overview of dhin strategic plan fy 17 – fy 21`overview of dhin strategic plan fy 17 – fy 21` 1....

Overview of DHIN Strategic Plan FY 17 – FY 21`

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DHIN is a Statutory Entity (16 Del. Code Chapter 103)

PurposeofDHINisBroad

• “Promotethedesign,implementation,operationandmaintenanceoffacilitiesforpublicandprivateuseofhealthcareinformationintheState.”

• “DHINshallbetheState’ssanctionedproviderofHIEservices”(§10301)

PowersandDutiesareExpansive• Allpowersofanot-for-profitCorporation• Communicateclinicalandfinancial

information• Monitorcommunityhealthstatus

(populationhealth)• Reliablesourceofinformationfor

consumersandpurchasers• Promoteefficiencyandimproved

communicationacrosstheentirehealthcareecosystem

• WorkwithgovernmentsandotherstatestointegrateintoorwiththeDHINand/orassisttheminproviding[RHIOs]

• “DevelopordesignotherinitiativesinfurtheranceofDHIN’spurpose”

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Historical ContextFORMATION CAPITALIZATION SUSTAINABLE

BUSINESSINNOVATION/EXPANSION

1997-- 2005 2006-- 2010 2011-- 2016 FY17à• Enablingstatute;DHIN

underHCC• Building trust• Consentmodel• Financialmodel• Assessment of

technology• PromulgationofDHIN

regulation• Contractforday-to-day

managementofDHIN• Environmentalscan

• LevelofEHRadoption

• Availabilityofbroadbandconnectivity

• Prioritizationofservicedevelopment

• AHRQgrant(1/3)• StateCapital BondBill

(1/3– 5-yrpledge)• Private$-for-$match

requiredtodrawdownStatefunds (1/3)

• Financialmodel basedoncostrecovery

• Exclusivelyfocusedoncoreservices(resultsdelivery&longitudinalcommunityhealthrecord)

• 2010:HIECooperativeAgreement,MU

• Statute amended;DHINtofunction asaself-sustaining business

• HireofCEOandstaff• Value-basedbusiness

model• Marketsaturationwith

coreservices• Modestexpansionof

servicelines• ExecutionofHIE

CooperativeAgreement• NoStatebondbill

funding sinceFY12• Loweredparticipation

feesinFY16• Fully executedFY12–

FY16business plan

• Thedomainofthis strategic plan

• 6statutes(FY15andFY16)givespecificroletoDHIN

• DMOST• ClaimsDatabase• Pre-Auth• Newborn

Screening• Genetictesting• LayCaregiver

• Currentgrantsexpandservices, constituents

• Consumer tools• LTPAC,BH• Analytics• AmbulatoryCCD

FY 17 – FY 21 Strategic Planning Methodology and Outputs• GartnerConsultingengaged

tofacilitate• Keystakeholdersidentified• One-on-oneinterviewswith

numerousstakeholders• Keydriversidentified(slide8)• CurrentStateAnalysis(slides9-12)

– OrganizationalStrengths– OrganizationalWeaknesses– Opportunitiesandthreats

• Identificationofstrategicprinciplesandthemes(slide14)

• Fivekeydomainstobestrengthened(slide15)– Mission,Vision,Values(slides16-18)– Governance,ProgramMgt– ITServiceManagement– ITCapabilities,Architecture,

Standards,Infrastructure– OrganizationalStructureand

Staffing• Five-yearRoadmap–

operationalizingtheVision(slides19-23)

– 5initiativesandsupportingworkstreams

– Roadmaptobeupdatedannually

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Key Drivers:Forces Shaping DHIN Strategic Direction• Purpose and duties of DHIN as defined by statute• Changes in the national landscape

– Meaningful Use requirements for HIE– Explosive growth in adoption of HIT– Growing demand for consent management at a granular level– Availability of alternative approaches to HIE– Alternative payment models driving new information needs– Funding levers used by CMS, ONC, CDC– 10-year Nationwide Interoperability Roadmap

• Expectations of the State– State Health Innovation Plan (SIM Grant)– Support for community health awareness– DMMA requirements with respect to HIE– Needs of other specific state agencies

• Evolving needs and expectations of DHIN members

Organizational Strengths

• NationalleaderamongpublicHIEs

• Nearuniversaladoptionofcoreservices

• Mechanismsexisttogetstakeholderinputandfeedback

• StrongandsupportiveBoardofDirectors

• Strongexecutivemanagement• DHINteamhasstrongself-

awareness• Strongstaffalignmentoncore

values• Financiallystrong

• Lowstaffturnover;highmorale• Culture– resultsdriven,creative

andentrepreneurial• Historyofsuccessfulmajor

federalgrantprocurementandsuccessfulexecution

• Continuousmonitoringofthetechnologymarketforrelevant,innovativesolutions

• Organizationalrolesandresponsibilitiesaredefinedanddocumented

• Neutrality• Transparency

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• Problems with FY 16 software upgrade set us back many months; staff spread thin in efforts to catch up; risk of burnout

• Gaps in expertise for anticipated future needs– Staff with clinical/HIT background– Familiarity with claims– Architecture planning/management– Data warehousing/analytics– Cybersecurity– Deep technical understanding of standards

• Planning, forecasting, resource estimation need improving

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Organizational Weaknesses

• Current contract with prime vendor expires 6/30/2018• Opportunity to “modularize” the technology stack, reduce single

vendor dependency• Current grants can offset the cost of technology refresh• Current grants drive new services; new revenue opportunities• User expectation of availability of all health data in CHR continues to

attract new data senders• State Innovation Model expectations re shared technology services

(provider-payer communications, claims database, consumer tools)• ACA driving new technology and information sharing needs• Advanced Meaningful Use (and MIPS) objectives emphasize HIE• New technologies (APIs, FHIR)• Secondary uses of data (eg for analytics service) provide revenue

opportunity8

Opportunities

Threats• Cybersecuritythreats

mayincreaseaspublicawarenessofDHINgrows

• IncreasedpublicawarenessofDHINthroughconsumerengagementinitiativesmaybringbacklash

• Unknownimpactofelectionoutcomes

• EndofHighmark’sannualcontributionof$1M;uncertainlevelofcontinuedsupport

• Increasednumberofdatasenders=increasedcomplexityinschedulingupgrades,etc.(datasendershavecompetingpriorities) 9

• NewCEOs&CIOsinfoundingorgs– lossofcollectivememory

• OngoingrequeststojustifyDHINfees(valueuncleartocustomers)

• Brandawareness– over-identificationofDHINwithCHR

• Increasinglycomplextechnologystack

• Refreshthetechnologywhilemaintainingserviceandoperations

• Historyofproblem-riddledsoftwareupgradeshaserodedstakeholderconfidence

• IncreasingcompetitionfromprivateHIEs

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Strategic Principles and Themes• Execute on the expansive vision of DHIN articulated in 16 Del.

Code Chapter 103• Remain the neutral facilitator of information exchange

between business competitors• Maintain national leadership position• Manage the business

– Growth in services – Growth in participants – Diversify revenue stream for stability– Align fees with value

• Move toward business model based on use of data vs contribution of data to the network

• All who receive value from DHIN should contribute proportionately to the value received

• Work to be perceived by our stakeholders as a strategic partner

• Need tobeclarifiedandrefreshed

• Managementoftechnology andservicesasanintegratedandcoordinatedportfolio

• Contractmanagementinamulti-vendorenvironment

• Stabilizationandreliabilityofcoreservices• Improvemarketawareness (competitive landscape)• Relationshipbuilding atC-suiteandbusiness leaderlevels• Segmentationofmarketingandcommunications• Legacyinterfacesanddatastandards• Define enterprisearchitecture(business, information, and

technology)• Procurementsalignedwithdefinedarchitecture

• Criticalskillsforspecificnewopportunities arelackingorimmature

• Currentorganizationalstructuremaynotbeideal11

Areas Needing Further Maturity:Five Key Domains

What do we do, for whom do we do it, and why?

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DHIN’s Mission

“Weserveprovidersandconsumersofcarethroughinnovativesolutionsthatmakehealthdatauseful”

(It’s not just moving, storing and displaying data)

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DHIN’s Vision

“Thereliedupon,highlytrustedinformationhubofthehealthecosystem…inwhichallparticipantsbothcontributeandreceivevalue...fuelingarobustLearningHealthSystem”

What do we want to be? A desirable, achievable future state…

What is the cultural glue that holds us together as an organization? What drives us? How do we behave/think/work?

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Core Values

• Embracethechallenge!• Beaccountable• Worktogether

• Five initiatives and 17 supporting work streams

• Five-year roadmap• Supported by Gartner research and a

detailed Implementation Guide• A flexible plan to address strategic themes

and achieve the desired future state• Will be updated annually

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Operationalizing the Plan (1)

Initiative WorkStream Focus1. Organizational

Capabilitiesa) Changemanagementb) Alignhumancapitalwith

strategicdirection

• Focus onorgstructure,skillsetdevelopmentthroughmixofnewhires,training,andcontractsupport

2. CustomerEngagementandMarketing

a) Segmentcustomercommunications

b) Performcompetitivemarketanalysis

c) Revisemarketingstrategyd) Alignrelationshipmanagement

capabilities withstrategicdirection

• Therightcommunicationchannelwiththerightdetailtotherightaudienceattherighttime– withfeedback

• UnderstandexistingandemergingHITecosystem

• Targetmarketingoftherightservicetotherightcustomersegment

• Fostera“strategicpartnership”approachtorelationshipmanagement

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Initiative WorkStream Focus3. ServiceOffering a) Recastportfolioofservice

offeringsalong withpackagingandpricing

b) IntroduceformalServiceOfferingManagement

• Maturationofmanagement offulllifecycleofserviceofferings

• Reviewofpricingstructureandbusinessmodeltoalignwithvisionandgoals

4. EnterpriseandSolutionArchitecture

a) Align technologyandservicessourcingstrategies

b) Strengthenarchitectureplanningandgovernance

c) Refreshsolutionarchitectured) AcquireCloudServices

Brokerage(CSB)e) Coreservicestechnologyre-

procurementandimplementation

• Explicitlinkagebetweenportfolioofservicesandsupportingtechnology

• Addrigortoarchitecturalplanning

• Modernizeand“modularize”solutionarchitecturetoallowfor“best-in-class”solutions

• CSBtosupportmultiplecloudandremotelyhosted solutionprovidersandserviceofferings

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Initiative WorkStream Focus5. Service

OperationsandManagement

a) Enhancechangeandreleasemanagementprocesses

b) Implementcustomerservicelevelmanagement

c) Strengthenvendormanagementacrossserviceofferingsandsolutions

d) ImplementCloud ServiceBrokerageandITServiceManagementFramework(ITSM)

• Improvequalityoftechnologybasedservices

• Reduce/eliminatethenumber,frequency,andimpactoftechnologyorapplicationrelatedservicedisruptions

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FY 17 – FY 21 Strategic Roadmap

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Initiative /Workstream FY2017 FY2018 FY2019 FY2020 FY2021

DHINOrganizational Capabilities1a Implement DHINChangeManagement

1bAlignHumanCapitalManagementwiththe DHIN’s

StrategicDirection

CustomerEngagementandMarketing2a SegmentCustomerCommunications

2b Perform CompetitiveMarketAnalysis

2cReviseClientSegmentation,Marketingand

Engagement/SalesStrategy

2dAlignRelationshipManagementCapabilitieswith

StrategicDirection

ServiceOfferings3a RecastPortfolioManagementof Offerings

3b Introduce FormalServiceOfferingManagement

EnterpriseandSolution Architecture4a AlignTechnologyandServicesSourcingStrategy

4b StrengthenArchitecturePlanningandGovernance

4c Refresh SolutionArchitecture

4dAcquireCloud ServicesBrokerageasFoundationfor

HIECap.&ServiceDelivery

4eCoreServicesTechnology\ Services(Results,CHR)

Re-procurement andImplementation

ServiceOperationsandManagement

5a Enhance ReleaseManagementProcesses

5b Implement CustomerServiceLevelManagement

5c StrengthenVendorManagementAcrossSolutions

5d Implement CloudServiceBrokerageandITSMFrameworkAcrossSolutions

OngoingCapabilityorPeriodicActivity

ActiveWorkstreamEfforts

Specific Roadmap Tasks for FY 17• NewHires

– ChiefInnovationOfficer(EA,Tech)– ClinicalInformaticist– IntegrationAnalyst(Mirth

certified)✅ DirectorofMarketing(done)

• StaffDevelopment– ITIL/ITSMFrameworktrainingfor

allstaff• Segmentedcustomer/

stakeholdercommunications– C-suiteexecutives– Projectmanagers– Businessleaders– Keylegislators– Stateagencies

• Standupformalportfoliomanagement– Mapexpensesandtechnology

componentstoserviceofferings– Evaluatepossibleservice“bundles”– Re-evaluatepricingmodel,fees

• Begintechnologyrefreshactivities– Pilot“MirthResults”– Acquireallhistoricdata– ImplementCDRinAmazonGov

cloud– Evaluatemodularsolutionsto

replaceancillaryfunctionality– BeginRFPsifneededforspecific

procurements• HITECHCertificationfor

stakeholderconfidence

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overview of dhin strategic plan fy 17 – fy 21`overview of dhin strategic plan fy 17 – fy 21` 1....

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