by Roger Kropf, PhD, and Guy Scalzi, MBA
Every health organization needs to prioritize its IT projects. There are too many adoption needs, too few financial and human resources to implement them, and not every idea that crosses your desk aligns with your organization’s strategic plan.
An effective IT governance structure brings clarity to chaos. Every stakeholder—from the CEO to frontline staff—needs to clearly understand each step in the process of IT project selection and implementation, including submitting proposals and budgets; the roles of individuals and committees; how and why decisions are made; and assurance that the IT prioritization process is transparent. This is typically done with a governance charter that is prepared and disseminated from the CEO.
Committees charged with prioritizing IT projects include several advisory committees and a governance committee.
Advisory committees create projects and review projects submitted to them for their likely return on investment. There are typically three to four advisory committees comprising clinical services, finance and ambulatory care. All committees should include a senior IT staff member to help validate or interpret proposed technology.
Chaired by the CIO, the governance committee reviews all proposals from the advisory committees and prioritizes proposals for the finance committee of the organization’s Board of Directors. The governance committee often includes top-level management and financial officers, senior medical staff and building services executives. CEOs can be included, but are usually involved only when projects are large, expensive or controversial.
How the Committees Work
The governance committee needs to meet regularly and follow the finance committee calendar for submission of proposals. Meetings are for considering new projects, setting priorities and reviewing existing and completed projects.
Transparency. The CEO needs to communicate that no IT project will be allowed to proceed unless it has gone through the governance process.
Some project sponsors may try to circumvent the process by underestimating budgets. For example, they may include the cost of software, but not the data conversion or hardware costs. Project reviews need to carefully consider each proposal to identify needed components and a realistic budget. The facts of a proposal may be verified by speaking directly to vendors.
Project Review. All of the health systems we studied require a business plan for significant projects above a stated dollar threshold. The business plan must address specific questions, and most health systems explicitly require project sponsors to describe how the project supports the system’s strategies.
Accountability. Every project should have a business sponsor who brings the project to the advisory and governance committees. The project sponsor provides the governance committee with a final report indicating whether the project was completed on time and on budget.
Each healthcare organization has to define a structure and process that fits its culture. Some organizations will push prioritization down to frontline staff. Others will ask them for advice and keep prioritization at the executive level. Some will require very detailed business plans and create a quantitative ranking process. Others will choose simpler processes.
What process fits best for your organization?
Roger Kropf and Guy Scalzi are the authors of IT Governance in Hospitals and Health Systems, (HIMSS Books, 2012). Available in print and eBook editions, the book is available at a 20% discount in November.