Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

IT Alignment and Strategic Planning

Chapter 12

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Learning ObjectivesTo be able to understand the importance of an

IT strategic plan.To review the components of the IT strategic

plan.To be able to understand the processes for

developing an information technology strategy.To be able to discuss the challenges of

developing an IT strategy.To be able to appreciate the ability of

information technology to improve organizational competitiveness and performance.

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

OutlineGoals of IT alignment and strategic

planningAn overview of strategyAreas requiring strategyVectors for arriving at IT strategyThe IT Asset and governing conceptsA normative approach to IT strategyChallenges of IT strategy and alignmentInformation technology as a competitive advantage

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Goals of Strategic IT Planning

Ensure that information technology plans and activities are well linked to the plans and activities of the organization

Ensure that the alignment is comprehensive: Each aspect of strategy has been addressed from an IT

perspective recognizing that not all aspects have an IT component and not all components will be funded

The non-IT organizational initiatives needed to ensure maximum leverage of the IT initiative, for example, process re-engineering, are understood

The organization has not missed a strategic IT opportunity, for example, those that might result from new technologies

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Goals of Strategic IT Planning

Develop the tactical plan that details approved project descriptions, timetables, budgets, staffing plans and plan risk factors

Create a communication tool that can inform the organization of the IT initiatives which will be undertaken and those that will not

Establish a political process that helps to ensure that the plan results have sufficient organizational support

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Overview of StrategyFormulation

Mission and goals Activities and initiatives

Implementation Structures Skills Organizational capabilities Organizational processes

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Areas Requiring IT Strategy

The application system agenda Should we implement the electronic health record?

Initiatives to improve the IT Asset How do we improve the security of our

infrastructure?Concepts that govern the approach to

a class of initiatives and applications Should we be on the cutting edge of technology or

adopt a more conservative approach?

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Strategy VectorsDerived from organizational strategyPersistent focus on core organizational

processes and information management

New information technologyStrategic trajectory/visionFundamental views of organizations

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Example of IT Strategy Derived from Organizational Strategy

How should IT support our disease management initiative?

Develop and publish best practices Monitor costs, quality and care activity of a

cohort Guide documentation Remind providers and patients of steps to be

taken Monitor and manage a specific patient

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Example of a New Technology Vector – Wireless Personal

Devices

Value Function Revenue Cost Savings Care Quality Patient Service Medical Information/ L L M L Textbooks Lab Test Orders M L L L Medication Orders H M H M Results Retrieval L M M L Patient Charting M L M L Charge Capture H M L M Supply Management L H L L Legend: H=High, M=Medium, L=Low

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Example of a Focus on a Core Organizational Process

Strategic Goal Improve service to outpatients Problem

- Patients have to call many locations to schedule a series of appointments and services

- The quality of the response at these locations is highly variable - Locations inconsistently capture necessary registration and insurance

information - Some locations are over-capacity whereas others are under-utilized

IT Solution

- Common scheduling systems for all locations - A call center for “one stop” access to all outpatient services - Development of master schedules for common service groups, e.g., pre-

operative testing - Integration of scheduling system with electronic data interchange connection

to payers for eligibility determination, referral authorization and co-pay information

- Patient support material, e.g., maps and instructions, to be mailed to patient

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Leadership Synthesisand Debate

IT Ramifications of Organizational Strategies

Continuous Process and Information Management Improvement

New Information Technology

Strategic Trajectory Fundamental Views

Application Inventory IT Asset Initiatives Governing Concepts

The Synthesis of the IT Strategy

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

The IT AssetApplications

Sourcing Application uniformity Application acquisition

Infrastructure We want our applications to be able to …,

e.g., support clinical decision support and be accessible from home

Broad properties of the infrastructure, e.g., security and reliability

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

The IT AssetData

Acquisition of new types of data Data meaning Organizational responsibility for managing

data Data analysis technologies

IT Staff Acquisition of new skills Organization of the IT staff Sourcing of the IT staff Characteristics of the IT staff

Governance

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Governing ConceptsWhat is it about the electronic medical

record that makes it important to us?What does “integrated systems” mean

to us?Should we treat IT as an expense or an

investment?Should we collaborate with other

organizations in our region on IT or view IT as a way to achieve a competitive advantage?

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

An Example of the Linkage Between Organizational Goals and the IT

Agenda

Strategic Challenge IT Agenda Capacity and growth management Emergency department tracking Inpatient electronic bed board Ambulatory clinic patient tracking Quality and safety Inpatient order entry Anticoagulation therapy unit On-line discharge summaries Medication administration record Performance improvement Registration system overhaul Anatomic pathology Pharmacy Order communication Transfusion and donor services Budget management and Disaster recovery external reviews JCAHO preparation Privacy policy review

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Contents of an Information Technology Strategic Plan

Inventory of the IT initiatives that will be undertaken

Linkage of the initiatives to the organization’s strategic plan

Initiative timeline and interdependencies

Plan budgetRisk assessment

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Challenges in IT Planning

The overall strategy is unclear or volatile

The linkage may be shallowSenior management may hesitate to

engage in the IT strategy discussionThe true value of an IT initiative may

be unclearIt is difficult to make tradeoffs between

IT investments

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

IT Alignment at Maturity Keen, 1993

IT planning was not a separate processIT planning had neither a beginning nor

an endIT planning involved shared decision

making and shared learning between IT and the organization

The IT plan emphasized themes

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Sources of an IT Competitive Advantage

Leverage organizational processesEnable rapid and accurate provision of

critical dataEnable product and service

differentiationSupport the alteration of overall

organizational form or characteristics

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Sustainability of an Advantage

Attempting to out hustle the competition

Freezing the systemChanging the basis of competitionLeveraging some other, significant organizational strengthLeveraging a well developed, strong IT Asset

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Good to Great Companies - IT Lessons Collins, 2003

- Avoided IT fads but were pioneers in the application of carefully selected technologies. - Became pioneers when the technology showed great promise in leveraging that which they

were good at doing (their core competency) and that which they were passionate about doing well.

- Used IT to accelerate their momentum to a being great company but did not use IT to

create the momentum. In other words, IT came after the vision had been set and the organization began to move to that vision. IT was not used to create the vision and start movement.

- Responded to technology change with great thoughtfulness and creativity, driven by a

burning desire to turn unrealized potential into results. Mediocre companies often reacted to technology out of fear, adopting it because they were worried about being left behind.

- Achieved dramatically better results with IT than rival companies using the exact same

technology. - Rarely mentioned IT as being critical to their success. - “Crawled, walked and then ran” with new IT even when they were undergoing radical

change.

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

SummaryIT planning has several objectivesIT strategies are developed through

five vectorsIT alignment remains a significant organizational challengeIT can be applied to improve an organization’s competitive positionIT is a tool; its value is achieved by thoughtful application