Chapter 12
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
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To be able to understand the importance of an IT
strategic plan.
To review the components of the IT strategic plan.
To be able to understand the processes for
developing an information technology strategy.
To be able to discuss the challenges of developing
an IT strategy.
To be able to appreciate the ability of information
technology to improve organizational
competitiveness and performance.
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Goals of IT alignment and strategic planning
An overview of strategy
Areas requiring strategy
Vectors for arriving at IT strategy
The IT Asset and governing concepts
A normative approach to IT strategy
Challenges of IT strategy and alignment
Information technology as a competitive
advantage
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
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Ensure that information technology plans and activities
are well linked to the plans and activities of the
organization
Ensure that the alignment is comprehensive:
 Each aspect of strategy has been addressed from an IT perspective
recognizing that not all aspects have an IT component and not all
components will be funded
 The non-IT organizational initiatives needed to ensure maximum
leverage of the IT initiative, for example, process re-engineering, are
understood
 The organization has not missed a strategic IT opportunity, for
example, those that might result from new technologies
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Develop the tactical plan that details approved
project descriptions, timetables, budgets,
staffing plans and plan risk factors
 Create a communication tool that can inform
the organization of the IT initiatives which will
be undertaken and those that will not
 Establish a political process that helps to
ensure that the plan results have sufficient
organizational support
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
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Formulation
 Mission and goals
 Activities and initiatives
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Implementation
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Structures
Skills
Organizational capabilities
Organizational processes
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
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The application system agenda
 Should we implement the electronic health record?
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Initiatives to improve the IT Asset
 How do we improve the security of our infrastructure?
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Concepts that govern the approach to a class
of initiatives and applications
 Should we be on the cutting edge of technology or adopt a
more conservative approach?
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Derived from organizational strategy
Persistent focus on core organizational
processes and information management
 New information technology
 Strategic trajectory/vision
 Fundamental views of organizations
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
APPROACHES TO STRATEGIC PLANNING
1
BusinessLed
2
MethodDriven
3
Admin
4
Organizational
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5
Technology
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Underpinning
Assumption
Business Plans
and Needs
Should Drive
IS Plans
Formalized
Planning
Methodology
Use Firm’s
Methodology
Continuous
Shared Planning
Activities
Quality Business/
Information
Modeling
Emphasis of
Approach
Use Business
Plans to Lead
Development of
IS Plans
Selection of
Best Method/
Best Consultant
Project ROI
User/IS
Cooperation and
Learning
Creation of
Business Process/
Information
Models
Slogan
Business
Drives IS
Planning
Needs a
Method
Follow the
Rules
Themes with
Teams
Model the
Business
Key to
Success
Operationalized
Business Plan
Integrated
Strategic,
Tactical, and
Implementation
Methodology
Effective
Steering
Committee
Experienced
Users and IS
Personnel
Quality Business
Process
Reengineering
Programs
Problem
Business Plan
Quality
Availability of
Methodologies
Tactical
Tactical
Difficult
How should IT support our disease management
initiative?
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Develop and publish best practices
Monitor costs, quality and care activity of a cohort
Guide documentation
Remind providers and patients of steps to be taken
Monitor and manage a specific patient
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Function
Revenue
Value
Cost Savings Care Quality Patient Service
Medical Information/
Textbooks
L
L
M
L
Lab Test Orders
M
L
L
L
Medication Orders
H
M
H
M
Results Retrieval
L
M
M
L
Patient Charting
M
L
M
L
Charge Capture
H
M
L
M
Supply Management
L
H
L
L
Legend:
H=High, M=Medium, L=Low
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Strategic Goal
Improve service to outpatients
Problem
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Patients have to call many locations to schedule a series of appointments and
services
The quality of the response at these locations is highly variable
Locations inconsistently capture necessary registration and insurance
information
Some locations are over-capacity whereas others are under-utilized
IT Solution
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Common scheduling systems for all locations
A call center for “one stop” access to all outpatient services
Development of master schedules for common service groups, e.g., preoperative testing
Integration of scheduling system with electronic data interchange connection
to payers for eligibility determination, referral authorization and co-pay
information
Patient support material, e.g., maps and instructions, to be mailed to patient
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
The Synthesis of the IT Strategy
IT Ramifications of
Organizational
Strategies
Continuous Process and
Information Management
Improvement
Strategic Trajectory
New Information
Technology
Fundamental Views
Leadership Synthesis
and Debate
Application Inventory
IT Asset Initiatives
Governing Concepts
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
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Applications
 Sourcing
 Application uniformity
 Application acquisition
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Infrastructure
 We want our applications to be able to …, e.g.,
support clinical decision support and be accessible
from home
 Broad properties of the infrastructure, e.g., security
and reliability
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
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Data
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IT Staff
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Acquisition of new types of data
Data meaning
Organizational responsibility for managing data
Data analysis technologies
Acquisition of new skills
Organization of the IT staff
Sourcing of the IT staff
Characteristics of the IT staff
Governance
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
What is it about the electronic medical record
that makes it important to us?
 What does “integrated systems” mean to us?
 Should we treat IT as an expense or an
investment?
 Should we collaborate with other
organizations in our region on IT or view IT as a
way to achieve a competitive advantage?
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Strategic Challenge
IT Agenda
Capacity and growth management
Emergency department tracking
Inpatient electronic bed board
Ambulatory clinic patient tracking
Quality and safety
Inpatient order entry
Anticoagulation therapy unit
On-line discharge summaries
Medication administration record
Performance improvement
Registration system overhaul
Anatomic pathology
Pharmacy
Order communication
Transfusion and donor services
Budget management and
external reviews
Disaster recovery
JCAHO preparation
Privacy policy review
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
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Inventory of the IT initiatives that will be
undertaken
Linkage of the initiatives to the organization’s
strategic plan
Initiative timeline and interdependencies
Plan budget
Risk assessment
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
The overall strategy is unclear or volatile
The linkage may be shallow
Senior management may hesitate to engage in
the IT strategy discussion
 The true value of an IT initiative may be unclear
 It is difficult to make tradeoffs between IT
investments
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
IT planning was not a separate process
IT planning had neither a beginning nor an end
IT planning involved shared decision making
and shared learning between IT and the
organization
 The IT plan emphasized themes
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Leverage organizational processes
Enable rapid and accurate provision of critical
data
 Enable product and service differentiation
 Support the alteration of overall organizational
form or characteristics
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
Attempting to out hustle the competition
Freezing the system
Changing the basis of competition
Leveraging some other, significant
organizational strength
 Leveraging a well developed, strong IT Asset
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
- Avoided IT fads but were pioneers in the application of carefully selected technologies.
- Became pioneers when the technology showed great promise in leveraging that which they
were good at doing (their core competency) and that which they were passionate about
doing well.
- Used IT to accelerate their momentum to a being great company but did not use IT to
create the momentum. In other words, IT came after the vision had been set and the
organization began to move to that vision. IT was not used to create the vision and start
movement.
- Responded to technology change with great thoughtfulness and creativity, driven by a
burning desire to turn unrealized potential into results. Mediocre companies often reacted
to technology out of fear, adopting it because they were worried about being left behind.
- Achieved dramatically better results with IT than rival companies using the exact same
technology.
- Rarely mentioned IT as being critical to their success.
- “Crawled, walked and then ran” with new IT even when they were undergoing radical
change.
Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser
IT planning has several objectives
IT strategies are developed through five
vectors
 IT alignment remains a significant
organizational challenge
 IT can be applied to improve an organization’s
competitive position
 IT is a tool; its value is achieved by thoughtful
application
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Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition
Wager ~ Lee ~ Glaser