The world of healthcare IT is rapidly changing and CIOs are finding that traditional governance models are not sustainable in the “fee for value” world.
Too often today we hear from both CIOs and clinical leaders that IT is operating in a silo and not well aligned with the emerging needs of the organization. Meaningful use and ICD-10 projects are good examples.
These initiatives are often managed by IT, yet the decisions on workflow, training, content development, and management call for collaboration from clinical, business, and operational leadership. Well meaning executive teams develop cross-functional governance models, yet when it comes to decision making and participation we find too often that governance structures are largely on “paper only,” with IT making it happen.
So, how can your organization evaluate the effectiveness of your IT governance? Performing a quick self-assessment to determine how your organization is currently measuring up against the following key elements of a successful IT governance model is a great starting point:
* Does your IT steering committee include leadership representation from clinical, business, and operational areas of the organization?
* What does your governance structure look like? Does it define joint accountability, beyond the CIO, to include other key organizational executives such as the COO, CNO, and CFO?
* Do you have a governance charter in place? And, does it call for joint decision-making and involvement of staff at all levels of the organization?
* Do you have a process for project prioritization?
o Is this handled by the IT steering committee?
o Do you have a formal process for submission of projects that includes ROI definition and a business case?
o Do you align prioritization with strategic goals and initiatives?
* How do you monitor participation and decision making input? Do you have formal minutes that note attendance, decisions, and next steps? Are defined quorum rules for decision-making in place?
* As you initiate new projects, do you identify and assign cross-functional team representation? If so, how do you handle backfill for members of the team involved in these projects?
* Do you have a formal clinical informatics program? If so, how does that program integrate with the IT department and the IT steering committee?
* Is the IT steering committee involved in decisions about data governance, business intelligence, and reporting?
* Have you identified and clearly documented criteria for IT steering team success?
* Do you have a process for regular evaluation of IT steering team effectiveness? If so, does this include processes to capture “lessons learned” and incorporate continuous improvement?
* Are you building technology skills and knowledge within your operational and business leadership teams so that they can “own” technology as it supports their business needs?
With the increased demand for major initiatives that are central to technology it is easy to revert to having IT “own” the project. Taking that approach will continue to produce a downstream effect of IT overload, a feeling that IT did not “listen” to the internal customers, and a myopic decision-making process that may miss the business needs of key constituents.
Participating in this short self-assessment process will help organizations identify those areas that they need to focus on in order to develop a successful IT governance model -- a model that is not only well defined on paper, but includes cross-organizational involvement, decision-making, and collaboration in support of successfully meeting the emerging IT requirements in today’s fee-for-value environment.
Bob Witkop, MBA, Director, Quality Management Office, CTG Health Solutions, is a consulting management professional with more than 17 years of experience in the healthcare information technology industry. His expertise is focused in strategy, project management, systems implementations, optimizations, testing, revenue cycle, and more recently, ICD-10 testing. He can be reached at firstname.lastname@example.org.
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