HIT Governance, Regulations and Policy

The management and leadership of an organization play a significant role in determining the effectiveness of information technology. The use of Health Information Technology (HIT) to improve the healthcare service delivery is constantly increasing, thus it becomes an imperative for every Health Care Organization (HCO) to have an effective Information Technology (IT) governance in place to ensure that the use of HIT aligns with the strategic goals and objectives of the organization, and to effectively prioritized the limited resources. As the Chief Information Officer (CIO) of the academic healthcare system, the purpose of this paper is to:

1. Define IT governance and describe the characteristics of a well-developed IT governance mechanism that are desirable for the organization.
2. Create an assessment of the current state of HIT governance in the organization.
3. Create an assessment of the organization’s HIT governance capabilities.

Definition of IT Governance

Gartner (2017) defines IT governance as “the processes that ensure the efficient and effective use of IT in enabling an organization to achieve its goals”.  It is composed of the processes, relationships in reporting, committees and roles that an organization develops to make decisions about IT resources and activities, and to manage the execution of the decisions. These decisions involve defining project management approaches, setting priorities, determining budgets and addressing IT problems.

Characteristics of a well-developed IT Governance Mechanism

Wager, Lee and Glaser (2013) has given the following characteristics of a well-developed HIT governance mechanism as enumerated below:

1. Objective and fair. Organizational participants should view governance as objective, fair, well-reasoned, and having integrity. The capability of governance to govern is highly dependent on the willingness of the organizational participants to be governed.
2. Efficient and timely. The governance processes should be efficient and not bureaucratic. It should arrive to decisions quickly.
3. Makes authority clear. A good IT governance enables committees and individuals who have decision authority to have a clear understanding of the scope of their roles and authority.
4. Capability to evolve. A good IT governance mechanism should evolve as the organization, its environment and the use of technology in the organization evolves.

Assessment of the Current State of HIT Governance and Capabilities of the Organization

1. Methodology

Basing from the described current IT governance structure of the organization in the scenario, and as the CIO of the organization, I believe that a good way to start in establishing a consideration to implement a new health IT governance structure for the organization is to assess the current health IT governance structure. The assessment will include identifying the organization’s current maturity by completing a baseline assessment using a qualitative tool which is the Informatics Capability Maturity Model (ICMM) developed by the United Kingdom’s National Health Service. The tool will not only assess the current maturity of the organization’s health IT governance, but it also determines how capable the organization will be to improve its current health IT governance in order to achieve its strategic objectives. The ICMM also provides an easy quick starting point for organizational level discussions on informatics capabilities and highlighting the most essential areas for consideration.

2. Procedure. Using the ICMM tool, I will evaluate my organization’s HIT governance current status and capabilities by assessing five different dimensions. In each of the dimensions are five levels of maturity that ranges from basic (least mature) to innovative (most mature). For each maturity level, I will compare the characteristics and recognize my organization’s appropriate position based on the maturity scale. Below are the five dimensions that will serve as my basis for my assessment:

1. Management of information. In this dimension, I would assess the organization’s procedures for data collection, data management, and sharing of information across the organization. Assessing this dimension would also enable me to understand the organization’s capability in information security, information availability and reliability. A high score in this dimension indicates that the organizational participants or users have access to the right information at the right time.
2. Use of business intelligence. In this dimension, I would assess the organization’s approach to analyzing and presenting data to produce the needed information for decision making in the organization’s business and clinical area. Assessing this dimension would also enable me to understand the organization’s capability to monitor key performance indicators and metrics, ability to communicate essential information and as well as on how the organization invest in its strategic assets such as IT.
3. Use of information technology. In this dimension, I would assess the organization’s innovative use of IT. Assessing this dimension would also enable me to understand the organization’s transfer of information, methods of information capture, and in sharing and reporting of information.
4. Business and informatics alignment. In this dimension, I would assess how the organization considers and values informatics as a strategic asset in meeting its goals and objectives. Assessing this dimension would also enable me to understand the organization’s focus of corporate resources on business activities, strategic plans, organization’s activities that are relevant to current strategies and the organization’s focus on outcome and results of activities within the organization.
5. Change management. In this dimension, I would assess the organization’s approach to realizing the benefits of informatics enabled business change. Assessment of this dimension would also enable me to understand the capability of the organization to realign its strategy and activities through periods of change and as well as capability of the organization to deal with complex changes and readiness for change.

After a thorough analysis and determination of my organization’s HIT governance status and capabilities based on the ICMM’s maturity scale, the result of the assessment will be brought up to the senior leadership of the organization for discussion and identification of areas in the organization that have the potential for informatics capability improvement. A low score across all five dimensions would probably suggest for either a need for improvement or change in the organization’s health IT governance structure. After discussing the results with the senior leadership and identifying the need for improvement or change, evidence or evidences will be collected to support the assessment and a proposal for capability development actions has to be created.

The last step would be to develop strategies that would reflect the actions agreed upon by all stakeholders in the organization. This could be improving the current health IT governance or identifying a potential health IT governance structure that would be appropriate for the organization. Basing from the described health IT governance of the healthcare system in the scenario, an IT governance structure that enables effective prioritization of competing initiatives is absolutely needed. After improving or implementing a new IT governance structure for an organization, it is imperative that the progress has to be reviewed again through reassessment using the ICMM tool.

References

IT Governance. (2017). Retrieved February 27, 2017 from http://www.gartner.com/it-glossary/it-governance/

Nelson, R. & Staggers, N. (2014). Health Informatics: An Interprofessional Approach. St. Louis, MO.: Elsevier Mosby.

United Kingdom’s National Health Service (n.d.). Informatics capability maturity model (ICMM) tool. Retrieved February 26, 2017 from http://content.digital.nhs.uk/article/4933/ICMM-tool

Wager, K.A., Lee, F.W., Glaser, J.P. (2013). Healthcare information systems: A practical approach for health care management (3^rd ed). San Francisco, CA: Jossey-Bass