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Managing the Tidal Wave of Demand for IT: The Keys to Successful IT Governance

Managing the Tidal Wave of Demand for IT: The Keys to Successful IT Governance. Dr. John Lee, Jamie Nelson, Guy Scalzi. May 2014. Guy Scalzi Principal Aspen Advisors. Definition of Governance.

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Managing the Tidal Wave of Demand for IT: The Keys to Successful IT Governance

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  1. Managing the Tidal Wave of Demand for IT: The Keys to Successful IT Governance Dr. John Lee, Jamie Nelson, Guy Scalzi May 2014

  2. Guy ScalziPrincipalAspen Advisors

  3. Definition of Governance Putting structure around how organizations align IT strategy with business strategy, ensuring they stay on trackto achieve their strategies and goals, and implementing good ways to measure IT’s performance. ~ K. D. Schwartz, CIO.com 5/22/07

  4. 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

  5. Keys to Success • Communicate • Meet regularly • Don’t allow gaming • Keep it simple and transparent • Ensure executive involvement

  6. Jamie NelsonVP and CIOHospital for Special Surgery

  7. 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 • 150 staff, many with clinical or business backgrounds • “Invest in IT as Enabler” part of strategic plan • 18 month Epic EHR and Revenue Cycle implementation underway • Epic Led • Epic Remote Hosting • Network core replacement

  8. Governance Structure Former State

  9. Culture + Values Linking HSS Vision to ITStrategic Direction Mission Support and align a world-class medical staff Vision 1 • 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 Enable growth and extend the brand Maximize quality and efficiency: Operational excellence 5 2 Patient Advance through research and innovation Serve as the most trusted educator 4 3 6 Elevate employee engagement 7 Invest in information technology

  10. Operationalizing the IT Strategy Opeartionalizing the IT strategy and tactical plan starts with effective IT governance. • 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 Executive IT Governance Group Surgical Advisory Board External Facing SystemsSteering Committee Research SystemsSteering Committee Education Systems Steering Committee Corporate Systems Steering Committee Technology Steering Committee Clinical Systems Steering Committee Stephen Magid, MD Stephanie Goldberg Laura Robbins Jamie Nelson Marc Gould Vincent Grassia Advisory Groups Security/ Standards Supply Chain Periop Finance Innovation Inpatient Rev Cycle Ops, DR and DC AMB IT Dept/PMs

  11. IT Project Request Process Timeline 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 Corporate & IT Strategy Refresh Starts Corporate & IT Strategy Refresh Ends IT Portfolio Annual Rebalancing Ends 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. Corporate Budgeting Process Ends IT Project Request Refinement Ends Corporate Budgeting Process Begins Next Year IT Portfolio Approved IT Project Request Refinement Begins IT Portfolio Annual Rebalancing Begins

  12. 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 projectreceives 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

  13. 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

  14. John Lee, MDCMIOEdward Elmhurst Healthcare

  15. 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 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 • Implementation of CPOE and improvement of patient safety.

  16. Use Case Scenario • Decision support • Alert fatigue

  17. Decision Support for a Driver

  18. Use Case Scenario • Clinical complexity • Technical complexity • Solution: break the blood (MD)-brain (IT) barrier • Agility • Governance challenges

  19. Keys to Success • Highly dependent on individual • Don’t accept out-of-the-box • Clinical focus with IT tools • Plan to scale

  20. Questions? John Lee, MDCMIOEdward Elmhurst Healthcare jlee@edward.org (630) 527-5144 Jamie NelsonVP and CIOHospital for Special Surgery nelsonj@hss.edu (212) 606-1654 Guy ScalziPrincipalAspen Advisors gscalzi@aspenadvisors.net (646) 369-9310

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