In August 2023, Healthcare IT news sat down with John P. Donohue, vice president of IS entity services at Penn Health Information Services, to discuss what an entity information officer is and why care delivery organizations Health may need such an employee.
Penn Medicine is ahead of the game with entity services, and Donohue provided insight on this topic. Today we’ll return to Penn Medicine and Donohue to build on the topic of entity services and discuss how IT can effectively integrate with operations to strategize and achieve top goals. investment has high priority.
Donohue here talks about creating opportunities for standardization in a complex health system, strategizing how to prioritize initiatives across the health system, realizing the benefits of programs and projects as well as identify opportunities for efficiency and cost savings.
Ask. What’s a good place for CIOs and other technology leaders at hospitals and health systems to start when effectively integrating IT with operations to align and get the most out of scaled investments? High priority?
ONE. There are several key touchpoints that help align IT with operations for high-priority investments. The first and possibly most important touchpoint is the annual budget planning process. In many cases, this is where important discussions are conducted around the organization’s overall priorities, investment needs, and staffing capabilities for those investments.
At this point, the organization signals its intentions around both the capital investment and the operating expenses required to make the investment. This process becomes more complex for large health systems, where this alignment needs to be enterprise-wide.
At Penn Medicine, the focus of the alignment and investment process is on consolidation and standardization across specific platforms for the purpose of cost optimization.
Additionally, we tend to rely on our mature governance processes, which in some ways are part of our organizational DNA. These governance processes are highly effective and really help strengthen alignment, allowing for any discussion around prioritization and standardization.
The regular cadence of these governance meetings ensures that we never stray too far from the alignment agreed as part of the annual budgeting process.
Finally, we often rely on a highly collaborative approach to project delivery for large-scale investments that require alignment. This means that both IT and operations have skin in the game when it comes to delivering the return on investment associated with high-visibility projects.
This approach has allowed us to focus on the overall benefits associated with the investment and has really tempered any criticism when challenges inevitably arise. With our approach, IT and operations are both encouraged to remain aligned and committed to focusing more resources on successful delivery.
In short, the alignment between IT and operations starts with the budget planning process. Then, it’s important to leverage existing governance processes to maintain alignment in finding, staffing, and making high-priority investments.
Finally, the “special sauce” is having senior IT and operations leaders maintain shared ownership of investment initiatives through the delivery and realization of identified benefits. determined.
Ask. You argue that creating opportunities for standardization across complex health systems is key. How can health IT leaders do this?
ONE. I would go a step further and suggest that senior IT leaders drive this standardization across complex healthcare systems. Without a strong stance on standardization, the IT organization and IT-related spending will never be cost-effective.
Given the cost and investment constraints most healthcare organizations are facing today, this should be considered a deciding factor in running a mature organization.
In my opinion, standardization starts with creating a centralized IT organization that eliminates shadow IT throughout the organization. A centralized IT organization will operate more efficiently and enable health systems to reduce costs associated with redundant functions and capacity.
An enterprise-wide IT organization has optimal visibility into IT investments across the organization and keeps a finger on the pulse of business and clinical needs and top investment priorities. This centralized organization can now begin to focus on streamlining infrastructure and applications to deliver greater efficiency, further reducing costs and improving system reliability at the same time. .
Once you have an effective, centralized IT organization, alignment across the business becomes smoother. To further support this alignment on a daily basis, we created the entity information officer role.
At Penn Medicine, we have several organizational units that we call “entities.” For example, each of our hospitals is considered an entity. This EIO role reports through IT, but the leader is embedded in the entity and works closely with the head of operations.
This IT leader has a team of people that they use to focus on local support requests. This EIO plays an advocacy role for both IT and operations, and allows us to consider standardization opportunities as entities consider new technologies or refresh end-of-life technologies.
Finally, a centralized IT organization can strategically focus on key platforms that are adopted as standards across the enterprise. An enterprise-wide commitment by both IT leadership and operations leadership to these platforms will pave the way for easier discussions about standardization and further drive cost out of the system.
Ask. You argue that strategizing the prioritization of initiatives across the health system is fundamental to effectively integrating IT with operations. How can this best be done?
ONE. We’ve found that having a formal prioritization process is key to effective alignment between IT and operations. I talked about some of the things that are important to getting into a platform position – centralized IT, standardization around key platforms, and leveraging governance.
The next step is to strategically prioritize investments so they are in the most effective sequence, keeping in mind the delivery of world-class healthcare by 2024 is a dynamic proposition – shifting priorities.
At Penn Medicine, we have a very formal prioritization process. Each unit determines its priorities (primarily informed through the annual budgeting process). With IT support, a detailed discovery process will be conducted around their prioritized requirements.
This process identifies project nuances, required investments (capital and operational), staffing requirements, and most importantly, return on investment.
These priority investment requests are regularly reviewed by a senior leadership team that includes our CIO. This is often the moment that gives the green light for an initiative to begin. This is also the last chance to look for further standardization opportunities and ensure we have alignment between IT and operations – there are no unexpected investments with this approach.
Ask. What should health IT leaders do when realizing the benefits of programs and projects?
ONE. In our organization, IT leaders are part of the process of both defining and validating the realization of benefits. Our project managers are involved early and often in the planning process. They work closely with operations to identify opportunities that deliver benefits both within IT and within the operations unit.
Once these investment projects are complete, we will work again with operations to confirm and validate the realization of the identified benefits. Furthermore, every two years we issue a formal benefits realization report that reviews investments over the previous two years with audited benefits identified and record.
This approach has created a culture where leaders know they will be held accountable for realizing the benefits they outline when recommending investments. This also demonstrates the alignment between IT and operations throughout the entire lifecycle of the investment – from planning to implementation and recording the benefits.
Q. What are the best practices for identifying opportunities to improve efficiency and save costs?
ONE. The most important best practice is to have a formal process that both IT and operations participate in together. If an organization has the discipline to implement and follow this type of process, leaders know they need to follow these rules.
IT and operations leaders know their priorities and initiatives won’t get much airtime if efficiency and cost savings aren’t identified. In today’s world, an initiative that doesn’t have the ability to recoup its investment fairly quickly will be a difficult initiative to sell.
It doesn’t take long for IT and operations leaders to develop a knack for identifying efficiencies and cost savings. Smart leaders realize this quite quickly. The first years tend to be quite easy as there are some easy outcomes to achieve.
As organizations begin to grow further, these savings opportunities become more difficult to identify and deliver. With automation and innovative AI, we are now seeing opportunities that were not possible years ago.
In short, smart leaders in both IT and operations know where they can identify savings through investment. The point is to instill discipline and rigor so they know they have to generate a return on investment and then will be responsible downstream when the project is complete.
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