cash flow modeling
Technical Architecture
The solution was built on a modern data architecture that prioritized scalability, real-time processing, and user adoption:
- • Source Layer: Practice Management System (ODBC → Azure SQL)
- • Transformation & Storage: Microsoft Fabric + OneLake (Delta format)
- • Audit & Logic Layer: SQL + Python for business intelligence and quality checks
- • BI & Workflow: Power BI, Power Automate, Power Apps, Microsoft Dynamics
- • ERP Integration: Sage Intacct for financial forecasting and cash flow modeling
Project Lifecycle
The implementation followed a structured seven-phase approach:
- Stakeholder Discovery & Workflow Mapping - Understanding current processes and pain points
- BPMN Swim Lane Analysis - Documenting cross-departmental workflows and handoffs
- Data Infrastructure Build - Establishing reliable data pipelines and storage
- KPI Dashboards & Note Auditing - Creating visibility into performance and quality
- CRM Task Automation - Streamlining patient lifecycle workflows via Power Platform
- EOS Goal Integration - Aligning operational metrics with strategic objectives (Microsoft Goals)
- ERP Financial Forecasting - Bridging clinical operations with financial planning (Sage Intacct)
Impact
The operational intelligence platform delivered measurable improvements across the organization:
- • 95% faster reporting cycles - From manual compilation to real-time dashboards
- • 60% reduction in manual oversight - Automated workflows eliminated countless status check-ins
- • Automated patient lifecycle management - From scheduling through billing, workflows were streamlined
- • Cross-department visibility - Performance dashboards live across all 10+ departments
- • Strategic foundation - Built infrastructure for EOS goal alignment and financial modeling
Challenges & Solutions
The Human Factor
The most complex challenge wasn't building the system—it was getting 200 people to use it effectively, especially as someone leading change from outside their reporting structure.
While I worked day-to-day in IT and Finance, this initiative touched departments like ABA, PT/OT/ST, Sales, Intake, and Medical—where I wasn't a direct manager or director. Building trust took time.
We made a conscious effort to:
- Keep departmental managers and directors in the loop and in control
- Lead through influence, not authority, by listening first and aligning with each team's values
- Anchor every conversation in how the change would improve patient care, which resonated with providers, technicians, and front-line staff
- Build tools and dashboards that made people's work easier and more meaningful, not harder
Technical Complexity
Managing data across multiple clinical systems required careful planning:
- Data Quality: Implemented automated validation and quality checks to ensure accuracy
- Real-time Processing: Built pipelines that could handle the volume and velocity of healthcare data
- Integration Challenges: Navigated complex EDI and API integrations with various systems
- Scalability: Designed architecture to grow with the organization's needs
What's Next
While I transitioned out before full EOS + ERP integration, we had already established the foundation for continued growth:
- • Microsoft Goals Integration: Rolled out department-wide Rocks tracking for strategic alignment
- • KPI Crosswalks: Prototyped connections between operational KPIs and long-term strategic outcomes
- • Financial Modeling: Begun mapping Sage Intacct data into Fabric to bridge clinical operations with cash flow forecasting
Lessons Learned
This was the capstone project of my time with the organization—bringing together process clarity, technical depth, and mission-driven change. It reinforced several key principles:
Start with the people, not the technology.
The most sophisticated system is worthless if people won't use it. Understanding workflows, pain points, and motivations is essential before writing a single line of code.
Build for transparency, not just efficiency.
Making data visible to the people doing the work creates ownership and drives continuous improvement.
Change management is as important as technical implementation.
Training, communication, and support are critical for successful adoption.
Think strategically about data architecture.
Building on Microsoft Fabric's unified platform enabled seamless integration across all systems and departments.
It was about more than automation or analytics—it was about building trust and transparency into how care gets delivered, how teams stay aligned, and how strategy becomes action. I left proud of what we accomplished, and excited for what would come next.