Managing the Tidal Wave of Demand for IT: The Keys to Successful IT Governance
Dr. John Lee, Jamie Nelson, Guy Scalzi
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May 2014
Guy ScalziPrincipal
Aspen Advisors
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Definition of Governance
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Putting structure around how organizations align IT strategy with business strategy, ensuring they stay on track to achieve their strategies and goals, and implementing good ways to measure IT’s performance.
~ K. D. Schwartz, CIO.com
5/22/07
Why Governance is Important
• Confers legitimacy on decisions• Standardizes processes• Shapes expectations• Ensures benefits are achieved• Aligns strategy• Provides input to capital budget process• Streamlines IT demand management
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Keys to Success
• Communicate• Meet regularly• Don’t allow gaming• Keep it simple and transparent• Ensure executive involvement
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Jamie NelsonVP and CIO
Hospital for Special Surgery
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Quick Facts
About IS Core Initiatives
• 30,000 orthopedic surgeries/year
• 35 OR’s; 11 MRI’s; 200 beds• 100 orthopedic surgeons • 3 time Magnet designation • 22 consecutive quarters
99th percentile Press Ganey Likelihood to Recommend question
• US News & World Report 2012-2013 America’s Best Hospitals issue ranked HSS:– #1 in Orthopedics– #3 in Rheumatology
• 18 month Epic EHR and Revenue Cycle implementation underway– Epic Led– Epic Remote Hosting
• Network core replacement
• 150 staff, many with clinical or business backgrounds
• “Invest in IT as Enabler” part of strategic plan
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Governance Structure
Former State
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Linking HSS Vision to ITStrategic Direction
Culture + Values
Patient
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Support and align a world-classmedical staff
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Advance through research and innovation
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Serve as the most trusted educator
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Enablegrowth andextend the brand
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Maximize quality and efficiency: Operational excellence
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6 Elevate employee engagement
Invest in information technology
VisionMission As an enabling strategic priority, our vision for IT
at HSS is to:“Provide world-class IT
systems and services aligned with HSS strategic initiatives
and commensurate with world-class care.”
Easy and consistent patient experience
Seamless transitions of care Time and cost savings through
automation and optimization Extend reach of HSS brand Always available, stable Future focused, scalable and
aligned with industry
Operationalizing the IT Strategy
IT Governance Group Members Lisa Goldstein, Chair Lou Shapiro, Stacey Malakoff, Catherine Krna,
Stephanie Goldberg, Jamie Nelson, Steven Magid, MD, Laura Robbins, Vincent Grassia,Marc Gould, Robin Merle and Karen Cohen
Goals Align IT expenditure with HSS strategic goals Increase organizational commitment to IT programs Insure adequate resourcing for IT projects Prioritize the demand for IT resources Align expectations across the business and IT Provide transparency on progress and outcomes Increase benefits realized from IT programs
Surgical Advisory
Board
Security/ Standards
Innovation
Supply Chain Periop
Executive IT Governance
Group
Advisory Groups
IT Dept/PMs
Finance
InpatientOps, DR and DC
AMB
Rev Cycle
External Facing SystemsSteering
Committee
Corporate Systems Steering
Committee
Technology Steering
Committee
Clinical Systems Steering
Committee
Research SystemsSteering
Committee
Education Systems Steering
Committee
Vincent Grassia Laura Robbins Marc Gould Jamie NelsonStephen Magid, MDStephanie Goldberg
Opeartionalizing the IT strategy and tactical plan starts with effective IT governance.
IT Project Request Process Timeline
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Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
IT Project Request Refinement Ends
IT Portfolio Annual Rebalancing Begins
Next Year IT Portfolio Approved
Corporate Budgeting Process Begins
Corporate & IT Strategy
Refresh Starts
IT Portfolio Annual Rebalancing Ends
IT Project Request Refinement Begins
Corporate & IT Strategy
Refresh Ends
Corporate Budgeting Process Ends
IT Governance committee meets 6x a year. Also meets for two rebalancing efforts 1x in March and 1x in October.
Steering Committees meet 6-12x a year. Also meet for two rebalancing efforts – 1x in March and 1x in October
IT Project Request Intake for Refinement
Process Ends for following year.
Communication to Business that IT Project Requests need to be in by
May for next year.
Use Case Scenario
• Annual capital budget process• IT no longer in the business of prioritizing – accountability at the
Steering Committee Level• CIO goal (tied to incentive comp) – no project
receives capital funding unless it has gone through Steering Committee Prioritization Process
• Steering Committees, staffed by business unit owners,negotiate priorities amongst themselves considering:– Strategic alignment– Employee and patient impact– Organizational impact– Financial impact– Risk factors– Alignment with single vendor strategy
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Keys to Success
• Projects requiring only operational dollarsstill need to go through the IT governance process
• Transparency is important – end users arelooking for process and communication
• Don’t let perfect get in the way of the good,(e.g., forget about weighting )– we used:
• Broken or bleeding• Strategic importance – can’t wait• Strategic importance – can wait• Can be deferred
• Figure out whether Executive IT Governance Group wants to be part of final decision-making process or just approver
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John Lee, MDCMIO
Edward Elmhurst Healthcare
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Quick Facts
About IS Core Initiatives
• Formed July 1, 2013• 676 beds, 3 hospitals• Edward, Elmhurst
Memorial, Linden Oaks• More than 50 locations• Service area of 1.9 million
residents in western suburbs of Chicago
• 7,600+ employees• 1,680 medical staff• 1,700 volunteers
• Implementation of CPOE and improvement of patient safety.
Edward• Epic Ambulatory (~120
physicians) July 2012• Epic in Edward and Linden
Oaks Hospitals April 2013• Share Epic with DuPage
Medical Group, independent multi-specialty group of ~ 400 physicians
Elmhurst• Next Gen in physician
practices (~100 physicians) >10 years
• Meditech in hospital >10 years
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Use Case Scenario
• Decision support• Alert fatigue
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Decision Support for a Driver
Use Case Scenario
• Clinical complexity• Technical complexity• Solution: break the blood (MD)-brain (IT)
barrier• Agility• Governance challenges
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Keys to Success
• Highly dependent on individual• Don’t accept out-of-the-box• Clinical focus with IT tools• Plan to scale
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Questions?
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Jamie NelsonVP and CIO
Hospital for Special [email protected]
(212) 606-1654
John Lee, MDCMIO
Edward Elmhurst [email protected]
(630) 527-5144
Guy ScalziPrincipal
Aspen [email protected]
(646) 369-9310