Health IT

Health IT workforce of the future: use frameworks to show value

In the next few years, the transition from fee for service to accountable care organizations/global payments is going to require significant IT change at a time when budgets will become increasingly constrained. We’ll have the combination of Meaningful Use Stages 1/2/3, ICD10/5010, and healthcare reform all occurring at the same time. IT organizations will be required to demonstrate their value, benchmark themselves against best practices, and justify their actions. There are numerous frameworks that can support a standardized approach to project scope definition, resource allocation, and service provision.

In the next few years, the transition from fee for service to accountable care organizations/global payments is going to require significant IT change at a time when budgets will become increasingly constrained.   We’ll have the combination of Meaningful Use Stages 1/2/3, ICD10/5010, and healthcare reform all occurring at the same time.

IT organizations will be required to demonstrate their value, benchmark themselves against best practices, and justify their actions.

There are numerous frameworks that can support a standardized approach to project scope definition, resource allocation, and service provision.

Although you may not use these techniques now, you should be familiar with them as the pressure increases to absorb increasing demand in the face of decreasing supply.

Here’s a brief overview of 3 leading frameworks.

Information Technology Infrastructure Library (ITIL)
ITIL grew out of work done by UK Government’s Central Computer and Telecommunications Agency in the 1980s to document best practices.   Since then ITIL has had 3 major revisions and the current version consists of 26 processes and functions documented in 5 volumes.
1. ITIL Service Strategy
2. ITIL Service Design
3. ITIL Service Transition
4. ITIL Service Operation
5. ITIL Continual Service Improvement

The primary focus of ITIL is to provide best practice definitions and criteria for operations management.    As with any framework there is significant debate about the pros and cons of ITIL.   As long as you keep in mind that ITIL is a set of best practices, to be adopted and adapted as best fits your local needs, it can be useful.   ITIL does not aim to be comprehensive and universal — use it where it helps maintain your ongoing services.

Control Objectives for Information and related Technology (COBIT)
COBIT was first released in 1996 by the Information Systems Audit and Control Association (ISACA) and IT Governance Institute (ITGI).  COBIT has been used to evaluate security and controls during various audits of my IT organizations.  The current version of  COBIT has 34 high-level processes, covering 318 control objectives, categorized in four domains:
1. Planning and Organization
2. Acquisition and Implementation
3. Delivery and Support
4. Monitoring and Evaluation

COBIT focuses on the definition, implementation, auditing, measurement, and improvement of controls for specific processes that span the entire IT implementation life cycle.

Capability Maturity Model (CMM)
CMM was originally developed by Carnegie Mellon University researchers as a tool for objectively assessing the ability of government contractors to perform a contracted software project.   Now it is applied more generally to any organization’s software development processes.  The predictability, effectiveness, and control of an organization’s software development processes evolve over time through 5 stages:

1. Initial (chaotic, ad hoc, individual heroics) — the starting point for use of a new process.
2. Managed — the process is managed in accordance with agreed metrics.
3. Defined — the process is defined/confirmed as a standard business process
4. Quantitatively managed
5. Optimizing — process management includes deliberate process optimization/improvement.

CMM provides a framework for measuring and transforming software development.

What’s the elevator speech about these various techniques? They are complementary frameworks.  COBIT systematically chronicles a checklist of all the things that an IT organization ought to be doing to implement appropriate controls and security.  ITIL explains how.   CMM measures the sophistication of the processes used along the way.

I’m very interested in hearing from the community — do your IT organizations use any aspect of these frameworks?   Have they been helpful to you to document the resource requirements of the IT organization and give users a transparent look into the work you perform?

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