Overview of Field IT Governance model proposed for VA Office of Information & Technology

1. Making IT Governance
Consistent with ITIL Best
Practices
Lessons in the Consensus Model of
Group Decision Making
MITRE Assessment Work Group
October 8, 2008

2. What is IT Governance?
 Align IT investments with business objectives
 Ensure that the right people make the right
group decisions
 Driven by Information Technology
Infrastructure Library (ITIL)– industry best
(ITIL)–
practice
 Standardize IT solutions
 Execute IT processes as efficiently as possible
 Manage strategy and complexity
 Minimize Risk, Maintain Quality

3. Who Decides What Investments To
Make?
 Involve all opinion leaders and thought leaders
 The involvement of key stakeholders in the group decision
is critical
 Balance company wide requirements with
technical requirements
 Well formed business requirements must come from the line
of business
 Provide strong organizational support of ITIL
core processes
 Project management, Business analysis, Communications,
Fiscal and procurement management
 SCIFD – standards, compatibility, interoperability, fiscal
discipline

4. Hi & Lo-Level IT
Lo-
Governance
 Line of Business
 Obligated to provide
needs & requirements
 Innovations, feedback
 IT community
Needs
Needs
Plans
Plans
 Obligated to provide
speed of execution,
depth of field,
Long Range Plans
Near Term Plans
standards, fiscal
Requirements
Requirements
Long Range
Near Term
discipline, customer
focus
 Local, Network and
Regional Dialogue
are key elements

5. IT Governance in the VHA Field
VHA Line of Business
VA OI&T Hi-level Governance
VHA OI
Tier 4
Regional Level
Regional Governance Districts Tier 3
Operations
Executive Partnership
Council Regional Level
Regional Regional Director Annual Tactical Plan
Annual Tactical Budget District Meetings
Governance Board Network Directors
Annual Report
Network AD Annual Performance
Network CFO Measurement
Network CMO
Network Level VISN Level
Operations
VISN Governance
Operations
Tier 2
VISN IDMC
NCIO VISN Level
Hospital Directors Annual Tactical Plan VISN Executive
VISN CIO Council Annual Tactical Budget
Hospital AD Board
Annual Report
Hospital CFO Annual Performance
Chiefs of Staff Measurement
Service Line Managers
Facility Level Facility Tier 1
Facility Governance
Operations Operations
VAMC IDMC Facility Level
FCIO Annual Tactical Plan VAMC Executive
VAMC Committees Annual Tactical Budget
Hospital Director Board
Annual Report
Hospital AD Annual Performance
Hospital CFO Measurement
Chief of Staff
Service Line Managers
Field Innovation
Development Existing Entities or Groups Councils
Existing Level & Activities

6. VA OI&T:Balancing the Best of IT Services across a
Region
Strengths of Centralization of Strengths of Decentralization at
Core Services closest point to care
 Common Infrastructure  Agility
 Economies of Scale  Buy in
 Standard Acquisition Process  Motivation
 World Class COOP services  Innovation
 Interoperability  Responsiveness
 Operational Efficiency  Knowledge of Needs
 Speed of Execution  Customer Identification
IT Services leveraged across the entire Region delivering on
expectations to established Service Level Agreements (measurable,
validated, predictable, responsive).

7. Executive Partnership Council at
Regional Level

8. IT Governance in the VBA Field
VBA Line of Business
VA OI&T Hi-level Governance
VBA OI
Tier 4
Regional Level
Regional Governance Districts Tier 3
Operations
Regional Level
Regional Executive Partnership Annual Tactical Plan
Council Annual Tactical Budget District Meetings
Governance Board
Regional Director Annual Report
Annual Performance
VBA leadership Measurement
Network Level Area Level
Operations
Area Governance
Operations
Tier 2
Area Level
Area Council Annual Tactical Plan Area Executive
VISN CIO Council Annual Tactical Budget
NCIO Board
Annual Report
VBA Area Leadership Annual Performance
Measurement
Facility Level Tier 1
RO Governance RO Operations
Operations
RO Level
Annual Tactical Plan RO Lines of
VAMC Committees Annual Tactical Budget
RO Council Business
Annual Report
FCIO Annual Performance
VBA RO Leadership Measurement
Field Innovation
Development Existing Entities or Groups Councils
Existing Level & Activities

9. IT Governance in the NCA Field
NCA Line of Business
VA OI&T Hi-level Governance Tier 4
Regional Level
Operations
Regional Level
Executive Partnership Annual Tactical Plan
Regional Council Annual Tactical Budget
Governance Board Regional Director Annual Report
Area Directors Annual Performance
Measurement
Facility Level Cemetary
Operations
Cemetary Governance
Operations
Tier 2
Cemetary Level
Cemetary councils Annual Tactical Plan Cemetary Executive
regional office CIOs Annual Tactical Budget Board
RO directors Annual Report
Annual Performance
Field Measurement
Development
Innovation
Existing Entities or Groups Councils
Existing Level & Activities

10. Achieving Balance in Multiple
Dimensions
Standards Innovation
Resources Customer Expectations
Security Ease of Access

11. Consensus Decision Making
 Consensus decision-making is a group
decision making process that not only seeks the
agreement of most participants, but also the
resolution or mitigation of minority objections.
 Consensus is usually defined as meaning both
general agreement, and the process of getting to
such agreement. Consensus decision-making is
thus concerned primarily with that process. .

12. Group Decision Making
Causes of Failure
 poor articulation of clear business
requirements
 poor involvement of key stakeholders
 Allowing elite interests to supersede
common interests
 IT Appropriation limits IT budget
 The Tragedy of the Commons

13. Consequences of Failure
 Parable of Easter Island –
collapse of a population of
8000 resulting in population
of 187 by the time of first
European contact
 Failed group decision
making lead to total
deforestation of island and
collapse of their agricultural
lifestyle
 Group allowed elite interests
to dominate utilization of
scare resources

14. Decision Making in Face of Scarce
Resources: The Polder Model
 The polder model is a term used to describe
the internationally acclaimed Dutch version of
consensus policy in economics, specifically in
the 1980s and 1990s.
 Term adopted for a much wider meaning,
consensus decision-making, 'a pragmatic
recognition of pluriformity' and 'cooperation
despite differences'.
 A popular explanation the reason this
decision-making style works so well in the
Netherlands is the unique fact that a large part
of the country consists of polders below sea-
level.
 Ever since the Middle Ages, competing or
even warring cities in the same polder were
forced to set aside their differences to
maintain the polders, lest they both be
flooded.
 Key element in this model is the appreciation
by all stakeholders of the risk consequences
of NOT coming to consensus

15. What is Consensus Decision
making?
 Consensus means to 'think or feel together'.
 Consensus is Inclusive: involves as many stakeholders as
possible
 Consensus is Participatory: Actively solicits the input and
participation of all decision-makers.
 Consensus is Cooperative: Participants strive to reach the best
possible decision for the group and all of its members, rather than
opt to pursue a majority opinion, potentially to the detriment of a
minority.
 Consensus is Egalitarian: All members of a consensus decision-
making body should be afforded, as much as possible, equal input
into the process. All members have the opportunity to table, amend
and veto or "block" proposals.
 Consensus is Solution-oriented: An effective consensus decision-
making body strives to emphasize common agreement over
differences and reach effective decisions using compromise and
other techniques to avoid or resolve mutually-exclusive positions
within the group.

16. Measures of Success
Key is measuring and monitoring of
critical success factors in the
optimization of IT Governance

17. Role of Feedback From OPS to measure
progress towards Success

18. Role of “insight” by the Line of
Business into Performance

19. Conclusion
 Fix group decision making dynamics by
understanding why past groups have been
unable to reach consensus
 Stick with ITIL principles
 Focus on clear Business Requirements
 Strengthen Regional Governance Model
 Fix IT versus non-IT definitions
non-