Healthcare CEO/CIOs are looking for fresh perspectives in advancing Healthcare Information Technology (HIT) strategy design, development, and deployment for more effective and efficient healthcare delivery.

1. HIT Service Strategy
Enabling Transformational Health Care

2. CEO/CIO Questions
• Healthcare CEO/CIOs are looking for fresh perspectives in
advancing Healthcare Information Technology (HIT) strategy
design, development, and deployment for more effective and
efficient healthcare delivery.
A number of important questions require immediate answers.
 Is there room to optimize service delivery capability?
 Do we effectively organize/manage/govern HIT Services to
maximize value and clinical relevancy?
 Are we sure that service performance will meet or exceed
federal 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 and
services?

3. HIT Services Must Be Agile
Survival in Volatility Requires a HIT Organization be Able to:
• Change size, shape, scope and style as needed:
– Size: Grow/shrink at many levels and rates via flexible resource capacity
arrangements (own, rent, lease, borrow).
– Shape: Centralized, distributed, networked as needed (simultaneous
component shapes if required).
– Scope: Occupy a varying footprint(s) in its value web as the value and
service lifecycles evolve.
– Style: Integrate, collaborate, franchise, etc., depending on dynamics of
markets and offers.
• Engage “self-directed” leadership, managerial and operational
behaviors within dynamic, environmentally determined
constraints.
• Embrace an “effectiveness over efficiency” culture, while
continuing to focus on efficiency.

4. Challenges Will Remain Constant
• The distributed vertical nature and volatility of today’s healthcare
environments, the global economy, and government legislation are
underscoring increased challenges with:
– Quality of Patient Care
– Responsiveness
– Innovation
– Competitive Positioning
– Speed to Delivery
– Reach
– Reliability
– Risk
– Cost Efficiency “We can't solve problems by using the same kind of thinking we
used when we created them.”-Albert Einstein
• Healthcare organizations will need a radically new transformational
approach to HIT on the part of the CIOs, business leaders and
clinicians.
• A transformational strategy will encompass an inclusive governance
process with streamlined decision-making authority, a radically
simplified IT architecture, mega-project-management capability,
resource allocations and strategic sourcing, change and effective
communication management.

5. HIT Organizations Currently Strive for a
Business - Aligned, Managed Environment
Today’s best practices show that HIT value
can be maximized when enterprise HIT
investments are aligned with healthcare goals
and HIT execution is well managed.
The key drivers of HIT value are:
• Outlook – How organizations make
Outlook
Health Care
Aligned decisions about technology
investments
• Performance – How well organizations
Tactical
implement those decisions
Performance
Reactive Managed

6. But Technological-Driven Transformation of
Health Care Is Challenging this Target
Extended
Clinical/Health
Care
Employers
Home PBMs, Retail RX Processes
Laboratories
Expanded
Physician Groups Channels &
Imaging Centers
Connections
Patient
Payers Hospitals Dynamic
Community Business
Health
Services
Models
Care Centers Government Care Managers

7. This Requires a New Mindset and a New
Approach to Technology Execution
Environmentally
Integrated
Outlook
Health Care
Aligned
Tactical
Performance
Reactive Managed Agile

8. The Pressures Felt by Most HIT
Organizations 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 to
provide the necessary technology skills?
• HIT governance challenges: How do we coordinate HIT spending
and activities throughout the organization? With our partners?
• The need for speed: How do we support business requirements to
respond to opportunities in days vs. months vs. years?

9. An Agile HIT Framework Provides a
Persistent Context for the Strategy Outputs
Strategic Directions Required for Driving Agile HIT Come in Two Flavors
• Getting Aligned and Managed . . . Externalizing &
– Drive efficiency and effectiveness of HIT delivery Transitional State Becoming Agile
and management processes Environmentally
Integrated
Agile
– Adopt an enterprise architectural view IT
– Focus on getting costs structured, understood, Getting Aligned
under control & Managed Health Care
Aligned
Health Care
Outlook
– Concentrate cost optimization on efficiency issues Aligned
Managed
– Drive opportunity portfolio prioritization through Health Care
Aligned
value tradeoff Managed
Transitional State
– Align business and HIT strategies
Tactical
• Externalizing and Becoming Agile . . .
– Integrate business and HIT strategies performance
Reactive Managed Agile
– Focus on improved services and delivery through
adaptive management and delivery processes
– Expand the view of infrastructure to “extra-
Because an organization’s HIT
structure” capabilities are typically distributed
– Create agility through a flexible services across the framework, their HIT
environment leveraging internal and external Strategy embraces a mix of activity
providers types

10. An Agile HIT Strategy Addresses the
Shortcomings of the Traditional HIT Strategy
• HIT defines an ongoing decision tool for leveraging IT to drive a
healthcare organizational success in a constantly evolving
community 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 other
entities in the environment as well as constraints imposed by it
• The strategy is not just about the new, but what to do with the
existing environment and current systems portfolio
• The strategy drives integrated architectures and implementations

11. An Agile HIT Strategy Translates Needs and
Opportunities from the Environment into Action
Technology
Health Care Environment
Environment
Visioning
IT Architectures
HIT Strategy Application
Health Care
Strategy Data
Technology
Health Care Security
Architecture Governance
What How
Transformation Services
HIT Current State
People HIT Future State
Process
Technology

12. What Does an Agile HIT Strategy Produce?
A plan for leveraging the HIT capabilities of the company
and the community environment to deliver healthcare Clusters of tech-enabled
business capability
success --------------
Provide decision making
Environment framework
Health Care Strategy
IT Strategy
IT Systems &
Services
Health
Healthcare
Care
IT Capabilities
Institutions Success
IT Operating Model
Skills and capability that enable
Systems & Service delivery
--------------
Rules of engagement for decision Sourcing strategy is critical
making
-------------------------
Coordinates complex
Creative Solutions
relationships, brokering

13. An Agile HIT Strategy Provides…
• HIT Systems and Services Directions, that
– Are strategic technology-enabled healthcare capabilities stewarded by HIT
– Provide the decision-making framework for all potential HIT investment
– Recognize
• the interplay of internal capabilities with those of healthcare partners and customers
• the potential need to support rapid healthcare 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 developed
and 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

14. The HIT Strategic Components Provide the
Basis 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/ technical
criteria
• 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

15. This Pragmatic Approach to HIT Strategy Focuses
on Sustained Value and Significant Benefits
• Integrates with and drives healthcare strategy, not an after-thought or
extension
– Provides a common language for healthcare/HIT discussions
• Recognizes ROI, needed capabilities, and risks
– Provides an explicit linkage between HIT investments and healthcare
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 to and tighter integration
of technology and healthcare decision making

16. Appendix A: Agile HIT Strategy and
Planning Approach

17. Agile HIT Strategy Development
Steps Tasks Resources
• Extract key healthcare strategies • Executive management team
• Document and review with key • Division management
Confirm healthcare management • HIT management
strategy • Create healthcare strategy summary • Strategy development team
• Confirm with key management
• Identify technology infrastructure • HIT management
enablers • Strategy development team
Identify key • Identify information management • Key business subject matter experts
technology enablers enablers
• Identify application enablers
• Define required system/service • Strategy development team
characteristics • HIT management
Define HIT systems & • Identify key product capabilities
services • Identify key service capabilities
• Identify sourcing opportunities
• Identify baseline HIT competencies • Strategy development team
Identify HIT • Identify common capabilities • HIT management
• Identify specialized capabilities
capabilities
• Identify appropriate sourcing
• Define the HIT governance structure • Strategy development team
• Define the HIT governance processes • HIT management
Define HIT for • Executive management team
Governance • HIT Product & Service delivery • Division management
• HIT management
• Identify product & service, governance, • Strategy Development team
Identify Implications capabilities implications • HIT Management, SMEs

18. Agile HIT Strategy and Planning Approach
The approach to HIT Planning begins with the development of a well-articulated
information technology strategy driven by the strategic direction of the healthcare
business.
This strategy serves as the foundation for the enterprise architectures for
applications, information, technology infrastructure, and HIT management.
Finally, the strategy, using the architectures as “roadmaps”, helps to establish the
plan of what technology initiatives will be implemented.
Applications HIT Transition Plan
Information Technology
Development
Strategy Architecture
Health Care Application Portfolio
Initiatives
Strategy
Health Care
3 Information
Information
Strategy
Strategy Architecture Information Repository
Initiatives
Technology Technology Infrastructure
Health Care Strategy Architecture Initiatives
Environment HIT Management
Management Initiatives
Strategy Architecture
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19. HIT Planning Approach
The HIT Strategy describes an overall direction for HIT in terms of its Systems
and Services to the healthcare business, the competencies it will leverage to
deliver those Systems & Services, and the governance structure that must be in
place to support the delivery.
• The Application Architecture builds on the product/system direction that is set in that
strategy to define an overall direction for the portfolio of applications in use and a detailed
description of the current and future state of the elements of the portfolio.
• The Information Architecture looks at the structure for managing the key information
for managing the healthcare business, who uses that information, where it’s created and
how it is managed.
• The Technology Architecture describes the enterprise direction for an enabling
infrastructure as driven by the strategic direction for applications and data.
• The Management Architecture describes the processes, tools and systems to be put in
place for the effective management of the HIT resource.
• The HIT Transition Plan defines how to get to the future state. The HIT Transition Plan
clusters potential project efforts into a series of prioritized programs or initiatives, reflecting
the interdependence all aspects of HIT and HIT management and their priorities with
respect to supporting the business strategy.
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20. HIT Transformation Map
2010
Stage 1 Year 1 Year 2
Major activity/
Long
milestone Major activity/
milestone Term
Major activity/
milestone Major activity/
milestone
Vision
Major activity/
Major activity/ milestone
milestone
Major activity/
milestone
Major activity/
milestone
Major activity/
Major activity/ milestone
milestone
Major activity/
milestone
Major activity/
Major activity/ Major activity/ Major activity/ milestone
milestone milestone milestone
Major activity/
milestone Major activity/
Major activity/ Major activity/ milestone
milestone milestone
Major activity/
milestone Major activity/
milestone Major activity/
milestone
Major activity/ Major activity/
milestone milestone
TODAY Major activity/
milestone

21. For More Information Contact:
John Anderson
creative@jpranderson.com
Innovative Solutions, LLC
52 Sandia Lane
Placitas, NM 87043
U.S.A.
01-815-354-7456