Examine the balance between defining HIT needs and applying available HIT solutions—?

How do you engage Physicians in Planning/Product Selection, when physicians generally lack the basic IT understanding to even determine what they would want from an HIT system, like an EHR..?

How do you engage Physicians in Planning/Product Selection, when each physician often has their own workflow and there is No way to implement a HIT system that meets every physician needs/wants…?

Reference

APA Format

Week 5 HIT Governance and Decision Rights

HCAD 610

Learning Objectives

Explain why healthcare information technology (HIT) strategic planning has become more important for healthcare organizations.

Summarize the five major components of HIT governance.

Describe the major elements of a healthcare organization’s planning effort.

Assess the major elements of an HIT strategic plan.

Describe systems theory, and explain why it is vital to HIT governance and planning.

Overview

Background of HIT governance and strategic planning

Organizing an HIT strategic planning effort

The importance of system integration

The basics of systems theory

Management control and decision support systems

Background

Governance is designed to address agency problem (separation of ownership from management).

Managers may become risk averse (to keep job). Behavior does not maximize outcomes.

Owners establish bonding contracts to align incentives or monitoring to control.

Background: HIT Planning

As healthcare organizations become more complex, HIT must accommodate that complexity with information architecture.

HIT Planning Domains

Strategic alignment

Risk management

Resource management

Performance measurement

Value delivery

Components of HIT Governance

Consistently applied HIT strategy

Alignment of HIT strategy with organizational strategy

Well-developed HIT infrastructure, architecture, and policies

Well-managed HIT project priorities and investments in HIT infrastructure

Documented HIT value or benefits to enhance accountability

Consistent HIT Strategy

Support strategic goals, objectives, and priorities of organization

35% of organizations had no HIT strategic plan in 1996

8% had no HIT strategic plan in 2002

Question not asked today

HIT plan can be part of or integrated with organization strategic plan

Alignment of HIT and Organizational Strategy

Must address six key questions:

What does the organization do?

Who does the organization do it to or for?

Where does the organization do it?

When does the organization do it?

Why does the organization do it?

How does the organization do it?

Well-Developed HIT Infrastructure, Architecture, and Policies

HIT development priorities 2012 (percentage of respondents):

Servers/virtual servers (19%)

Mobile devices (18%)

Desktops/virtual desktops (16%)

Security systems (16%)

Storage and backup (8%)

Wired/wireless networks (7%)

Data Standardization

System integration vital in future

Can’t share information without data standardization

Facilitate exchange within and outside organization

Data Standardization (cont’d)

Multiple projects underway to develop and distribute standards:

American National Standards Institute (ANSI)

Health Industry Business Communication Council

Health Level Seven (HL7)

Healthcare Information Technology Standards Panel (HITSP)

Data Standardization (cont’d)

Health Level Seven (HL7)

Voluntary effort involving providers, vendors, government, and others

HIPAA established standards that providers are required to follow to receive Medicare, Medicaid, and other payments

Standards adoption is work in progress

Health information exchanges’ (HIEs) impediment due to failure to specify a standard structure and format of data

Hardware and Software Standards

Steering committee and CIO standards, such as central review and approval of purchases:

Ensures compatibility with enterprise-wide data standards

Terminals and workstations use common operating systems

Cost advantages through purchase of site licenses

Eases technical support capacity

Prevents illegal use of unlicensed software

Well-Managed HIT Project Priorities and Investments

Capitalize on specialized skills of HIT staff in selecting and purchasing hardware and software

HIT management must manage competing priorities

Documented HIT Value or Benefits

Value of investment needs to be documented to justify ongoing organizational support

Financial

Cost reductions

Revenue enhancements

Productivity gains

Clinical

Service delivery

Outcome measures

Organizational

Risk reduction

Stakeholder satisfaction

Organizing HIT Strategic Planning Effort

Responsibilities for HIT management:

Board delegates to CEO

CEO delegates to CIO

Important due to expanding size and complexity of healthcare organizations

Organizing HIT Strategic Planning Effort (cont’d)

Purpose of strategic governance and HIT planning:

IT governance helps the organization make business decisions more accurately and in a more timely manner.

Steering Committee

HIT steering committee

Designed to engage key user groups

Ensures diversity of input to governance function

Steering Committee Membership

Executive management (CIO)

Medical staff

Nursing staff

Financial management

Clinical support services

Planning and marketing

Other major system users

Organizing HIT Strategic Planning Effort

Steering committee assumes responsibility for HIT plan that addresses:

Priorities for new and replacement systems

Specifications for IT infrastructure

Capital and operating budget

HIT Strategic Technology Plan

Major elements of HIT technology plan:

Statement of HIT goals and objectives aligned with the strategic goals of the organization

Priorities for the portfolio of computer applications to be developed

Specification of overall system architecture

Software development plan

HIT management and staffing plan

Resource requirements, including capital and operating budget projections

HIT: Systems Analysis

Systems analysis is the process of collecting information about functional information system requirements and the environment in which the system will operate.

Systems analysis is needed regardless of whether the system will be developed in-house or will be implemented using vendor software.

HIT: System Characteristics

Unity or integrity—unity of purpose

Healthcare systems are complex

Complex systems contain hierarchical structure

Most posses stability and equilibrium

Deterministic or probabilistic

Simple systems with feedback

Closed or open

HIT Systems

Management control and decision support systems:

Inputs

Conversion process

Outputs

Sensor

Monitor (standards)

Control process (corrective action)

Useful Management Information

Information, not data driven

Relevant and sensitive

Unbiased

Comprehensive

Timely

Action oriented

Uniform (for comparison)

Performance targeted

Cost-effective

Web Resources

Governance

American National Standards Institute (ANSI; www.ansi.org)

Centers for Disease Control and Prevention, National Center for Health Statistics (http://healthindicators.gov/)

CharlesRiver Advisors (www.charlesriveradvisors.com/)

Dearborn Advisors (www.dearbornadvisors.com/)

Environmental Protection Agency (EPA; www.epa.gov/enviro)

Health Management Technology magazine (www.healthmgttech.com)

HL7 (www.hl7.org)

The Joint Commission (www.jointcommission.org)

Strategic Plans

Advanta Health Partners strategic plan (www.advantapartners.com/projects/project9_itsd.html)

Centers for Disease Control strategic plan (www.cdc.gov/od/ocio/docs/CDC_IT_Strategic_Plan_2012_2016.pdf)

Indiana University School of Medicine (http://technology.iusm.iu.edu/iusm-strategic-plan/)

Stanford University Medical Center (http://medstrategicplan.stanford.edu/retreat03/IRT.ppt)

University of Utah strategic plan (www.healthcare.utah.edu/technology/itsPlan/2010%20UUHC%20ITSP%20Full%20Version.pdf)

Examine the balance between defining HIT needs and applying available HIT solutions—?

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