WHITE PAPERS
White Paper #One: Information Management (IM) and Information and Communication Technology (ICT) Strategic Planning.
Here is where to start with the e-health agenda. The typical elements of an IM/ICT strategic plan include the objectives, approach, deliverable and level of effort. The plan for IM/ICT must align to your countrie’s and/or health institution’s vision and goals.
Objectives:
The overall objectives of this Information and Communications Technology (ICT) and Information Management (IM) strategy initiative are:
To develop a concise strategy for ICT that includes the administrative and clinical applications as well as the ICT infrastructure services including hardware and software, which will form a basis for current requirements and to meet planned future business needs to some future date.
To define the IM knowledge management application requirements as well as the infrastruture including the data element definitions and information reporting requirements to meet the current and future knowledge management needs.
To identify ICT and IM implementation alternatives: the cost, benefit and risk implications for each option.
To recommend an IT implementation plan and critical success factors for the ICT and IM strategy.
To explore the application software solution providers from both the commercial and open systems sector.
Approach:
The ICT/IM strategy study will follow the strategic planning process in following the figure below and can be conducted over a minimum of period time in following five steps:
Preparation: including the collection and clarification on the background materials (including the web site, organization chart, strategic plan, annual reports, workshops etc.), external survey of the ICT environment, organizing the study participants and a steering committee, scheduling the on-site visit for the interviews with key managers and conducting an educational/discovery workshop session with key users.
Investigation: includes the development of an interview guide, conducting and documenting the results of the interviews of the key people, conducting an educational/discovery workshop with key front-line users, summarizing and presenting of an external ICT and IM survey. The key interviews and discovery workshop findings will be presented to the steering committee for approval.
Development: includes the development of an ICT and IM conceptual vision, guiding principles, critical success factors, and overview application model based upon the institutions strategic business plan goals and objectives. Also the satisfaction with the current systems, the knowledge management needs and the expected changes in the internal and external environments will have to be developed. The findings will be presented and approval by the steering committee.
Options: include the development of at least 3 options and the assessment of current and estimated future costs, resources required and the benefit and risk implications for each for presentation and priority selection by the steering committee.
Solutions: includes a review and analysis of the commercial and open systems application vendors appropriate to the institution’s needs for from the short to the long term.
Report: includes an analysis of the results of the findings, the preferred option and the recommended action plan for implementing the ICT and IM strategy.
o The first chapter will describe the proposed vision for ICT and IM—where you want to be.
o The second chapter will describe the current environment—where you are now.
o The third chapter will describe the proposed strategy—how you are going to get there.
o The fourth chapter will describe the human resource capacity consideration—what the impact will be on patients and providers on the journey to get there.
o The fifth chapter will describe the ICT and IM resource estimate for the preferred option, the soft benefits, real risks and financial returns—how much you need to invest to get there.
o The sixth chapter will describe and compare the commercial versus the open system solutions available to meet the priority application needs—what is the best of “bread” or “budget” software development approach to adopt.
o The final chapter will describe the next steps in the implementation plan with assigned responsibilities—recommended steps to moving forward.
The ICT/IM strategy for an institution has two components: formulation and implementation.
Formulation is making decisions about the vision and core values of the stakeholders: and the goals, objectives, activities and initiatives it will undertake to achieve them.
Implementation is making decisions about how the institution’s structure, acquired skills, software development approach, establishes organizational capabilities and creates new business processes in order to achieve ICT/IM goals, objectives and priorities. The ICT/IM assets include data, applications, infra/infostructure, staff and governance.
Deliverables
The major deliverable of this type of study will be ICT and IM Strategy report that will have buy-in by both the institutions administration and clinical users. While identifying the major ICT and IM initiatives over the next few years, the ICT Strategy should help deal with the short-term IM knowledge management requirements and identify other short-term accomplishments that could yield benefits quickly and contribute to the longer-term implementation plan. Software solutions will be evaluated for both the commercial and open systems sources. As well the ICT and IM Strategy will be capable of being updated periodically as priorities change, health systems directions are explored and new opportunities present themselves.
Study Scope and Level of Effort
The ICT and IM Strategy study will focus on administrative and clinical requirements, but not typically the education and research programs. The software solutions evaluation will include both open systems and commercial vendors with demonstrated solutions and references. An independent health care ICT consultant/advisory usually is hired to lead the planning process. The level of effort is estimated by the consultant. For example, a XXX bed hospital it is estimated to take YY person days, based on Z weeks on-site, to do the interviews, the educational/discovery workshop and conduct steering committee meetings. The site visits including preparation and analysis is estimated at another X days. Finally, the preparation, development of options and the report is estimated at another YY days. The typical planning project is estimated at ZZ person days of external effort.
White Paper #Two: Business Design (BD) and Change Management (CM) Transformation
Steve Russell is an associate with the EELI Group, which provides business transformation consulting services focused on aligning people, process and technology with the business strategy and vision so that measurable benefits will be achieved. The EELI Group lead by Izabela Waglay was involved in the implementation of the HIV/AIDS surveillance solution in Trinidad and Tobago in 2008.The EELI Group can assist in defining and documenting the strategic plan direction, (i.e. outlining the vision, goals and objectives to be achieved as described above). Furthermore the EELI Group can provide the business design and change management consulting to leverage and align them with the provided strategic direction.
Business Design supports:1. The definition of the required changes in terms of client experience driven processes, policies, procedures, practices, business parameters and rules.2. The identification of the required systems functions and features to support an effective execution of business processes.3. The definition of required performance measurements at various levels (service, process, process step, role) and monitoring and reporting capabilities. 4. The identification of required people capabilities (skills, mindsets, behaviors) to achieve strategic goals.
Change Management supports:1. The definition of changes in organizational design and impacted roles, responsibilities, skills, behaviors and measurements to realize the anticipated benefits of change.2. Timely education and communication programs for impacted clients in order to achieve acceptance and internalization of change. 3. The establishment of the change governance to manage the change continuum in alignment with the evolving strategic goals.
Business Transformation Methodology
EELI Group has developed an integrated business transformation methodology, Metamorphia™ , which is a unique methodology containing methods, techniques, templates, and tools for the effective delivery of an end to end integrated business solution (People, Process, Technology) in alignment with the ever evolving business strategy that supports realization of the anticipated benefits.Metamorphia™’s unique value is its focus on how to define an integrated solution design and then deploy it among all affected stakeholders (internal and external) ensuring that the expected results can be measured and realized.
Business Transformation Definition
EELI Group’s Metamorphia™ methodology defines Business Transformation as:
A key executive leadership initiative to align People, Process and Technology of an organization (at regioal or country level) with its strategy and vision leading to realization of the expected benefits.
The path to a successful transformation includes the following components depicted in the figure below:
The path to successful business transformation must always integrate (to various degrees, depending on the size, complexity, span of impact) all of the following components:
Strategic Direction definition is either a first step in the roadmap, or a fundamental input driving the remaining stages of the business transformation. Strategy direction encapsulates the target, the idealized design of the future state and typically consists of:
Vision Statement: expanding the entity’s mission, products and services portfolio, place and importance of entity’s clients, and guiding values and principles driving all aspects of the business operations that covers in more detail the following two aspects:
Operations: servicing citizens and patients at every interaction point and delivering any type of product/service.
Infrastructure: establishing and evolving the infrastructure to enable an effective delivery of products and services to al citizens and patients.
Organization Management: establishing and evolving overall strategy processes, policies enabling the effective management of the entire business entity and its associated entities (when applicable).
Client (citizen and patient) Experience Framework: defining of the intentional and consistent experiences and excellence targets at each point of a client interaction with the entity (s) delivering product/service
Cross Service Convergence (when applicable): intentional designing of the process, people, and technology convergence when delivering multiple products or services to the same client.
Optimization Targets: defining metric targets or increased productivity and reduced costs in all aspects of the business operations while at the same time securing increased revenues.
Employee Satisfaction: measuring individuals’ satisfaction where individuals are broadly defined as both: employees of the institution initiating the product or service as well as any partners who are engaged in the delivery of the product or service.
Sustainability: ensuring the continuing delivery of the product/service entity or collaborating entities over time, such as becoming optimized, continually learning, innovating, responding to their clients and employees needs.
Traceability: tracing of all the aspects of the business operations, such as having the capability and the willingness to expose and explain business entity activities and performance measurements in the causal context linking actions, deliverables, and results at all levels of the organization.
Change Governance: the processes that need to exist for the successful ongoing transformation at the organization. It plays an active role in the management of all organization initiatives and provides formal methodologies, templates, structures, and terms of reference for this maintenance.
The elements of good change governance include:
A view that spans all initiatives within the organization.
A structured process for assessing all change impacts.
A system of accurate status reporting across all stakeholders.
A process for the management and resolution of issues.
Business Design (Process, People, Technology) including:
Process & support systems design is rooted in the understanding of the current problems and ‘Points of Pain’, but driven by desired, outcomes, and founded on the innovative best practice based and measured process, people, and technology design principles,
Capabilities & requirements definition covers a full spectrum of process, people and technology capabilities keeping those that effectively support the delivery of the results and adding those that enhance the quality of product and service and increase client and employee satisfaction.
Policies, procedures, business rules definition is essential for the successful configuration of the integrated, measured, transparent, and technology enabled (when applicable) business operation,
Change Management (including Communications & Training) is a proactive, structured process of realizing results of the business transformation at an organizational and individual level.A change management program will facilitate the needed transformation for the impacted people within and outside of the organization by identifying and communicating changes to:
Enterprise processes and systems,
Operating principles and policies,
Organization design and culture,
Roles and responsibilities,
Skills, behaviors, and mindsets,
People systems to influence their alignment and motivation including measurements.
The figure below outlines the critical stages of the business transformation initiative roadmap.
In principle, any transformation or even smaller change should always involve the elements of impacts to processes, people, and technology that should be examined in the context of the intended strategy and goals and the anticipated outcomes that is the benefits that should be realized.
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