Tuesday, February 2, 2016

Healthcare IT Organization and Infrastructure: Ready. Set. Change.

Changes in healthcare delivery and reimbursement models are disrupting the way healthcare organizations and IT departments, in particular, operate. This rapidly-evolving healthcare business climate demands an innovative and agile IT department that can maintain its core systems.  
 IT Departments have traditionally focused on reliable, high volume, transactional systems and infrastructural services, sometimes called "low speed" activities. This approach is out of sync with the the emerging needs of the IT department’s customers within the healthcare organization, which require a more responsive, agile, "high speed" way of working.
CIOs are beginning to recognize there is value to both approaches. Consultancies, such as Gartner and McKinsey, recommend a "both/and" approach to structuring IT departments and projects. Gartner calls this style of IT management "bimodal" IT, andMcKinsey calls it "two-speed."
At the same time, IT departments are seeing changes in the infrastructure used to support their initiatives. In what is becoming an outdated model, a small set of vendors provided the infrastructure that was managed by an enterprise's IT department in its own data center. Today's infrastructure is typically cloud-based and increasingly commoditized.
A cloud-based infrastructure simplifies hardware procurement, system management and security. It also implies that an enterprise must share control of its information assets with third party cloud providers. While such a notion has traditionally been a sticking point for health IT departments, attitudes are shifting.
The trends toward a two-speed architecture and outsourcing infrastructure have implications for department structure, IT infrastructure, and budget for 2016 and into the future.
Department Structure
IT departments that are structured around the low speed model should re-organize around a two-speed model. In addition to running appropriate projects in a high speed style, they must organize employees, processes, governance, and internal as well as external communication around a two-speed approach. 
IT Infrastructure
While low speed assets will likely remain hosted on premises and managed internally, IT departments will want to transition as many applications and services as possible to cloud-based deployments, especially for the high speed side of the department. One example of a successful migration of a high speed resource to a cloud infrastructure isMedstar Health, which reduced the cost of web site hosting by 40% while improving performance and uptime.
Although outsourced infrastructure may result in a cost savings, overall IT budgets must increase to meet the new business challenges presented by new, value and quality-based healthcare models.
Currently, there isn’t a software category for systems that fully support the emerging models of alternative payments, in part because the reimbursement models themselves remain in flux. IT departments can’t rely on their usual methods of identifying, evaluating, and selecting mature products from a set of established vendors. To keep pace with dynamic business conditions, IT departments should morph into IT development shops, building their own solutions to meet their organizations’ specific needs.

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