Chapter 12 IT Alignment and Strategic Planning Learning Objectives To be able to understand the importance of an IT strategic plan. To review the components of the IT strategic plan. To be able to understand the processes for developing an IT strategy. To be able to discuss the challenges of developing an IT strategy. To describe the Gartner Hype Cycle recognizing the wide range of emerging technologies at various stages of maturity. Information technology (IT) investments serve to advance organizational performance. These investments should enable the organization to reduce costs, improve service, enhance the quality of care, and, in general, achieve its strategic objectives. The goal of IT alignment and strategic planning is to ensure a strong and clear relationship between IT investment decisions and the health care organization’s overall strategies, goals, and objectives. For example, an organization’s decision to invest in a new claims adjudication system should be the clear result of a goal of improving the effectiveness of its claims processing process. An organization’s decision to implement a care coordination application should be a consequence of its population health management strategy. Developing a sound alignment can be very important for one simple reason—if you define the IT agenda incorrectly or even partially correctly, you run the risk that significant organizational resources will be misdirected; the resources will not be put to furthering strategically important areas. This risk has nothing to do with how well you execute the IT direction you choose. Being on time, on budget, and on specification is of little value to the organization if it is doing the wrong thing! IT Planning Objectives The IT strategic planning process has several objectives: To ensure that information technology plans and activities align with the plans and activities of the organization; in other words, the IT needs of each aspect of organizational strategy are clear, and the portfolio of IT plans and activities can be mapped to organizational strategies and operational needs To ensure that the alignment is comprehensive; in other words, each aspect of strategy has been addressed from an IT perspective that recognizes not all aspects of strategy have an IT component, and not all components will be funded To identify non-IT organizational initiatives needed to ensure maximum leverage of the IT initiative (for example, process reengineering) To ensure that the organization has not missed a strategic IT opportunity, such as those that might result from new technologies To develop a tactical plan that details approved project descriptions, timetables, budgets, staffing plans, and plan risk factors To create a communication tool that can inform the organization of the IT initiatives that will and will not be undertaken To establish a political process that helps ensure the plan results have sufficient organizational support At the end of the alignment and strategic-planning process, an organization should have an outline that at a high level resembles Table 12.1. With this outline, leadership can see the IT investments needed to advance each of the organization’s strategies. For example, the goal of improving the quality of patient care may lead the organization to invest in databases to measure and report quality, predictive algorithms to identify patients at risk of readmission, and the EHR. Table 12.1 IT initiatives linked to organizational goals Goal IT Initiatives Research and education Research patient data registry Genetics and genomics platform Grants management Patient care: quality improvement Quality measurement databases Order entry Electronic health record Patient care: sharing data across the system Enterprise master person index Clinical data repository Common infrastructure Patient care: non-acute services Nursing documentation Transition of care Financial stability Revenue system enhancements Payroll-personnel system Cost accounting

Chapter 14 Health IT Leadership Case Studies Faculty members and others who teach health administration students are often in search of case studies that can be used to help students apply theory and concepts to real-life IT management situations, encourage problem-solving and critical thinking, and foster discussion and collaboration among students. This chapter provides a compendium of case studies from a variety of health care organizations and settings. It is intended to serve as a supplement to the preceding chapters and as a resource to faculty members and students. Many of these case studies were originally written by working health care executives enrolled as students in the doctoral program in health administration offered at the Medical University of South Carolina. We wish to acknowledge and thank these students for allowing us to share their stories and experiences with you: Penney Burlingame Randall Jones Barbara Chelton Catrin Jones-Nazar Stuart Fine Ronald Kintz David Freed George Mikatarian David Gehant Michael Moran Patricia Givens Lorie Shoemaker Shirley Harkey Gary Wilde Victoria Harkins Most of the cases begin with background information that includes a description of the setting, the current information system (IS) challenge facing the organization, and the factors that are felt to have contributed to the current situation. (All real names and identifying information have been changed from the original cases to protect the identity of the individuals and organizations involved.) Following each case is a set of recommended discussion questions. To the extent possible, the cases are organized by the corresponding chapter(s) to which they relate (see Table 14.1). Table 14.1 List of cases and corresponding chapters Title of Case Corresponding Chapter(s) Case 1: Population Health Management in Action Chapter 4 Case 2: Registries and Disease Management in the PCMH Chapter 4 Case 3: Implementing a Capacity Management Information System Chapter 5 Case 4: Implementing a Telemedicine Solution Chapter 5 Case 5: Selecting an EHR for Dermatology Practice Chapter 5 Case 6: Watson’s Ambulatory EHR Transition Chapter 5 Case 7: Concerns and Workarounds with a Clinical Documentation System Chapter 6 Case 8: Conversion to an EHR Messaging System Chapter 6 Case 9: Strategies for Implementing CPOE Chapter 6 Case 10: Implementing a Syndromic Surveillance System Chapters 6 and 12 Case 11: Planning an EHR Implementation Chapters 6 and 12 Case 12: Replacing a Practice Management System Chapters 6 and 13 Case 13: Implementing Tele-psychiatry in a Community Hospital Emergency Department Chapters 6, 7, and 13 Case 14: Assessing the Value and Impact of CPOE Chapter 7 Case 15: Assessing the Value of Health IT Investment Chapter 7 Case 16: The Admitting System Crashes Chapter 10 Case 17: Breaching the Security of an Internet Patient Portal Chapter 10 Case 18: The Decision to Develop an IT Strategic Plan Chapter 12 Case 19: Selection of a Patient Safety Strategy Chapter 12 Case 20: Strategic IS Planning for the Hospital ED Chapter 12 Case 21: Board Support for a Capital Project Chapters 12 and 13 We hope you find the cases thought-provoking and useful in applying the concepts covered in this book to what is happening in health care organizations throughout our nation. We have also included at the end of the chapter a listing of other published cases and webinars that may be useful to you and your students. Case 1: Population Health Management in Action Although the integration of patient-centered medical homes and accountable care organizations into the health system is still emerging—as are best practices and key learnings from these early efforts—there have been myriad examples demonstrating encouraging returns and improvement in quality of care. The Patient-Centered Primary Care Collaborative recently profiled several organizations that have adopted patient health management (PHM) tools and strategies to address the preventive and chronic care needs of their patient populations.Prior to beginning work on this assignment, read Chapters 12 through 14 from the Wager, Lee, & Glaser (2017) text, read the articles by Kahn (2015) and by Laihonen (2015), and watch the video Dave deBronkart: Meet E-Patient Dave(Links to an external site/) (2011)/
You will select a Strategic Organizational Goal from the following list that you will use to develop a strategic plan for your proposed health information system:

Research and education
Patient Care: Quality improvement
Patient Care: Sharing data across the system
Patient Care: Non-acute services
Financial stability

Before beginning to develop your strategic goal, it is important to understand your objectives/ In other words, as you choose your Strategic Goal, keep in mind the overall impact you want this goal to have on your department or the organization as a whole/ As an example, if you chose Patient Care: Sharing Data Across the System, you can start by thinking about the expeditiousness of information from the pharmacy back to the care team, and how such interface may impact patient outcome/ A good acronym to use to sort through your thought process is PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time); the PICOT approach is spelled out below:

Population/Patient problem – Who is it that you are trying to provide service for?
Intervention – What is it you are trying to do? Or, what are you fixing?
Comparison – Is there a possible alternative to this system? Or, why did I choose this system?
Outcome – What is the goal here?
Time – How long will this plan take to be implemented?

The plan for your chosen Strategic Organizational Goal should

Outline one problem an organization faces related to your selected Strategic Organizational Goal/
Develop a solution to the problem identified that utilizes your health information system from Week 1/
Evaluate the essentials steps in creating information governance/
Articulate the roles and responsibilities of key players in policy, strategies, and challenges/

The Strategic Plan paper

Must be two to three double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center(Links to an external site/)/
Must include a separate title page with the following:

Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted

Must begin with an introductory paragraph that has a succinct thesis statement/
Must address the topic of the paper with critical thought/
Must end with a conclusion that reaffirms your thesis/
Must use at least three scholarly or peer-reviewed sources in addition to the course text/

The Scholarly, Peer Reviewed, and Other Credible Sources(Links to an external site/) table offers additional guidance on appropriate source types/ If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor/ Your instructor has the final say about the appropriateness of a specific source for a particular assignment/

Must document all sources in APA style as outlined in the Ashford Writing Center/
Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center/