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Wag the Dog

May 1, 2007
by Pedro Rivera
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Is your IT department running the business operations or is your business operations running the IT?

Today's information technology (IT) seems to change every year from one user conference to the next. Your staff attends these professional conferences and comes back energized with the latest software updates. Why does it always seem that your healthcare organization is the only one that has been doing it the same way for the last 20 years and everyone else is so far ahead of the game?
Pedro Rivera

Aligning business strategies to IT is a challenge for both IT and business operations. You hear of new systems and technologies and wonder if it's a good fit for your organization, and you turn towards your IT department for guidance. Most often, IT will give you sound advice about the technology, but also information on limited resources, training curve, and how many projects they have on the table.

You're left satisfied that you got your answer, but wonder if you got the right answer. Far too many times, the IT department has its hands in every aspect of the business process and, as such, becomes the driver for any major business change. Unfortunately there are some IT departments that start saying what can't be done instead of trying to figure out how to get things done. The tail starts wagging the dog.

Turning corners and making maps

Have you noticed how many times software updates or new installations are conducted and IT states that you must change your workflow or the way you do business because it's the way the information has to be entered? Maybe you just got funding for a technology project and you hand it over to your IT department to come up with the best use. Either way, you just turned a very important corner in the operations of your business. You have empowered your IT department to make business decisions.

The primary reason why IT projects fail is because the users were not involved early in the design process, or they come in too late and realize that it will not fit the workflow, and demand costly changes. The lesson here is that there is no such thing as an IT project. Rather, it is a business improvement project. Radiology imaging (PACS), physician order entry, electronic health records and practice management software should be treated as business improvement and not an IT systems installation.

What about server operating system upgrades, application upgrades and network upgrades? These all involve the backbone of your operations and although you may not need to be intimately involved, you should have representation at all project milestone meetings.

The key is to manage your IT department from a service standpoint. The same metrics used for your front-end patient representatives can be applied to your IT support staff. Remember your old Total Quality Management training? Customers can be external or internal to your organization. Certain tools can be used or services contracted that will help capture IT performance. Having concrete performance data for IT helps you determine if they are below, meeting, or exceeding business expectations. If you hear providers complain that the system is too slow, how do you measure that? Is it user impatience or truly a system response issue?

For years, businesses have operated like computers, in that they are too complicated and too technical to try to understand. It's easier to leave the bits and bytes to the "techies." But the reality now is that business and IT are intertwined. You can no longer afford not to have a basic understanding of information technology. Most business management programs have information technology courses as part of the curriculum for this same reason. How many of your business operations staff have gone back to obtain either IT business certifications or attend software user conferences? Are you looking for MBA's with an IT minor?

Likewise, what certifications or graduate level work does your senior IT staff hold? Your healthcare professionals are required to go back for training and obtain CEU's to keep pace with changes in the healthcare industry. How many technology changes have taken place in the last three years? Has your IT staff kept up?

Does your organization have an IT project committee or an IT department review process that is managed by business operations? IT projects are managed in the same way that any project is managed. You use the same methodology and often the same project tracking tools. The key is to have business drivers, senior vice president champions and key users providing the directions for the project. The IT staff is only there to help determine how to make it happen.

Does your technology department get report cards on how software or hardware installations are conducted and if milestones are met? Part of the committee review process is to help close out projects and provide "Lessons Learned." This review time can also be used to provide a report card on how well IT was able to meet business requirements and how accurately the software changed to meet business "best practices."

Conversely, you should conduct periodic quality checks during the project to make sure input is provided for business requirements. Don't wait until the demo before go-live to raise concerns.