Strategic planning for Healthcare IT

Healthcare Financial Management, Jan, 2005

Implications for IT Staffing

This is no place for misguided optimism, says Ciotti. "If you're going to go with a new computerized physician order entry and electronic medical record system, you're going to have to expand the IT department--maybe with a nurse or two, or a physician informaticist, or maybe as many as five to 10 additional people."

Value Realization Plan

Hospitals often do an ROI study to justify getting a system into the budget, but that leaves a lot of questions unanswered. Among them, Arlotto includes the following:

* How are we going to optimize this system?

* How will we make improvements over the life of the system?

* What measures will we use to evaluate progress?

* How will we manage risks associated with system implementation?

* What behaviors, skills, and expertise will we need to add to take full advantage of the system?

* How can we ensure that we remain flexible enough to adjust to changing circumstances?

Recommendations

In essence, how are we going to get from here to there? Ciotti recommends breaking the planned steps into tactical (for example, "Should we replace the current network?") and strategic (for example, "Should we continue the evolution toward an electronic medical record and add wireless capability as the network is expanded and upgraded?"). The former steps go into the operating and capital budget for the next year or two, complete with very specific numbers from vendors. The latter may or may not come to fruition; ballpark quotes will do in this section.

This makes it easier to say no, according to Ciotti: "If the lab wants a new system and there's no money for it, they'll feel better if they see that they're in the strategic recommendations, where it will be re evaluated in a year or two."

Documentation

Policies and procedures designed to guide selection, purchase, and implementation of technologies should be brought together and disseminated to everyone involved in IT planning. Project budgets, timelines, personnel, and skill sets that are needed can be pulled out into a separate resource plan.

Chris Miller, senior management consultant with the Superior Consultant Company, Dearborn, Mich., suggests two additional sections: one for technical environment documents describing all applications to be used, including the computing platform on which they will run, their underlying database, and application interface information; and the other for maps--a network infrastructure map of wires, wireless network cables, fiber cables, and so on, and a high-level process map that shows information flow.

A Communication Plan

How are you going to communicate the plan, and to whom? In addition to key stakeholders--board members, top executives, system "owners"--Ciotti recommends presenting the plan to "everybody in the institution at the management level--all the department heads, all the nurse managers, all the clinical and financial users. Even if they're not going to get something for their area, they should know what you're spending money on and why.