Governing High Complexity - Verse 2

In late 2002 having been newly recruited from Seattle, and upon entering the halls of one of the top cancer centers in the world, I was presented with enormous challenges. The central IT division was almost equal in size to it's "federated components." These "islands of automation" in most cases were highly effective - but perhaps were not the most efficient from a data integration and cost perspective. They were in many cases highly independent. Although I functioned in the Deputy CIO role, our organization had at least 20 or so "other CIO's." I can attest to the fact that most all of them had the next great idea! In fact, the division of Radiology under physician leadership had built an absolute world-class clinician portal called "Clinic Station." Having spent a number of years with this team, and having had a long career as a leader and a technologist - I would say Clinic Station today has few, if any, equals...it was and is a smashing success (thanks to Kevin, and Chuck)! Clinic Station through leveraging the SOA (.xml) environment continues to improve with new releases. Stay tuned for new developments as "Research Station" rolls out in the near future...


The challenge - the costs of managing this portfolio in a distributed manner were and are absolutely staggering. Also, not all functions could be efficiently integrated such as CPOE, Medication Management, etc. And what about using the data for clinical research? Data was everywhere - it was the land of databases...

Structured decision making, or the lack thereof often led to poor technology choices - the result of which became a very (massively) expensive "de-installation" project for other clinical applications. What the scenario lacked was effective decision making rooted in the technical and user community, managed by a collaborative governance team.

Extraordinary expense levels could not continue, and data integration became the new mantra. So how did we go about managing for results, and leading for transformation in this scenario?

As the Deputy CIO and in conjunction with our team of operational executives and physicians; we formed the Information Services Executive Team (a few consultants were added to the mix). The team began to define the need for:

1. Effective IS Governance.
2. A clear and credible organizational IS Strategy.
3, Well coordinated IS projects.
4. The need to provide substantial value through those projects.
5. Building relationships between central and distributed IS organizations.

From there we laid out the charge, the guidelines, the committee's, participation, etc. Today, and according to Gartner Research, the organization has reached a pinnacle in governing itself around IS technology, people, and related process issues. We were pioneers in tackling these problems with all it's political implications - I was proud to be part of the solution.

One size does not fit all, and we at InterOPERANT can help you design, build and implement the proper solution for your organization. Much of our research comes from Gartner, the CISR at MIT, Sloan School of Management, http://mitsloan.mit.edu/cisr/. Also, see our blog post, "Governance - Verse1." As well, InterOPERANT relies on the work from HITSP, and are commenting members of ANSI, HITSP, http://www.hitsp.org/.

Today, health care organizations are just beginning to understand how to manage the expense and complexities of it's information technology functions. As I have mentioned in prior posts, IT is both a value creation, and service delivery center all tied to core functions and processes at every level of the organization. It is a concept which must be embraced by everyone - and effective, and participative (read collaborative) governance will help create, and deliver real value across perceived organizational boundaries.

Some of you may have friends at Stanford Hospital and Clinics - we do. They have a huge appetite for advanced clinical systems, and an annual capital budget of $40 to $60 million allocated to information systems. Not only are they huge and wonderfully complex, but in 2004 they established a seven year system-wide information technology out-source contract with Perot Systems Corporation. As well, a few large scale consulting firms got involved...2007 found trouble in paradise.

Today, they are well on there way toward implementing an elegant and strong governance solution to manage their commitment to information technology out-sourcing. This is one of the most difficult of all challenges. If they can do it, so can you. We at InterOPERANT will help you achieve your climb to the summit!

Best,

Don Lyons
InerOPERANT
CEO and Managing Partner