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Transcript of HIT Service Strategy
Creative Solutions
HIT Service StrategyEnabling Transformational Health Care
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Forces Confronting Health Care CIOs• Health care IT (HIT) is experiencing volatile change driven, in
part, by government incentives and mandates in the U.S., alongwith a mass of economic and quality dynamics concerned withimproved patient-centered care.
– Many organizations already have existing plans for implementingEMRs and EHRs along with growing needs to replace aging fleetsof financial systems*.
– Federal mandates accelerate project timelines and expenditures,squeezing hospital capital budgets already under strain fromsteadily rising costs, rising by approximately 10 percentannually—and outpacing revenues.**
– Global economics and technology trends, for all IT industries, callfor further cost reductions through consolidation, virtualization,SaaS, and cloud computing arrangements.
– CEO’s are increasingly looking for real business value metricsfrom IT and not simply cost recoveries and SLA performancemeasures.
*HIMSS Analytics from John Hoyt, VP Healthcare Organizational Services - HIMSS** McKinsey Quarterly August 2010
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Financial Incentives – Small Offsets
• Federal Incentive Programsoffer only about 15-20 Percentoffset of the total coast toimplement EHR withinmandated timeframes.
• The government predicts ashortfall of about 50,000qualified health IT workersover the next five years.
• 8 in 10 hospital CIOs arereportedly concerned or veryconcerned they will not be ableto demonstrate meaningful useof EHRs within the federallyestablished deadline of 2015.
*PricewaterhouseCoopers’ HealthResearch Institute.
Source - 2010 HIMSS CIO Leadership Surv ey s 2005-2010
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Federal Penalties are Significant• “An accelerated timetable means that US health care providers
have until the end of 2015 to make the investments or face finesstarting at $2,000 a bed in the first year and up to $35,000 abed by 2019. In addition, both revisions to the Health InsurancePortability and Accountability Act (HIPAA) 5010 and the switchto ICD-10 require providers to apply strict new data-codingstandards—no small task given the number of databases,hospital systems, and clinicians affected.” *
• “To meet these various requirements, US hospitals will need tospend approximately $120 billion, at an average cost of$80,000 to $100,000 per bed, for the required projectplanning, software, hardware, implementation, and training.”**
• The rapidly aging population of baby boomers continues toballoon the need for more hospital beds and penalty dollars.There is little decline in population numbers after thisgeneration in the U.S.
•McKinsey Quarterly August 2010**Ibid
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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 tomaximize value and clinical relevancy?
Are we sure that service performance will meet or exceedfederal 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 andservices?
• Health Care CIOs are looking for fresh perspectives inadvancing HIT strategy design, development, and deploymentfor more effective and efficient health care delivery.
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HIT Services Must Be Agile
• Change size, shape, scope and style as needed:
– Size: Grow/shrink at many levels and rates via flexible resource capacityarrangements (own, rent, lease, borrow).
– Shape: Centralized, distributed, networked as needed (simultaneouscomponent shapes if required).
– Scope: Occupy a varying footprint(s) in its value web as the value andservice lifecycles evolve.
– Style: Integrate, collaborate, franchise, etc., depending on dynamics ofmarkets and offers.
• Engage “self-directed” leadership, managerial and operationalbehaviors within dynamic, environmentally determinedconstraints.
• Embrace an “effectiveness over efficiency” culture, whilecontinuing to focus on efficiency.
Survival in Volatility Requires a HIT Organization be Able to:
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Challenges Will Remain Constant• The distributed vertical nature and volatility of today’s health care
environments, the global economy, and government legislation areunderscoring increased challenges with:
– Quality of Patient Care– Responsiveness– Innovation– Competitive Positioning– Speed to Delivery– Reach– Reliability– Risk– Cost Efficiency
• Health care organizations will need a radically new transformationalapproach to HIT on the part of the CIOs, business leaders andclinicians.
• A transformational strategy will encompass an inclusive governanceprocess with streamlined decision-making authority, a radicallysimplified IT architecture, mega-project-management capability,resource allocations and strategic sourcing, change and effectivecommunication management.
“Insanity: doing the same thing over and over again and expectingdifferent results”. -Albert Einstein
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HIT Organizations Currently Strive for aBusiness - Aligned, Managed Environment
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Performance
Health CareAligned
Tactical
Reactive Managed
Today’s best practices show that HIT valuecan be maximized when enterprise HITinvestments are aligned with health caregoals and HIT execution is well managed.
The key drivers of HIT value are:
• Outlook – How organizations makedecisions about technology
investments
• Performance – How well organizations
implement those decisions
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But Technological-Driven Transformation ofHealth Care Is Challenging this Target
ExpandedChannels &
Connections
DynamicBusinessModels
ExtendedClinical/Health
CareProcesses
Patient
Government
CommunityHealthServices
Imaging Centers
Payers
Care Centers
Employers
Care Managers
Hospitals
Physician Groups
PBMs, Retail RXHomeLaboratories
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This Requires a New Mindset and a NewApproach to Technology Execution
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Performance
Health CareAligned
Tactical
Reactive Managed Agile
EnvironmentallyIntegrated
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The Pressures Felt by Most HITOrganizations 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 toprovide the necessary technology skills?
• HIT governance challenges: How do we coordinate HIT spendingand activities throughout the organization? With our partners?
• The need for speed: How do we support business requirements torespond to opportunities in days vs. months vs. years?
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An Agile HIT Framework Provides aPersistent 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 externalproviders
Health CareAligned
Tactical
Reactive Managed Agile
EnvironmentallyIntegrated
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performance
HealthCare
AlignedManaged
GettingAligned &Managed
Externalizing &Becoming AgileTransitional State
Transitional State
Agile
IT
HealthCare
AlignedManaged
Because an organization’s HITcapabilities are typicallydistributed across the framework,their HIT Strategy embraces a mixof activity types
Strategic Directions Required for Driving Agile HIT Come in Two Flavors
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An Agile HIT Strategy Addresses theShortcomings of the Traditional HIT Strategy
• HIT defines an ongoing decision tool for leveraging IT to drive ahealth care organizational success in a constantly evolvingcommunity 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 otherentities in the environment as well as constraints imposed by it
• The strategy is not just about the new, but what to do with theexisting environment and current systems portfolio
• The strategy drives integrated architectures and implementations
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Health CareEnvironment
Vis
ioni
ng
HIT StrategyHealth CareStrategy
HIT Current State
Health CareArchitecture
IT ArchitecturesApplication
DataTechnology
SecurityGovernance
Transformation ServicesPeople
ProcessTechnology
TechnologyEnvironment
HIT Future State
HIT Strategy Translates Needs andOpportunities from the Environment into Action
What How
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Health Care Strategy
IT Strategy
IT Operating Model
What Does the HIT Strategy Produce?
Environment
IT Systems &Services
IT CapabilitiesHealthcare Institutions
Health Care
Success
Clusters of tech-enabledbusiness capability
--------------Provide decision making
framework
Skills and capability that enableSystems & Service delivery
--------------Sourcing strategy is criticalRules of engagement for
decision making-------------------------
Coordinates complexrelationships, brokering
A plan for leveraging the HIT capabilities of the companyand the community environment to deliver health caresuccess
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An Agile HIT Strategy Provides…
• HIT Systems and Services Directions, that– Are the strategic technology-enabled health care capabilities stewarded by HIT– Provide the decision-making framework for all potential HIT investment– Recognize
• the interplay of internal capabilities with those of health care partners and customers• the potential need to support rapid health care 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 developedand 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
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The HIT Strategic Components Provide theBasis 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/ technicalcriteria
• 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 Focuseson Sustained Value and Significant Benefits
• Integrates with and drives health care strategy, not an after-thought orextension
– Provides a common language for health care/HIT discussions
• Recognizes ROI, needed capabilities, and risks– Provides an explicit linkage between HIT investments and health care
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 and tighter integration oftechnology and health care decision making
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HIT Strategy Development
Confirm health carestrategy
Identify keytechnology enablers
Define HIT systems &services
Identify HITcapabilities
Define HITGovernance
• Extract key health care strategies• Document and review with key
management• Create health care strategy summary• Confirm with key management
• Identify technology infrastructureenablers
• Identify information managementenablers
• Identify application enablers
• Define required system/servicecharacteristics
• 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, capabilitiesimplications
• Strategy Development team• HIT Management, SMEs
20
HIT Strategy and Agile Planning ApproachThe approach to HIT Planning begins with the development of a well-articulatedinformation technology strategy driven by the strategic direction of the health carebusiness.
This strategy serves as the foundation for the enterprise architectures forapplications, information, technology infrastructure, and HIT management.
Finally, the strategy, using the architectures as “roadmaps”, helps to establish theplan of what technology initiatives will be implemented.
Health CareEnvironment
StrategyApplications
Architecture
InformationStrategy Architecture
Technology
Architecture
ManagementArchitecture
Hea
lth
Car
eIn
form
atio
n T
ech
no
log
yS
trat
egy
HIT Transition Plan Development
HIT ManagementInitiatives
3
Health CareStrategy
TechnologyInfrastructure Initiatives
Information RepositoryInitiatives
Application PortfolioInitiatives
InformationStrategy
Strategy
Strategy
Architecture
21
HIT Planning ApproachThe HIT Strategy describes an overall direction for HIT in terms of its Systemsand Services to the health care business, the competencies it will leverage todeliver those Systems & Services, and the governance structure that must be inplace to support the delivery.
• The Application Architecture builds on the product/system direction that is set in thatstrategy to define an overall direction for the portfolio of applications in use and a detaileddescription of the current and future state of the elements of the portfolio.
• The Information Architecture looks at the structure for managing the key informationfor the managing the health care business, who uses that information, where it’s createdand how it is managed.
• The Technology Architecture describes the enterprise direction for an enablinginfrastructure as driven by the strategic direction for applications and data.
• The Management Architecture describes the processes, tools and systems to be put inplace for the effective management of the HIT resource.
• The HIT Transition Plan defines how to get to the future state. The HIT Transition Planclusters potential project efforts into a series of prioritized programs or initiatives,reflecting the interdependence all aspects of HIT and HIT management and their prioritieswith respect to supporting the business strategy.
22
Characteristics of an HIT Strategy &Architecture Methodology
• An accelerated methodology for developing a HIT StrategicPlan has the following important characteristics:
– A process perspective that recognizes that HIT strategy &architecture is not a one-time event but a continuous process thatwill evolve as the health care environment evolves
– An iterative approach to strategic plan development; buildingintermediate versions and gaining consensus
– A collaborative effort that leverages experience in strategicplanning development and the health care business and appliedtechnology knowledge
– Acceleration through parallel tasking and leveraging facilitatedsessions
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The HIT Implications and Potential HIT Enablers of the HealthCare Business and Practice Strategies Drive the HIT Strategy
HIT Strategy Process Flow
Division /FunctionalHealth UnitStrategies
HIT Implications
• What is the impact of thehealth care business andpractice strategies on theHIT systems and services?
• How does the health caredirection and perceptionof HIT affect themanagement of HIT?
Health CareStrategy and DataGathering
• Gather informationon future direction
• Organize aroundhealth care units andcare processes
• Review and confirminformation with keystakeholders
Current State DataGathering
• Identify applications anddata portfolios
• Document the existinggovernance model
• Document currentinfrastructure
HIT Principles
HIT Systems andServicesDirection
HIT Capabilities
HIT Strategy
HIT OperatingModel
CorporateHealth CareStrategies
Health CareOrganizationalPerception of
HIT
HIT Enablers
• How can HIT support theimplementation of thehealth care business andpractice direction andstrategies through new orenhanced:
• Infrastructure services• Applications• Information
Managementcapabilities
Health CareDirection
• Corporate businessdirection asarticulated by seniormanagement
Current Stateof HIT
Health CareProcessDirection
Health Care Business and Practice Functions/Strategy Drive the Overall HIT Strategy,Architecture and Planning Process
Future State HIT Design and Migration Planning –Techniques: Identifying HIT Drivers
HIT StrategyHealth Care
Strategy
Health CareEnvironment
Systems andServices
HIT OperatingModel
Capabilities andSourcing
Principles
IT Architectures
Infrastructure Architecture
Application Architecture
Information Architecture
HIT Initiative Portfolio
Infrastructure Initiatives
Application Initiatives
Data Initiatives
HIT ManagementInitiatives
HIT ManagementEnvironment
HITPortfolios
Processes
Tools Applications
ResourcesInformation
Repositories
Infrastructure
HIT Current State
HIT ManagementEnvironment
HITPortfolios
Processes
Tools Applications
ResourcesInformation
Repositories
Infrastructure
HIT Future State
TechnologyEnvironment
What How
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Technology ArchitectureGuidebook
StrategyWorkshop
Health Care &IT Process Architecture
ApplicationArchitecture
InformationArchitecture
InfrastructureArchitecture
Approach & Deliverables (I)
Gather Health CareStrategies and BuildFunctional Decomp
Current StateApplicationInventory
Current StateInformationInventory
InfrastructureCurrent State &Change Drivers
HITDirections
HIT Process Scorecard
BusinessArchitecture
AppStrategy
Information Strategy
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ApplicationStrategy &
Architecture
InformationStrategy &
Architecture
TechnologyArchitectureGuidebook
ApplicationPortfolioFutureState
Disposition
Info StoreFutureState
Disposition
TechnologyInfrastructure
TransitionPlan
Transition Plan
Approach & Deliverables (II)
Develop HIT Systems,Services, Capabilities
Assess HIT Processes
HIT StrategyGuidebook
Application PortfolioAnalysis
Information PortfolioAnalysis
Exec Briefings
HIT Process Assessment &Recommendation
Arc
hit
ectu
re M
ain
ten
ance
& C
om
mu
nic
atio
n P
lan
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ED & Clinical Solutions
EHR & Practice Management
Revenue C
ycle
&
Access M
anagement
Ente
rpri
se P
erfo
rman
ce
Man
agem
ent
Me
an
ing
ful U
se
Stage 1 Year 22010
Year 1
TODAY
HIT Transformation Map
Long Term
VisionMajor activity/
milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone Major activity/
milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
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Appendix A: Detailed Project Approach
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Detail Project ApproachCharacteristics of an HIT Strategy & Architecture
Methodology
Project Approach
• Project Kickoff
• Track I – HIT Strategy Development & Accelerated Solutions Environment
• Track II – Application Architecture
• Track III – Information Architecture
• Track IV – Technology Architecture
• Track V – Management Architecture
• HIT Transition Plan
30
• Review Project Management standards and practices
• Develop project charter
• Develop an enterprise communication plan
• Develop issue resolution and status reporting format andprocedures
• Identify client participants for interview s and w orkshops.Begin to schedule appointments.
• Gather existing IT documentation
•Current system inventory
•HIT budgets
•HIT organization
• Gather existing documentation on business strategies andcurrent and planned business organizational structures
• Agree upon structure for f inal documents
Activities
• Project Charter, including project objectives, schedule, teamleads and risk management strategy
• Issue Resolution and status reporting templates
• Enterprise communication template
• Deliverable templates
• Interview schedule
• Complete project schedule
Deliverables
The key objective of the Project Kickoff is to organize team members, set direction, reviewavailable information, agree on deliverable format and establish the remaining schedule
Strategy Project Kickoff
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• Gather and synthesize the enterprise and business unitstrategies
• Interview key stake holders to confirm and refine thehealth care business and practice direction
• Create an framew ork outlining the key HIT systems andservices and how they support the business
• Create a straw man HIT strategy .•Identify the future state capabilities and characteristicsof each of the HIT systems and services
•Identify the key HIT principles
•Identify a proposed HIT governance model
• Conduct a facilitated session w ith representation frombusiness and HIT to update, confirm and ratify the HITstrategy.
Activities
• HIT strategy guidebook w hich establishes the overarchingHIT direction from a health care business and practiceperspective. The follow ing w ill be addressed:
•HIT Systems & Services - a description of IT’scontribution to the achievement of health carestrategies
•HIT Principles - a statement of fundamental values thatprovides ongoing guidance for decision making
•HIT Governance mode identifying the basic structurefor managing IT
•Key HIT capabilities required to deliver, operate,support and manage the HIT systems and services andpotential alternatives for sourcing
Deliverables
Track I focuses on the development of the HIT Strategy. The strategy sets the direction for thearchitectures and transition plan and be aligned to the enterprise business strategies
Track I - HIT Strategy Development Process
32
• Develop an inventory of the current state applicationsportfolio:
• The inventory will include identifying information aswell as information on the Strategic, Functional, andTechnical quality of the application
• Map each application to the corresponding functions itsupports from the systems and services model.
• Develop an application strategy that establishes a strategicdirection for the systems supporting each key businessprocess
• Develop the future state application architecture• recommend a disposition for each group of applications
• These recommendations will focus on aligning thestrategic, functional, and technical quality of theapplication portfolio with the direction set by the HITstrategy
• Conduct a facilitated w orkshop to verify the applicationarchitecture direction
Activities
• Application Inventory that provides
• Application indentif ier and ow ner information
• Technical platform and sizing information
• Qualitative judgments on the functional quality
• Assessment of strategic alignment
• Application Strategy, to include
• Application principles
• Applications mapped to key business processes
• Strategies for application integration and interfacing
• Application architecture, to include:
• A mapping of the applications to the HIT systems andservices they support
• A detailed disposition report that defines a path foreach major application
Deliverables
The majority of the HIT Systems & Services defined in the HIT Strategy are applications systems. The Application Architecture
– builds on the product direction set in that strategy to define an overall direction for the portfolio of applications
– defines how the applications support the business processes and what direction the this portfolio should take to
support the business strategies
The objective of Track II is to create a tool for the active management of the enterprise applications portfolio. Key activities &deliverables to include:
Track II - Application Architecture Process
33
Activities Deliverables
The Information Architecture is driven by both the HIT Strategy and the Application Architecture. The Information Architecture
– Looks at the structure for managing the key information for the managing the business, w ho uses that information,
w here it’s created and how it is managed.
– Will define the direction for the major enterprise information repositories.
The objective of Track III is to create a tool for the active management of the portfolio of key information repositories. Keyactivities & deliverables to include:
Track III - Information Architecture Process
• Generate an inventory of the data stores currently in usethat provides:
• identif iers and ow ners
• technical platform information
• applications associated w ith data stores
• Examine the subject area mapping of the inventory todetermine the level of redundancy and complexity ofinformation control
• Conduct an Applications and Information Strategyw orkshop to determine the set of HIT directions for theinformation portfolio that are directly linked to the healthcare strategy
• Conduct a facilitated w orkshop meeting w ith data ow nersto develop the future state architecture and modeling
• Inventory of data stores, mapped to subject areas
• Information architecture , to include:
• an analysis of the current state and a recommendedfuture state model w ith the business
• a definition of data subject areas and constituencies
• an assessment of the limitations of current state
• a recommendation for a future state model forinformation placement
• a strategy for data ow nership and managementprocess
34
DB #1 DB #2 DB #3 DB #4 DB #5
Application#1
Application#2
Application#3
Application#4
Application#5
Application#6
Application#7
Health CareProcess #1
Health CareProcess #2
Health CareProcess #3
Health CareProcess #4
Health CareProcess #5
Reference DataInformational DataTransactional Data
Val
ue
Ch
ain
Ap
ps
Dat
a
Understanding how applications and data support the business is key to making strategic HIT & HealthCare business and practice decisions
Data Warehouse
DataMart DataMart DataMart
The Application & Data Architectures Define HowApplications & Information Support the Business
35
• Identify the technology architecture drivers from thestrategy and application and data architectures
• Identify the current technology infrastructure in terms oftechnologies, standards and implementation
• Develop a future state direction for each of the keytechnology architecture components:
• Application services
• Data services
• Commerce services
• Netw orks
• Netw ork based services
• Platforms
• Security
• Conduct a facilitated w orkshop to verify and confirm thetechnology architecture direction
Activities
• Technology architecture guidebook outlining
•Framew orks
•Models
•Standards
For each of the technology components outlined in theactivities
Deliverables
The Technology Architecture provides a roadmap for the construction of an enabling infrastructure
Creation of the technology architecture occurs after the determination of the strategic direction of the applications and data
The objective of Track IV is to determine the future technology architecture that will drive the implementation of requiredInfrastructure to support the healthcare business and practice activities & deliverables include:
Track IV - Technology Architecture Process
36
Components of a Technology Architecture
The technology architecture or infrastructure blueprintis divided into distinct components
• Service (Application) Components– Commerce, Communications,
Content, Customization
• Technology Components– Application Services– Data Services– Platforms– Security– Network and Communications
Each component represents a well defined set of technologies, vendors,standards, and disciplines.
The technologies and standards selected for any one component setmay have significant influence on the others.
App. Services
Network and
Security
DataServices
Platforms
Commerce ContentCustom-ization
Commun-ications
37
Architecture Component Classification Recognizesthe Evolutionary Nature of Infrastructure
EMERGING TECHNOLOGY
CORE ARCHITECTURECORE ARCHITECTURE
CoreArchitecture
– Strategicinfrastructuredirection
– Replicatedtechnologythroughout anorganization
– Full range ofinfrastructureservices provided
Special-Use– Isolated infrastructure needed to meet a
specific and isolated business need– “One off” solutions that are bolted onto
the core architecture
Declining– Technologies that are not strategic for the future– May be a candidate for immediate transition or may
be on a “sunset” path for several years
DECLININGDECLINING
Emerging– Technology under
evaluation– Limited services
initially available– Competing
emergingtechnologiesmight replacecore or special-use
EMERGING EMERGING TECHNOLOGYTECHNOLOGY
EMERGING TECHNOLOGY
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• Identify the key governance drivers from the HIT strategy
• Identify all the constituencies involved in managing andsetting the direction for HIT
• Identify the roles and responsibilities for the constituents
• Identify the key competencies required for delivering andmanaging HIT
Activities
• A management architecture that w ill:
• Define the governance structure for managing HIT
• Define the constituents involved in managing HIT andtheir roles and responsibilities
• Key competencies that w ill be required for HIT
Deliverables
The Management Architecture will define the HIT governance / HIT organizational structure required to support the HITstrategy and managed the future state HIT environment. The management architecture will define:
– The HIT Governance structure
– The HIT Organizational structure
The Management architecture will be developed as an outcome of the HIT strategy. The HIT Strategy will set the directionfor HIT governance and the architecture will define specific governance model and organizational structure, includingroles & responsibilities
Track V - Management Architecture Process
39
· Service Level Agreements· Knowledge, Resource Sharing· Competitive Pricing
Franchise
Centersof
Excellence
CentralizedControl
SeparateSubsidiary
Joint Venture
Outsourcing
· Economies of Scale· Chargeback Cost
Recovery· Architecture Control
· Pooling of keycompetencies
· KnowledgeSharing
· Proven, ReusableModel
· Portable Solution
· Shareholder-driven Objectives· Revenue Generation Potential· Various Ownership Options
· Shared Risk· Leverages Partner
Resources
· ContractualRelationship
· Predictable Costs· Reduces Capital
Outlays
SharedService
Management Architecture Can Consider aRange of Governance Structures
40
Analysis &
Synthesis
HIT Systems& Services
HIT Roles &Responsibilities
The HIT systemsand related servicesthat support healthcare operation
HIT ServiceProviders
Organizations thatdevelop, manage &support HIT systems
HITProcesses
Key processes fordeveloping, supportingand managing HIT
A Process For Creating Roles andResponsibilities is Driven by the HIT Strategy
HIT Users
HITInfluencers
The health care users of the HITsystems and services and theorganizations/people thatinfluence & guide HIT
Health Care Business and Practices
HIT
HITPrinciples
Basic beliefs and tenetsconcerning themanagement of HIT drivenby the health care business
HIT Policies &Procedures
The process involves analyzing andsynthesizing the requirements for HITsystems & services and determining the roles& responsib ilities for delivering, managingand planning those systems & services
41
• Perform gap analysis and identify key initiatives
• Detail the initiatives in terms of:
• Value propositions
• Resources
• Timeframes
• Prioritize and document initiatives
Activities
• Portfolio of strategic initiatives, key aspects to include:
• Business cases
• Initiative prioritization
• Transition program including:
• A description of each initiative : duration,dependencies and order of magnitude capital costs
• Program overview : capital costs estimates (if know n)and an aggregation of timing/dependencies to providean order of magnitude estimate of the level ofinvestment required
• Timeline
Deliverables
The Transition Plan defines the the initiatives that need to be undertaken to implement the HIT strategy and the valueproposition that will result. The plan will include:
– The initiatives that can be accomplished in the 12-24 months following the completion of the plan
– Identify the value proposition for each initiative
– Identify the estimated resources and timeframe for implementation
The objective of the transition plan is to develop a short term HIT implementation plan supported by business cases.
HIT Transition Plan Process
Creative Solutions
ED & Clinical Solutions
EHR & Practice Management
Revenue C
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&
Access M
anagement
Ente
rpri
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erfo
rman
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Man
agem
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Me
an
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ful U
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Stage 1 Year 22010
Year 1
TODAY
HIT Transformation Map
Long Term
VisionMajor activity/
milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone Major activity/
milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Major activity/milestone
Creative Solutions
Appendix B: Strategy Project Work Samples
Creative Solutions
Strategy Work Sample: Assessing the CurrentState of HIT and its Service Agility
• Use existing organizational documentation sources, questionnaires, an HITService Agility tool, and executive interviews to review and assesscapabilities in Applications, Information Management, TechnologyManagement, and Technology Infrastructure across dimensions of services,all stakeholders, common industry models and standards.
• Compare current processesenvironments and costs with leadingpractices and benchmarks todetermine how well services compareto most other companies within healthcare.
• Document areas of strength,weaknesses, quick hits andrecommendations for developing theHIT strategy.
HIT Service Agility FrameworkInfrastructure Application
Management & OrganizationInformation
The hardware and software that supports theApplications, Information, Processes and Users
Software that supports the automation of businessprocesses or functions (Purchased Packages,Custom Developed, Systems Integration)
Processes that support the ongoing delivery andoperation of HIT solutions, organization design &the roles that perform those processes
Information repositories and tools for access andanalysis of key business data elements (e.g.,Customers, Products, Transactions, Documents)
• Data ownership• Information managed as an enterprise asset• Data quality strategy• Data warehouses• Enterprise wide data model and repositories
• Hardware/Software• Outsourced commodities• Architectural standards• Rapid technology introduction• Workstations• Scalability of services• Consistent HIT processes• Quality of Services• Platforms• Networks
• System development lifecycle - application process• Application framework - core set of common services• Buy, build, integrate• Portfolio rationalization process• Application implementation decisions guided by enterprise application architecture
• HIT strategy and planning with business strategy• Managed portfolio of services and initiatives• Consistent financial management of HIT costs• Resource management process
Creative Solutions
Strategy Work Sample: Assessment Domainsand Dimensions of Services
Management Applications Information Infrastructure
Sample
Del
iver
able
Sample
Del
iver
able
Componen
t
Componen
t
Creative Solutions
Strategy Work Sample: Assessment Tools,Interviews and Process Document Reviews
Sample
Del
iver
able
Sample
Del
iver
able
Componen
t
Componen
t
Creative Solutions
IS is a relatively low cost services provider. Overall IS costs arebelow the benchmark mean for *** and % of total revenue (-21% variance for both benchmarks).
–Low infrastructure costs (data center, network, PC hardware,etc.) offset high c laims system costs (significantly above thebenchmark range) and increased overall personnel costs (atthe high end of the benchmark range).
–IS’s cost performance is significant considering xyz’s relativesize in the industry. Stratification of respondents in theGartner Study indicates that IS costs *** increases ascompany size increases (based on total revenue). ISeconomies of scale are not typically realized with increasedsize.
Demand for IS services is high for an organization of xyz size.Overall staffing levels are at the high end of the benchmarkrange (+36% variance from the mean).
–Development and maintenance staff are both significantlyabove benchmarks. Ratio of development to maintenancestaff is good, but slightly weighted toward maintenance.
–Management, administrative, and infrastructure staff appearwell leveraged. Adjusting development and maintenancestaff to benchmark means produces an overall staffing levelthat is below the benchmarks.
Observations Recommendations
Assess current staffing strategy for improvements in staff flexibil ityand availabil ity.
–Conduct a resource planning analysis to understandcapacity alignment with current competency requirements.Initiate a resource planning process (potentially in the PMO)that will proactively plan and address future capacitymanagement.
•Resource planning and budget process should beintegrated with demand management and portfolioprioritization processes to ensure appropriateresources are fully uti l ized throughout the year.
•Research business analyst skil l set match andaddress gaps appropriately (training, infuseexperienced resources, etc.), particularly in the areaof IT.
–Implement staffing management tools that allow moreeffective balancing across BAU and development ofstrategic business capabilities.
–Develop an accelerated on-boarding and cross-trainingprogram that effectively organizes materials on xyz’s businessprocesses and the IS supporting applications.
We believe there are currently no tangible benefits in outsourcingthe IS util i ty functions (Data Center, Network) at xyz.
–Current IS infrastructure costs are low, therefore outsourcerswill not be able to reduce the costs enough to overcome theinherent risks of outsourcing.–Current operational services are satisfactory and improving.–xyz mainframe environment, although mature, is a dynamicenvironment (major development is ongoing) that normallydoes not lend well to the outsourcing financial model.
Sample
Del
iver
able
Sample
Del
iver
able
Componen
t
Componen
t
Strategy Work Sample: High Level and DetailedAssessment Deliverables
Creative Solutions
Strategy Work Sample: Supporting Observationsfor Ratings in Each Focus Area within the Four
Domains
This section ofthe scorecard
provides theoverall
assessment forthat component
of the Domain.
These observationssupport our ratingsin the threecategories thatcontribute most tooverall agility:
Is the strategicdirection for thiscomponent well-defined and alignedto the business?Is this process welldocumented? Howwell is it executed?
These are the leading practices thatrepresent a perfect score – which very
few, if any, companies can attain.
Sample
Del
iver
able
Sample
Del
iver
able
Componen
t
Componen
t
Creative Solutions
IT Costs as a % of Total Revenue
2.0% 2.9% 3.2%
•IS Total Costs
•Total Revenue
Budget versus ActualSystem
$135 M
$5,768 MFinance
•Total IT Costs
2.3%
• Low IT costs as a % of total revenue
• Benchmark mean for IT Operating Budget as a % of Gross Revenue = 2.1%
• Total Revenue includes Premium Revenue, Interest Income, and Fees and Other Income
• Metric variance from mean: -21%
Strategy Work Sample: Benchmark Detail - ISCosts
Data factored by Finance from actualcosts
2.4% $265 MM Costs/
$10,913 MM Revenue
Budget versus Actual System
AdjustmentsValueData SourceElement
CommentsMetricData SourceMetric Data Description
Informational Metrics
Observations/ Assumptions
Metric Data Description
Benchmark Name Benchmark Metric
75th %Mean25th %
Sample
Del
iver
able
Sample
Del
iver
able
Componen
t
Componen
t
Creative Solutions
Strategy Work Sample: HIT Systems &Services Model Current & Future State
Financial Reporting Systems - Current & Future State
Informational reporting and access for financial dataDescription
Current State Future State
! Multiple point systems, primarily composed of productivity tools that process output from operational applications
! Primarily used for ad hoc analysis
! Hyperion and Clarus
! Shared analysis capabilities for accessing financial systems for ad hoc analysis
! Management and Financial Analysts across EEEE
! Management and Financial Analysts across EEEE
! Business day availability (hours of outage)
! Business day availability (hours of outage)
! Primarily manual Interfaces between financial applications and productivity environment
! Some users have database views defined in Access for retrieving financial data
! Automated, direct interface to operational financial data, with download capabilities for local analysis
Portfolio/ Usage
Users
Availability/ Performance
Integration/ Interfacing
! Functionality limited to what a user can program in the MSOffice environment
! Direct access to financial information
! Variety of reporting formats: fixed, variable and multi -dimensional
! Access to centralized financial data that has consistent metadata definitions
Capabilities
3. Current & futurecharacteristics ofeach HIT system orservice are reviewedbased on businessdrivers.
2. Mapping of each HIT system to service on the left isreviewed.
1. The entire HIT environment (applications, databases,infrastructure) is reviewed as represented in businessservice terms shown below.
4. The systems & services modelis also used to structure otherreviews, e. g., HIT spending (notshown).
Sample
Del
iver
able
Sample
Del
iver
able
Componen
t
Componen
t
Marketing
•Advertising•Marketing
•Research
•Communications
•Strategic Planning
•Direct Customer
Communication
Marketing
•Advertising•Marketing
•Research
•Communications
•Strategic Planning
•Direct Customer
Communication
Financial
•Accounting Corporate &
General
•Credit
•Financial Planning & Analysis
•Inventory Accounting
•Payables
•Product Accounting
•Tax
•Treasury•Imaging
Financial
•Accounting Corporate &
General
•Credit
•Financial Planning & Analysis
•Inventory Accounting
•Payables
•Product Accounting
•Tax
•Treasury•Imaging
Logistics
•Logistics Support•Forecast &
Replenishment
•Transportation
Logistics
•Logistics Support•Forecast &
Replenishment
•Transportation
Store
Operations
•Specialty Sales
•Store Planning
•Support
•Store Operations•Loss Prevention
•Contractor Yard
•Point of Sale
•Sales Reporting
Store
Operations
•Specialty Sales
•Store Planning
•Support
•Store Operations•Loss Prevention
•Contractor Yard
•Point of Sale
•Sales Reporting
Administration
•Legal•Audit
•Fleet
•Travel
•Maintenance/Repair
•Real Estate
•Aviation•Facilities
•Procurement/Supply
•Time Reporting
Administration
•Legal•Audit
•Fleet
•Travel
•Maintenance/Repair
•Real Estate
•Aviation•Facilities
•Procurement/Supply
•Time Reporting
Human Resources
•Payroll
•Human Resources
•EEO
•Garnishment•Share Wealth
•Stock Options
Human Resources
•Payroll
•Human Resources
•EEO
•Garnishment•Share Wealth
•Stock Options
Merchandising
•Item
•Item Management
•Pricing•Bookmarking
•Stocking
•Vendor/Merchant
Program
•Assortment Planning
•Store Ranging
Merchandising
•Item
•Item Management
•Pricing•Bookmarking
•Stocking
•Vendor/Merchant
Program
•Assortment Planning
•Store Ranging
Electronic
Commerce
•eLink
•abc.com
•eProcurement
•Collaborative Planning
•EDI/XML Portal
Electronic
Commerce
•eLink
•abc.com
•eProcurement
•Collaborative Planning
•EDI/XML Portal
Distribution Center
•Warehouse Management•Warehouse Planning
•Labor Management
•Productivity Planning
•Yard Management
•Fleet Management
Distribution Center
•Warehouse Management•Warehouse Planning
•Labor Management
•Productivity Planning
•Yard Management
•Fleet Management
Sample IT Systems Model
Marketing
•Advertising•Marketing
•Research
•Communications
•Strategic Planning
•Direct Customer
Communication
Marketing
•Advertising•Marketing
•Research
•Communications
•Strategic Planning
•Direct Customer
Communication
Financial
•Accounting Corporate &
General
•Credit
•Financial Planning & Analysis
•Inventory Accounting
•Payables
•Product Accounting
•Tax
•Treasury•Imaging
Financial
•Accounting Corporate &
General
•Credit
•Financial Planning & Analysis
•Inventory Accounting
•Payables
•Product Accounting
•Tax
•Treasury•Imaging
Logistics
•Logistics Support•Forecast &
Replenishment
•Transportation
Logistics
•Logistics Support•Forecast &
Replenishment
•Transportation
Store
Operations
•Specialty Sales
•Store Planning
•Support
•Store Operations•Loss Prevention
•Contractor Yard
•Point of Sale
•Sales Reporting
Store
Operations
•Specialty Sales
•Store Planning
•Support
•Store Operations•Loss Prevention
•Contractor Yard
•Point of Sale
•Sales Reporting
Administration
•Legal•Audit
•Fleet
•Travel
•Maintenance/Repair
•Real Estate
•Aviation•Facilities
•Procurement/Supply
•Time Reporting
Administration
•Legal•Audit
•Fleet
•Travel
•Maintenance/Repair
•Real Estate
•Aviation•Facilities
•Procurement/Supply
•Time Reporting
Human Resources
•Payroll
•Human Resources
•EEO
•Garnishment•Share Wealth
•Stock Options
Human Resources
•Payroll
•Human Resources
•EEO
•Garnishment•Share Wealth
•Stock Options
Merchandising
•Item
•Item Management
•Pricing•Bookmarking
•Stocking
•Vendor/Merchant
Program
•Assortment Planning
•Store Ranging
Merchandising
•Item
•Item Management
•Pricing•Bookmarking
•Stocking
•Vendor/Merchant
Program
•Assortment Planning
•Store Ranging
Electronic
Commerce
•eLink
•abc.com
•eProcurement
•Collaborative Planning
•EDI/XML Portal
Electronic
Commerce
•eLink
•abc.com
•eProcurement
•Collaborative Planning
•EDI/XML Portal
Distribution Center
•Warehouse Management•Warehouse Planning
•Labor Management
•Productivity Planning
•Yard Management
•Fleet Management
Distribution Center
•Warehouse Management•Warehouse Planning
•Labor Management
•Productivity Planning
•Yard Management
•Fleet Management
Sample IT Systems Model
Sample IT Services ModelIT Strategy &
Planning
• Def ine an IT Strategy A ligned to
the Business
• Establish IT Direction
• Establish IT Strategy and
Priorities
• Approve (Disapprove) Proposed
Init iatives
• Determine the IT Initiat ive/
Investment Portfolio
• Schedule IT Service Delivery
• Manage the IT Resources
• Create Customer Support
Strategy
• Manage Business/IT Liaisons
• Def ine and Manage IT
Communication Strategy and
Plan
• Manage Financial Plans and
Budgets
• Manage IT Relat ionships
• Manage IT Costs and Benef its
• Manage the IT Asset Portfolio
• Manage the IT Relat ionship
Portfolio
• Manage IT Supplier
Relationships
• Manage Problem Resolution
IT Strategy &
Planning
• Def ine an IT Strategy A ligned to
the Business
• Establish IT Direction
• Establish IT Strategy and
Priorities
• Approve (Disapprove) Proposed
Init iatives
• Determine the IT Initiat ive/
Investment Portfolio
• Schedule IT Service Delivery
• Manage the IT Resources
• Create Customer Support
Strategy
• Manage Business/IT Liaisons
• Def ine and Manage IT
Communication Strategy and
Plan
• Manage Financial Plans and
Budgets
• Manage IT Relat ionships
• Manage IT Costs and Benef its
• Manage the IT Asset Portfolio
• Manage the IT Relat ionship
Portfolio
• Manage IT Supplier
Relationships
• Manage Problem Resolution
Communications
Infrastructure
• Provide Telecommunication
Services
• Provide Connectiv ity Services
• Provide Collaboration Services
• Fix and Correct Problems
• Manage Problem Resolution
Communications
Infrastructure
• Provide Telecommunication
Services
• Provide Connectiv ity Services
• Provide Collaboration Services
• Fix and Correct Problems
• Manage Problem Resolution
Solution Delivery
• Def ine Component Projects
• Analyze Business Requirements
• Buy/Build Business Components
• Deliver/Deploy Components
• Manage Component Projects
• Manage the IT Delivery Process
• Schedule IT Service Delivery
• Maintain Legacy Systems
• Maintain Sof tware Components
• Maintain Other Components
• Fix and Correct Problems
• Manage Problem Resolution
Solution Delivery
• Def ine Component Projects
• Analyze Business Requirements
• Buy/Build Business Components
• Deliver/Deploy Components
• Manage Component Projects
• Manage the IT Delivery Process
• Schedule IT Service Delivery
• Maintain Legacy Systems
• Maintain Sof tware Components
• Maintain Other Components
• Fix and Correct Problems
• Manage Problem Resolution
Operations
Infrastructure
• Provide Operational IT
Environment
• Provide IT Controls
• Manage IT Environment
• IT Inventory Management
• Conf iguration Management
• Disaster Recovery
• Acquire Technology
• Monitor and Measure IT
Environment Performance
• Set Service Level Agreements
(SLAs)
• Provide Customer Support
• Maintain Legacy Systems
• Maintain Hardw are Components
• Maintain Sof tware Components
• Maintain Other Components
• Manage Problem Resolution
• Provide Help w ith IT
Environment
• Provide Customer Training
• Provide Information About IT
Environment
• Fix and Correct Problems
Operations
Infrastructure
• Provide Operational IT
Environment
• Provide IT Controls
• Manage IT Environment
• IT Inventory Management
• Conf iguration Management
• Disaster Recovery
• Acquire Technology
• Monitor and Measure IT
Environment Performance
• Set Service Level Agreements
(SLAs)
• Provide Customer Support
• Maintain Legacy Systems
• Maintain Hardw are Components
• Maintain Sof tware Components
• Maintain Other Components
• Manage Problem Resolution
• Provide Help w ith IT
Environment
• Provide Customer Training
• Provide Information About IT
Environment
• Fix and Correct Problems
Information
Management
• Develop Know ledgebase/
Repository
• Provide Business Information
Services
• Provide Data Administration
Services
• Provide Database
Administration Services
• Maintain Legacy Systems
• Maintain Sof tware Components
• Maintain Other Components
• Fix and Correct Problems
• Manage Problem Resolution
Information
Management
• Develop Know ledgebase/
Repository
• Provide Business Information
Services
• Provide Data Administration
Services
• Provide Database
Administration Services
• Maintain Legacy Systems
• Maintain Sof tware Components
• Maintain Other Components
• Fix and Correct Problems
• Manage Problem Resolution
IT Research,
Architecture & Engineering
• Explore Emerging IT
Capabilities
• Monitor Industry Activ ity
• Conduct Research and
Development
• Products
• Packages
• Hardw are
• Technology
• Business Processes
• Identif y and Develop Concepts
• Determine Feasibility of
Concepts
• Def ine and Evolve IT
A rchitectures
• Technology
• Data
• Applications
• Manage Problem Resolution
IT Research,
Architecture & Engineering
• Explore Emerging IT
Capabilities
• Monitor Industry Activ ity
• Conduct Research and
Development
• Products
• Packages
• Hardw are
• Technology
• Business Processes
• Identif y and Develop Concepts
• Determine Feasibility of
Concepts
• Def ine and Evolve IT
A rchitectures
• Technology
• Data
• Applications
• Manage Problem Resolution
IT Consulting
• Def ine IT Principles
• Develop Standards, Methods
and Techniques
• Provide Project -based
Consulting
• Provide Project -based
Training
• Def ine IT Performance
Metrics/ Measures
• Measure and Monitor IT
Performance
• Develop Business Process
Benchmarks
• Provide Quality Assessment
Services
• Provide Business Process
Improvement Services
• Manage problem resolution
• Def ine & Maintain IT
Processes and Procedures
•Product management
•Asset management
•IT inventory management
•Conf iguration
management
•Version management
•Program/project
management
• Scope management
• Risk management
• Issues management
• Change management
•Organization change
management
•Disaster recovery
•Strategic planning
•Resource management
•IT portfolio management
•Product portfolio
management
•Customer support
IT Consulting
• Def ine IT Principles
• Develop Standards, Methods
and Techniques
• Provide Project -based
Consulting
• Provide Project -based
Training
• Def ine IT Performance
Metrics/ Measures
• Measure and Monitor IT
Performance
• Develop Business Process
Benchmarks
• Provide Quality Assessment
Services
• Provide Business Process
Improvement Services
• Manage problem resolution
• Def ine & Maintain IT
Processes and Procedures
•Product management
•Asset management
•IT inventory management
•Conf iguration
management
•Version management
•Program/project
management
• Scope management
• Risk management
• Issues management
• Change management
•Organization change
management
•Disaster recovery
•Strategic planning
•Resource management
•IT portfolio management
•Product portfolio
management
•Customer support
Business Products
• Perform Product Management
Processes
• Product Ow nership
• Product Responsibility
• Product Accountability
• Init iative Def inition/
Prioritization
• Manage Product Portfolio
(Strategic/Tactical)
• Full Product Life Cycle
• Product/Portfolio
Interdependencies
• Related Init iatives (Training,
Business Processes)
• Manage Product Delivery
Process
• Development/ Deployment
Management
• Manage Business/IT A lignment
• Develop Business/IT Awareness
• Manage IT Customer/End -user
Relationship
• Manage Problem Resolution
Business Products
• Perform Product Management
Processes
• Product Ow nership
• Product Responsibility
• Product Accountability
• Init iative Def inition/
Prioritization
• Manage Product Portfolio
(Strategic/Tactical)
• Full Product Life Cycle
• Product/Portfolio
Interdependencies
• Related Init iatives (Training,
Business Processes)
• Manage Product Delivery
Process
• Development/ Deployment
Management
• Manage Business/IT A lignment
• Develop Business/IT Awareness
• Manage IT Customer/End -user
Relationship
• Manage Problem Resolution
Professional
Development
• Establish MIS Human Resources
Strategy
• Def ine Roles and
Responsibilities
• Def ine Personnel Resource
Requirements
• Perform Recruiting Activ ities
• Develop and Monitor
Performance Management
Process
• Def ine and Maintain Education
Curriculum
• Provide Ongoing Training
• Manage Problem Resolution
Professional
Development
• Establish MIS Human Resources
Strategy
• Def ine Roles and
Responsibilities
• Def ine Personnel Resource
Requirements
• Perform Recruiting Activ ities
• Develop and Monitor
Performance Management
Process
• Def ine and Maintain Education
Curriculum
• Provide Ongoing Training
• Manage Problem Resolution
Creative Solutions
Strategy Work Sample: HIT Capabilities andSourcing
Range of IT Capabilities
• Supplier / Vendor Management• Partner Management
• Relationship Management• Help Desk
• IT Training
• End-User Training Development• End-User Training Delivery
• Documentation & Communication
• Governance• IT Value Management
• Strategic Planning• IT Architecture Definition & Refresh
• Project Management
• Lifecycle/Portfolio Management• Business Analysis
• Security Administration
Common Capabilities
• Operations
• Infrastructure Engineering• Infrastructure Implementation
• Information Management
• Data Analysis
• Package / Service Selection• Package Implementation &
Integration
• Application Development• Software Product Development
• Application Maintenance
Infrastructure EnvironmentInformation EnvironmentApplications Environment
• Supplier / Vendor Management• Partner Management
• Relationship Management• Help Desk
• IT Training
• End-User Training Development• End-User Training Delivery
• Documentation & Communication
• Governance• IT Value Management
• Strategic Planning• IT Architecture Definition & Refresh
• Project Management
• Lifecycle/Portfolio Management• Business Analysis
• Security Administration
Common Capabilities
• Operations
• Infrastructure Engineering• Infrastructure Implementation
• Information Management
• Data Analysis
• Package / Service Selection• Package Implementation &
Integration
• Application Development• Software Product Development
• Application Maintenance
Infrastructure EnvironmentInformation EnvironmentApplications Environment
IT Capability Description – Application Environment
• System Design
• Application Developm ent
• Software Development for
Integration
• Data Migration
• Database Development
• New System Development
• Major Enhancem ent
The ability to provide custom applications that will be
software products to be sold to external customers.
Software Product
Development
• Minor Enhancem ents
• Bug Fixes
• Integration Support
• User Administration
The ability to maintain and enhance existing system
functionality.
Application Maintenance
• System Design
• Application Developm ent
• Software Development for
Integration
• Data Migration
• Database Development
• New System Development
• Major Enhancem ent
The ability to provide custom applications to fulfill
customer facing services. Includes the delivery of the right information in the right format (Palm, Wireless, etc.)
Application Development
• System Design
• Package Configuration
• Software Development for
Integration
• Data Migration
• Database Development
The ability to install and configure applications and integrate them with existing systems.
Package Implementation & Integration
• RFP Development
• Technical E valuation
• Functional E valuation
• Verify Business Requirements
• Proof of Concept
The ability to provide applications which fully support
business needs and conform to IT system standards.
Package Selection
CharacteristicsDescriptionIT Capability
• System Design
• Application Developm ent
• Software Development for
Integration
• Data Migration
• Database Development
• New System Development
• Major Enhancem ent
The ability to provide custom applications that will be
software products to be sold to external customers.
Software Product
Development
• Minor Enhancem ents
• Bug Fixes
• Integration Support
• User Administration
The ability to maintain and enhance existing system
functionality.
Application Maintenance
• System Design
• Application Developm ent
• Software Development for
Integration
• Data Migration
• Database Development
• New System Development
• Major Enhancem ent
The ability to provide custom applications to fulfill
customer facing services. Includes the delivery of the right information in the right format (Palm, Wireless, etc.)
Application Development
• System Design
• Package Configuration
• Software Development for
Integration
• Data Migration
• Database Development
The ability to install and configure applications and integrate them with existing systems.
Package Implementation & Integration
• RFP Development
• Technical E valuation
• Functional E valuation
• Verify Business Requirements
• Proof of Concept
The ability to provide applications which fully support
business needs and conform to IT system standards.
Package Selection
CharacteristicsDescriptionIT Capability
1. HIT capabilities are the combination of skills and knowledge with methods and tools thatsupport the development, deployment and management of the HIT systems & services.
2. The full set of HIT Capabilities maps are determined as shown in the example modelbelow.
Str
ate
gic
Im
po
rtan
ce
Ability to Meet Future Enterprise Needs
Core (differentiates
XY Z from
competition)
Necessity (required
capability to
compete in the
industry)
Support (base capability
requi red to
operate)
Weak(does not
support business need)
Sufficient(supports basic business need)
Strong(exceeds
business needs)
Invest to Create and
Maintain Systems
Reduce Investment
if Possible
Consider Buying for
Competitive Parity
Consider
Outsourcing
IT Capability Sourcing Evaluation Framework
3. .. and sourcing options analyzed &determined
Sample
Del
iver
able
Sample
Del
iver
able
Componen
t
Componen
t
Creative Solutions
Strategy Work Sample: Organization andGovernance
OpportunityArea
Evaluation
Project
Concept
Assessmentand Scope
IdentificationImplementation Maintenance
Business CaseDevelopment
Project Portfolio Management
Methodology Development
Resource Allocation
II III IV
Strategic Plan Refresh
ImplementStart Under-stand
Design Build ImplementStart Under-stand
Design Build
Project ManagementProject
ApprovalBusiness Case Development
Architecture Guidance
Architecture Compliance
Architecture Guidance
Project AuditProject
Approval
Architecture Guidance
IT Measurement
IT R&D Management
IT Management Processes
RE
VIE
W
PR
OC
ES
SE
S
LIF
E C
YC
LE
PR
OC
ES
SE
SD
IRE
CT
ION
SE
TT
ING
PR
OC
ES
SE
S
Communication Education
Communication Education
This diagram illustrates how each IT Management processes intera ct with each other:
Governance Structure
Investment Council
(CFO, CIO, COO, Corporate Development)
Investment Council
(CFO, CIO, COO, Corporate Development)
Application
Delivery
Managers
Application
Delivery
Managers
IT Business
Steering Committee
IT Business
Steering Committee
• Coordinate IT activity for single business unit
• Promote projects
• Delivery of projects, maintenance activities and small enhancements
• Responsible for people/staff management• Determine level of required maintenance• Production support and maintenance
XYZ Executive ManagementXYZ Executive Management
• Set business strategy• Approve capital funding• Charters IT roles and authorities
• Overall direction setting for IT future• Enterprise investment priorities• Major project approval
Project
Office
Project
Office
IT
Relationship
Managers
Relationship
Managers
• Work with business/staff groups to develop prioritized list of projects and requested level of capped small enhancements
• Single point of contact for business groups• Liaison to business strategy• Business initiatives formation
• Common processes (chargeback, budgeting,
resource planning, etc.)• Recommend aggregate demand• Manage major projects at the enterprise level
Technology
Planning &
Infrastructure
Technology
Planning &
Infrastructure
• Strategy, standards & architectures
• Enterprise infrastructure
Outsourcing
Management
Outsourcing
Management
• Coordinate activities of outsourcing partners (CSC, Acxiom )
• Manage financial relationship with partners and
Service Level Agreements • Coordinate planning for disaster recovery and
business resumption
IT Governance
Council
IT Governance Functions
ITCommunity
BusinessCommunity
IT Investment
Portfolio
IT Strategy
IT Projects
Business
IT
Sponsor Owner
Project
Manager
Project Management Portfolio Management
IT Projects IT Portfolio
Steward
IT Strategy
Business Mgmt
Strategic Planning
IT Mgmt
Business
IT
Sponsor Owner
Project
Manager
Project Management Portfolio Management
IT Projects IT Portfolio
Steward
IT Strategy
Business Mgmt
Strategic Planning
IT Mgmt
Appropriate Roles & Responsibilities
Represent processes that involve joint Business / IT participati on
Database Systems
Administration
Server Support
Desktop Support
Asset Management
First Level Network Support
First Level Application Support
Application Integration
Infrastructure Support
Security Administration
Operations Infrastructure
Network Services
Network Security Services
Data Interchange Services
Internet E-mail Services
Communications Infrastructure
Data Administration
Information Reporting,Analysis,
& Discovery
Data Movement Services
Imaging Services
Metadata Management
Information Management
Research
Architecture
Engineering
IT Research, Architecture & Engineering
Management Information SystemsIT Organization Model
Determining the processes formanaging HIT and making decisionsabout HIT investments on anenvironmental basis.
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Strategy Work Sample: HIT Principles
IT Principles
• IT will partner with the business units to enable them to make use of the full power of technology to meet our commitment to be a “best of class” company
• XYZ’s approach to managing technology and information will address the enterprise requirements as a whole, not isolated business units
! XYZ will accommodate business unit specialized solutions when required for competitive advantage
! XYZ will prefer shared services, resources and technologies that address multiple business needs, as a first choice
• XYZ will follow a disciplined approach to making IT investment decisions. This approach will be characterized by:
! Targeting a balance of investments that are required to remain competitive, that meet acceptable ROI thresholds, and that create options for the future
! Employing a consistent and efficient process to initiate and evaluate investment decisions and manage and measure IT investment success
• XYZ will provide centralized support of technology --Business units will be responsible for project sponsorship and full participation and support of technology initiatives
• XYZ will strive to be a close follower in adopting emerging technologies
• Applications & Information
! XYZ will first reuse, then buy, then build new application and information solutions
! XYZ will manage, define and share data at the enterprise level
! Target an 80% solution, understanding that a bias toward action supersedes a “perfect world”
• Technology Infrastructure
! All technology investments will be made consistent with the three -year IT strategic plan
! XYZ will select open standards and technologies that are current and market -centric
! XYZ’s technology architecture will be service -based and will minimize redundant products and technologies
! XYZ will enable cross -business unit integration and shared or reusable processing
• They are developed jointlywith all HIT stakeholders.
• They address the entire HITlandscape: - Applications - Information & Knowledge - Infrastructure - HIT Management
• Principles are high level guidelines and constraints which help directthe actions of the HIT organizations throughout the enterprise.
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Capability A
Strategy Work Sample: CompetencyAlignments with Tools and Processes to Deliver
HIT Capabilities
1 62 3
Are HIT competencies grouped to deliverflexible HIT capabilities that candynamically be sourced from across thebusiness environment?
Internal SharedExternal
KEY
ExampleCapability: Solution DevelopmentCompetencies: Business Analysis, Architecture, Development, …Tools: Rational Rose, ERWIN, …Processes: Rational Unified Process
Capability B
2 83 7
Capability C
7 108 9
External ITCapability
Shared ITCapability
Internal ITCapability
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Strategy Work Sample: HIT Resource Allocation
Creating HealthCare Capabilities Operations &
Support
Ongoing Health Care Support
Maintenance
System/Service#1
$Headcount
$Headcount
$Headcount
. . .$
Headcount$
Headcount$
Headcount
Product/Service #n$
Headcount$
Headcount$
Headcount
HIT System & Service Delivery
HIT Initiative portfolioHIT Asset portfolio +those HIT Initiativesthat are focused solelyon operating &maintaining the HITAsset portfolio
Resources allocatedto Planning andManaging HIT
HIT Planning and Management
HIT Planning and Management
$Headcount
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Strategy Work Sample: Strategy InitiativesIT Strategy - App & Data
Initiative Summary
Initiative Information
Initiative Name Current or Future Initiative
Develop Enterprise Data Warehouse - product Current Future
Description
The critical success factor for this initiative is the creation of an IRM function (Initiative One from this sub team.)
Priority Ranking w ithin Your Sub-Team Sub-Team Name
High Medium Low
Est. Duration IT Strategy (linked to)
< 6 mths 6 - 12 mths 1 - 2yrs > 2 yrs 1, 2, 3, 4, 5, 6
Est. Annual Financial Benefit Upfront / One-Time Investment Confidence LevelConfidence of Dollar Estimates
1 ) < 500k 1 ) < 500k 1 ) 100%
2 ) 500k - 1m 2 ) 500k - 1m 2 ) 80%
3 ) 1m - 5m 3 ) 1m - 5m X 3 ) 60%
4 ) 5m - 10m X 4 ) 5m - 10m 4 ) 40%
5 ) 10m - 20m 5 ) 10m - 20m 5 ) 20%
6 ) > 20m 6 ) > 20m 6 ) 5%
Benefits / Business Value / Rationale
1. Savings derived from:
a.) Better management of our product lines, franchises, analysis for new products, acquisitions, etc.
b.) Business based trending, ability to look at all products and find all information about a single product or category
c.) Immediate access to enterprise-wide business intelligence for initiatives requiring consistent view of our products (e.g. e-Commerce, exchanges, etc.)
d.) Improved decision making based on comprehensive, integrated views of market, channels, customers, etc.
e.) Consistent source of information, quality controlled environment for reporting, analysis, management review, . . .
f.) Leverage information and resources; improve responsiveness
Risks
Dependencies
a) Creation of Data Stewardship position and related policies and procedures.
b) Creation of Data Architecture & Decision Support Function to enable the creation of the models behind the ODS.
c) Creation and continued operation of the enterprise ODS
d) Information must be recognized as a business asset, and must be developed and managed separately from applications
Develop and implement an architecture and Enterprise Data Warehouse (EDW) to support business intelligence across the enterprise. The
resource will include multiple subject areas, be shared by multiple functions, and will feed division and functional area data marts and
warehouses. Implement the initial product subject area within the data warehouse. Assess and coordinate related current division projects.
Product Information
1. Data Architecture groups not appropriately established - (includes authority, organization, resources) - operational implementation will fail
without the proper organizational support.
2. Lack of Divisional Commitment - Divisions will need to be directed to cooperate.
3. Enterprise Data Sources Too Strict - Results in stifling organizational / marketplace growth with too restrictive policies.
4. Historical data may be poorly utilized.
5. Data quality and value limited if operational data stores not adequately implemented
Sample: Application Portfolio Initiatives
Information Repository InitiativesTechnology Infrastructure Initiatives
IT Management InitiativesOne for each selected initiative
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Strategy Work Sample: Transformation Maps• Transformation maps and the required actions from all sections of the HIT
Strategy are developed.
• They determine how the organization establishes clear priorities and set majorobjectives / milestones to be achieved in each area over time.
• Transformation maps are useful for communication across the enterprise andfostering alignment with health care business and practice areas.
Systems Roadmap: Supply Chain Management Systems
Systems ProjectsSystems Projects Prev.Spend
Prev.
Spend2000
Q1 Q2 Q3 Q4
2001
Q1 Q2 Q3 Q4
2002
Q1 Q2 Q3 Q4
2003
Q1 Q2 Q3 Q4
2004
Q1 Q2 Q3 Q4
2005
Q1 Q2 Q3 Q4
Supply Chain Managem ent
MMP Process Improvements
DRS II
Top 10,000
MTM Local Fill
SWS Reclass Efficiencies
SDS Reengineering
Matl . Flow Dec Tree - mand.
Low Vol. / Seasonal Forecast.
Parts & Customer Segmentation
in Supply Chain Mgmt (SCM)
Mechanized Promise Info Sys
US Matl . Flow Renewal
SCM Continuous Improvement
Supply Chain Managem ent
MMP Process Improvements
DRS II
Top 10,000
MTM Local Fill
SWS Reclass Efficiencies
SDS Reengineering
Matl . Flow Dec Tree - mand .
Low Vol. / Seasonal Forecast.
Parts & Customer Segmentation
in Supply Chain Mgmt (SCM)
Mechanized Promise Info Sys
US Matl . Flow Renewal
SCM Continuous Improvement
Value Delivered
$170k
$4,541k
$3,200k (see Assumptions)
$700k
$3,500k
$1,600k
$1,690k
$TBDk
$20,000
$650k $650k $650k $650k $650k
$200k
Supplier Direct Ship improvementsSupplier Direct Ship improvements
MMP improvements for forecasting completeMMP improvements for forecasting complete
Complete renew al of US Supply Chain management systems using technology proven in EuropeComplete renew al of US Supply Chain management systems using technology proven in Europe
Incremental material f low improvements completeIncremental material f low improvements complete
$TBDk
$236k
Total Benefits: TBD
Total Benefits: $26m
Total Benefits: TBD
Total Benefits: $675k
Total Benefits: $2,000k
Total Benefits: $1,9b -- Revenue Enhancement
Total Benefits: $240k
Total Benefits: $150k
Total Benefits: TBD
Total Benefits: TBD
Total Benefits: TBD
Cost and benefit figures from
Systems Plan 2000 -2004
Transformation Map – Worldwide IT
Infrastructure
ManagementData Management
Systems and Services
(New and Existing)
2002 2004 2005
Governance
IM
Capabilities
Business Capabilities &
Processes
MovingTargetMovingTarget
2003
2001 2002 2003
IM Organization Measures
InvestmentPortfolio is a Competitive
Advantage for XYZ
Pro
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Inv
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Po
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• Identify portfolio owners at executive level
• Conduct focused investment discussions w/ business leads
• Set direction, make high level resource allocations, and appoint process owners
• Coordinate business case development
• Charter projects within key investment areas
• Rationalize new and ongoing project efforts – from consolidated timeline for initial efforts
• Kick -off conceptual design for initial efforts
• Coordinate rev iew sessions –prepare options for 2002 budget
• Fine-tune process
20
03
20
02
20
01
• Establish metrics and targets around key investment areas and portfolio decisions
• Merge metrics into decision models for investments and alternatives
• Conduct capability audit for ex isting IM organization
• Establish integrated processes that align people, processes, measures, and decision making
• Optimize investment decisions based on measures/metrics
• Executemature
decisionprocesses
• Revisit strategic intent and integrate with maturedecision processes
• Measure performance
• Plan the next wave
• Complete migration to Program Management Office for all Investments
• Integrate delivery metrics and value into decision processes
• Solidifygovernance processes
• Establish global IM leadership team, including new positions forarchitecture, Europe and Research & Development
• Establish program management structure and teams
• Establish communications, and logis tical processes
• Establish leadership roles
• Review ex isting project management and implementation methods
• Introduce common delivery structure and methods for all projects
• Introduce common project methodology terms, tools, and templates (process modeling, implementation approach…)
• Introduce project accounting and reporting tools and techniques
• Manage change to effectively introduce new processes and roles
• Align resources behind s trategic investments and critical deliverables
• Agree measures andtargets
• Create high -performance teams throughout the organization
• Finalize migration to newroles and responsibilities
• Optimizeorganization
• MeasurePerformance
• Identify key indiv iduals to support program management teams
• Ensure soundness of structures, systems, and processes
Transformation Map – IT Management
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For More Information Contact:
John [email protected]://www.linkedin.com/in/johnxe22
Creative Solutions LLC6009 Buffalo Ridge RdEarlysville, VA 22936U.S.A.
01-815-354-7456