Hit Service Strategy

HIT Service Strategy Enabling Transformational Health Care

CEO/CIO Questions

A number of important questions require immediate answers.

Is there room to optimize service delivery capability?

Do we effectively organize/manage/govern HIT Services to maximize value and clinical relevancy?

Are we sure that service performance will meet or exceed federal and customer expectations?

Is the budget allocated correctly?

Is there room to optimize our spend?

Should we prioritize or redistribute HIT spend?

How best should we strategically source HIT skills and services?

• Healthcare CEO/CIOs are looking for fresh perspectives in

advancing Healthcare Information Technology (HIT) strategy

design, development, and deployment for more effective and

efficient healthcare delivery.

HIT Services Must Be Agile

• Change size, shape, scope and style as needed:

– Size: Grow/shrink at many levels and rates via flexible resource capacity

arrangements (own, rent, lease, borrow).

– Shape: Centralized, distributed, networked as needed (simultaneous

component shapes if required).

– Scope: Occupy a varying footprint(s) in its value web as the value and

service lifecycles evolve.

– Style: Integrate, collaborate, franchise, etc., depending on dynamics of

markets and offers.

• Engage “self-directed” leadership, managerial and operational

behaviors within dynamic, environmentally determined

constraints.

• Embrace an “effectiveness over efficiency” culture, while

continuing to focus on efficiency.

Survival in Volatility Requires a HIT Organization be Able to:

Challenges Will Remain Constant • The distributed vertical nature and volatility of today’s healthcare

environments, the global economy, and government legislation are underscoring increased challenges with:

– Quality of Patient Care

– Responsiveness

– Innovation

– Competitive Positioning

– Speed to Delivery

– Reach

– Reliability

– Risk

– Cost Efficiency

• Healthcare organizations will need a radically new transformational approach to HIT on the part of the CIOs, business leaders and clinicians.

• A transformational strategy will encompass an inclusive governance process with streamlined decision-making authority, a radically simplified IT architecture, mega-project-management capability, resource allocations and strategic sourcing, change and effective communication management.

“We can't solve problems by using the same kind of thinking we

used when we created them.”-Albert Einstein

HIT Organizations Currently Strive for a

Business - Aligned, Managed Environment

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tlo

ok

Performance

Health Care

Aligned

Tactical

Reactive Managed

Today’s best practices show that HIT value

can be maximized when enterprise HIT

investments are aligned with healthcare goals

and HIT execution is well managed.

The key drivers of HIT value are:

• Outlook – How organizations make

decisions about technology

investments

• Performance – How well organizations

implement those decisions

But Technological-Driven Transformation of

Health Care Is Challenging this Target

Expanded

Channels &

Connections

Dynamic

Business

Models

Extended

Clinical/Health

Care

Processes

Patient

Government

Community

Health

Services

Imaging Centers

Payers

Care Centers

Employers

Care Managers

Hospitals

Physician Groups

PBMs, Retail RX Home

Laboratories

This Requires a New Mindset and a New

Approach to Technology Execution

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tlo

ok

Performance

Health Care

Aligned

Tactical

Reactive Managed Agile

Environmentally

Integrated

The Pressures Felt by Most HIT

Organizations Validate this Model

• Pressure on current HIT spending:

– Are we delivering maximum business value for the resources spent?

– How do we deliver more with less?

– How do we minimize capital investment?

• Scarce resources: How do we hire, retain, retrain, or obtain staff to

provide the necessary technology skills?

• HIT governance challenges: How do we coordinate HIT spending

and activities throughout the organization? With our partners?

• The need for speed: How do we support business requirements to

respond to opportunities in days vs. months vs. years?

An Agile HIT Framework Provides a

Persistent Context for the Strategy Outputs

• Getting Aligned and Managed . . .

– Drive efficiency and effectiveness of HIT delivery and management processes

– Adopt an enterprise architectural view

– Focus on getting costs structured, understood, under control

– Concentrate cost optimization on efficiency issues

– Drive opportunity portfolio prioritization through value tradeoff

– Align business and HIT strategies

• Externalizing and Becoming Agile . . . – Integrate business and HIT strategies

– Focus on improved services and delivery through adaptive management and delivery processes

– Expand the view of infrastructure to “extra-structure”

– Create agility through a flexible services environment leveraging internal and external providers

Health Care

Aligned

Tactical

Reactive Managed Agile

Environmentally

Integrated

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tlo

ok

performance

Health Care

Aligned

Managed

Getting Aligned

& Managed

Externalizing &

Becoming Agile Transitional State

Transitional State

Agile

IT

Health Care

Aligned

Managed

Because an organization’s HIT

capabilities are typically distributed

across the framework, their HIT

Strategy embraces a mix of activity

types

Strategic Directions Required for Driving Agile HIT Come in Two Flavors

An Agile HIT Strategy Addresses the

Shortcomings of the Traditional HIT Strategy

• HIT defines an ongoing decision tool for leveraging IT to drive a healthcare organizational success in a constantly evolving community environment

• The process is practical and scenario driven

• It recognizes that technology both enables and improves healthcare strategy

• The process examines opportunities made available by other entities in the environment as well as constraints imposed by it

• The strategy is not just about the new, but what to do with the existing environment and current systems portfolio

• The strategy drives integrated architectures and implementations

Health Care

Environment

Vis

ionin

g

HIT Strategy Health Care

Strategy

HIT Current State

Health Care

Architecture

IT Architectures Application

Data

Technology

Security

Governance

Transformation Services People

Process

Technology

Technology

Environment

HIT Future State

An Agile HIT Strategy Translates Needs and

Opportunities from the Environment into Action

What How

Creative Solutions

Health Care Strategy

IT Strategy

IT Operating Model

What Does an Agile HIT Strategy Produce?

Environment

IT Systems &

Services

IT Capabilities Healthcare

Institutions

Health

Care

Success

Clusters of tech-enabled

business capability

--------------

Provide decision making

framework

Skills and capability that enable

Systems & Service delivery

--------------

Sourcing strategy is critical Rules of engagement for decision

making

-------------------------

Coordinates complex

relationships, brokering

A plan for leveraging the HIT capabilities of the company

and the community environment to deliver healthcare

success

An Agile HIT Strategy Provides…

• HIT Systems and Services Directions, that – Are strategic technology-enabled healthcare capabilities stewarded by HIT

– Provide the decision-making framework for all potential HIT investment

– Recognize • the interplay of internal capabilities with those of healthcare partners and customers

• the potential need to support rapid healthcare business and technology evolution

• HIT Capabilities & Sourcing Strategies, that – Describe the combination of skills and knowledge with methods and tools that

support the development, deployment and management of the HIT systems & services

– Examine sourcing options and define the critical skill sets that must be developed and maintained within an organization

• An HIT Operating Model, that defines – HIT management structures and processes

– HIT delivery structure and processes

– Roles, responsibilities, and interaction with partners and customers that support the model of agile execution

The HIT Strategic Components Provide the

Basis for HIT Transformation Tools

• HIT Initiative Planning & Prioritization – Development of a set of processes and tools to organize and prioritize HIT

initiatives

– Focus on resolving the issues around resource management and prioritization of scare resources

• HIT Portfolio Management / Portfolio Rationalization – Development of the disciplines and processes around managing the HIT

environment as a portfolio of assets

– Can also include an effort linked to “cost reduction” that focuses on rationalizing an existing portfolio based on business/ health/ technical criteria

• HIT Organization Design – Focused on developing a new HIT organization based on changes in the

environment such as:

• Acquisition / divestiture

• Re-centralization

• A re-evaluation of the HIT strategy

This Pragmatic Approach to HIT Strategy Focuses

on Sustained Value and Significant Benefits

• Integrates with and drives healthcare strategy, not an after-thought or extension

– Provides a common language for healthcare/HIT discussions

• Recognizes ROI, needed capabilities, and risks

– Provides an explicit linkage between HIT investments and healthcare capabilities

– Enables a consistent framework for prioritizing HIT demands in an environment of permanent volatility

– Coordinates previously fragmented HIT investments

– Resolves capability development, acquisition, and partner challenges

• Evolves an organization, as opposed to simply maintaining it:

– Plans for new assets in the form of intellectual capital and strategic

capabilities, not just salaries and depreciated hardware – Allocates resources to the right investments while containing costs

– Determines clear roles and responsibilities for distributed HIT decision making, enabling an organization to act quickly and with confidence

Greater “technology ROI” derives from greater agility in response to and tighter integration

of technology and healthcare decision making

Appendix A: Agile HIT Strategy and

Planning Approach

Agile HIT Strategy Development

Confirm healthcare

strategy

Identify key

technology enablers

Define HIT systems &

services

Identify HIT

capabilities

Define HIT

Governance

• Extract key healthcare strategies

• Document and review with key

management

• Create healthcare strategy summary

• Confirm with key management

• Identify technology infrastructure

enablers

• Identify information management

enablers

• Identify application enablers

• Define required system/service

characteristics

• Identify key product capabilities

• Identify key service capabilities

• Identify sourcing opportunities

• Identify baseline HIT competencies

• Identify common capabilities

• Identify specialized capabilities

• Identify appropriate sourcing

• Define the HIT governance structure

• Define the HIT governance processes

for

• HIT Product & Service delivery

• HIT management

• Executive management team

• Division management

• HIT management

• Strategy development team

Steps Tasks Resources

• HIT management

• Strategy development team

• Key business subject matter experts

• Strategy development team

• HIT management

• Strategy development team

• HIT management

• Strategy development team

• HIT management

• Executive management team

• Division management

Identify Implications • Identify product & service, governance,

capabilities implications

• Strategy Development team

• HIT Management, SMEs

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Agile HIT Strategy and Planning Approach The approach to HIT Planning begins with the development of a well-articulated information technology strategy driven by the strategic direction of the healthcare business.

This strategy serves as the foundation for the enterprise architectures for applications, information, technology infrastructure, and HIT management.

Finally, the strategy, using the architectures as “roadmaps”, helps to establish the plan of what technology initiatives will be implemented.

Health Care

Environment

Strategy

Applications

Architecture

Information Strategy Architecture

Technology

Architecture

Management

Architecture

Healt

h C

are

Info

rmati

on

Tech

no

log

y

Str

ate

gy

HIT Transition Plan

Development

HIT Management

Initiatives

3

Health Care

Strategy

Technology Infrastructure

Initiatives

Information Repository

Initiatives

Application Portfolio

Initiatives Information

Strategy

Strategy

Strategy

Architecture

19

HIT Planning Approach

The HIT Strategy describes an overall direction for HIT in terms of its Systems and Services to the healthcare business, the competencies it will leverage to deliver those Systems & Services, and the governance structure that must be in place to support the delivery.

• The Application Architecture builds on the product/system direction that is set in that strategy to define an overall direction for the portfolio of applications in use and a detailed

description of the current and future state of the elements of the portfolio.

• The Information Architecture looks at the structure for managing the key information for managing the healthcare business, who uses that information, where it’s created and how it is managed.

• The Technology Architecture describes the enterprise direction for an enabling infrastructure as driven by the strategic direction for applications and data.

• The Management Architecture describes the processes, tools and systems to be put in place for the effective management of the HIT resource.

• The HIT Transition Plan defines how to get to the future state. The HIT Transition Plan clusters potential project efforts into a series of prioritized programs or initiatives, reflecting the interdependence all aspects of HIT and HIT management and their priorities with

respect to supporting the business strategy.

Stage 1 Year 2 2010

Year 1

TODAY

HIT Transformation Map

Long

Term

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For More Information Contact:

John Anderson

[email protected]

Innovative Solutions, LLC

52 Sandia Lane

Placitas, NM 87043

U.S.A.

01-815-354-7456