HSM 397 NSU Health Information Systems Discussion
Sample Answer for HSM 397 NSU Health Information Systems Discussion Included After Question
Question Description
I’m working on a health & medical discussion question and need an explanation and answer to help me learn.
1. What factors are contributing to the need for even more effective HIT governance?
2. With the increase in the use of external service providers (e.g., cloud-based data centers, externally provided applications), what are some of the challenges that CIOs and HIT departments must address in order to successfully leverage these options? What are some of the risks associated with these
options?
A Sample Answer For the Assignment: HSM 397 NSU Health Information Systems Discussion
Title: HSM 397 NSU Health Information Systems Discussion
Health Administration Press Chapter 3 Leadership: The Case of the Healthcare Chief Information Officer Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Learning Objectives • List job duties and analyze functional responsibilities of senior healthcare leadership and the chief information officer (CIO). • Identify key knowledge, skills, and attributes of the CIO position. • Describe the typical priorities of contemporary CIOs. • Prepare and assess an organizational chart for the HIT department or area of a healthcare organization. • Illustrate future challenges faced by healthcare CIOs. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Leadership: The CIO • Serves as a member of the executive management team—the C-suite • Typically reports to the CEO, COO, or CFO • Facilitates HIT governance processes and typically serves on senior HIT governance committee/council Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Leadership: The CIO (cont.) Senior management role re: governance for successful organizations. CIOs must: • Design governance to focus on organizational objectives and performance • Understand when to redesign • Be involved in HIT decisions • Make choices among conflicting alternatives • Clarify when special handling of information or systems is required Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Leadership: The CIO (cont.) • • • • • Provide an appropriate incentive structure Assign ownership and accountability Design governance at multiple organizational levels Provide transparency and education Implement common mechanisms for oversight Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press The CIO and Management Skills To succeed, the CIO must: 1. Be committed to leadership 2. Lead in a collaborative manner 3. Embrace the “soft” side by being open and caring 4. Forge relations in this people endeavor 5. Communicate effectively 6. Inspire others 7. Build/develop people Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Responsibilities of HIT Leadership • Enterprise-wide planning • IT leadership • Management and oversight • Human resources management • Financial management Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Knowledge, Skills, and Abilities of HIT Leadership • Collaboration • Understand nature of health system • Formulate HIT portion of strategic plan • HIT strategic business and market planning • HIT needs analysis • Organization’s HIT situation • HIT culture • State of industry assessment • Technology assessment • Evaluation, adoption, and implementation standards • HIT policy development Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Characteristics of a Successful CIO • Monitor external activities, assess impact of external changes on HIT, and prepare organization to respond • Understand clinical processes sufficiently to discuss issues with the chief medical officer (CMO) • Understand business and financial processes sufficiently to discuss issues with the chief operations officer (COO) and the chief financial officer (CFO) • Communicate well with heterogeneous group of individuals within HIT • Possess sufficient technical skills to gain respect of technical staff Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Leadership: Variability There is little standardization of scope of services. The organization depends on: • Degree of centralization/decentralization of computer systems • Use of in-house developed software applications • Use of packaged software or contracts with application service providers (ASPs) • Extent to which functions/tasks are outsourced to contractors Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press CIO Reporting Relations Highly varied reporting relations: • 51% of CIOs report directly to the CEO • 17% of CIOs report directly to the COO • 28% of CIOs report directly to the CFO • Remainder report to other senior leader or board of directors Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Typical Organization Chart: Large Organization Chief Technology Officer • Enterprise architecture • Service mgt. and operations • Clinical engineering CIO CMIO Chief Information Security Officer Deputy CIO, Applications Deputy CIO, Program Mgt. Chief Data & Analytics Officer • Information security • Clinical apps • Business apps • Project portfolio mgt. • Data architecture • Database administration • Reporting and analytics Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press The CTO’s Typical Organization Chief Technology Officer Director, Service Mgt. & Operations Director, Enterprise Architecture • Service desk • Release mgt. • Change mgt. • Desktop, voice and video support • Technology deployment • Infrastructure operations • External service provider mgt. • Network operations • Account creation and maintenance • Enterprise architecture • Network, video, and telecomm engineering • Technology assessment Director, Clinical Engineering • Biomedical equipment assessment • Biomedical equipment deployment • Biomedical equipment maintenance Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Leadership: Staffing • Staffing should be consistent with organization of HIT (varied). • Directors often have more technical/operational knowledge than CIO. (Health information managers often have Registered Health Information Administrator [RHIA] certification.) • Three common staff levels: • Professional • Technical • Clerical Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Leadership: Staffing (cont.) • Rapid staff growth in recent years • Shortages in many key areas: • Network and architecture support • Cybersecurity • Informatics • Process/workflow design • Application support/development • Analytics • Staffing depends on outsourcing and degree of centralization. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Leadership: Budgeting • Low share of organization budget but growing • Hospital and health system spending on HIT: • Average 4.3% of overall revenue • Average 4.6% of operating expenses • 58% of typical HIT departmental operating budget is related to personnel costs (either employee salaries and benefits or outsourced HIT services) Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press CIO Salary by Type of Organization (2018) Average across all organization types: Type of Organization CIO—Hospital/acute care facility CIO—Stand-alone hospital < 25 beds CIO—Academic health center CIO—Children’s hospital $235,806 $243,035 $136,183 $287,385 $309,028 Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press CIO Salary by Level of Education (2018) Education/Degree • MD • PhD • Master’s degree $381,688 $220,076 $236,724 • Bachelor’s degree • Associate’s degree • High school diploma $206,535 $172,360 $121,500 Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press CIO Salary by Region (2018) Pacific Northeast Southeast Midwest Mountain South Central $262,272 $231,122 $228,125 $238,710 $186,125 $238,275 Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Outsourcing and Multisourcing Outsourcing function has benefits: • Reduced in-house staffing requirements • Smaller capital investment in equipment • More flexibility in meeting changing requirements • Reduced time to implement new applications • More predictable cost structure Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Outsourcing and Multisourcing (cont.) Outsourcing function has risks: • Heavy dependence on vendors—What if one goes bankrupt? • Higher cost due to vendor fees and profits • Contractors do not fully understand the operation and culture of the organization Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Outsourcing and Multisourcing (cont.) Focuses of outsourcing: Cybersecurity Access to key HIT skills Access to needed technology 44% 73% 71% Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Evolving Role of the CIO • The successful CIO must embrace innovation and be able to leverage data much more effectively to the benefit of the entire organization. • The successful CIO must have the ability to connect multiple pieces of strategy, technology, and people for better sustainable outcomes. • The successful CIO must adapt to become the orchestrator of multiple IT support functions that do not necessarily report directly to the CIO (e.g., chief analytics officer, chief digital officer, etc.) Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Future Challenges • Greater responsibility placed on leadership (CIO) that may transcend traditional HIT functions (e.g., clinical engineering) • Scope of responsibilities has expanded (e.g., digital health, analytics) • Business units have growing desire for greater autonomy from HIT and CIO Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Web Resources • American College of Healthcare Information Administrators (ACHIA, www.achca.org) • American Health Information Management Association (AHIMA, www.ahima.org) • American Medical Informatics Association (AMIA, www.amia.org) • Applied Health Informatics Learning and Assessment (www.nihi.ca/hi) • College of Healthcare Information Management Executives (CHIME, chimecentral.org) • Healthcare Information and Management Systems Society (HIMSS, www.himss.org) • HIT and quality improvement training, Health Resources and Services Administration, US Department of Health and Human Services (www.hrsa.gov/library/health-informationtechnology) Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Chapter 4 Health Information Technology Governance and Decision Rights Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Learning Objectives • Define governance as it applies to health information technology (HIT) and describe its primary purpose. • Summarize the five major components of HIT governance. • Explain why charter, representation and decision rights, and accountability are vital to a governance plan. • Explain why HIT strategic planning has become more important for healthcare organizations. • Describe the major elements of a healthcare organization’s planning effort. • Assess the major elements of an HIT strategic plan. • Describe systems theory and explain why it is vital to HIT governance and planning. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Overview • Background of HIT Governance • Organizing an HIT Strategic Planning Effort • The Importance of System Integration Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Background of HIT Governance • Purpose • Governance for leadership • Governance plan Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Background: Purpose • Governance is designed to address agency problem (separation of ownership from management). • Managers may become risk averse (to keep job). Behavior does not maximize outcomes. • Owners establish bonding contracts to align incentives or monitoring to control. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Background: HIT Governance for Leadership • Consistently applied HIT strategy • Alignment of HIT strategy with organizational strategy • Well-developed HIT infrastructure, architecture, and policies • Well-managed HIT project priorities and investments in HIT infrastructure • Documented HIT value or benefits to enhance accountability Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Consistent HIT Strategy • Supports strategic goals, objectives, and priorities of organization. • Many organizations have no HIT strategy documented. • HIT plan can be part of or integrated with organization strategic plan. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Alignment of HIT and Organizational Strategy Must address six key questions: 1. What does the organization do? 2. Who does the organization do it to or for? 3. Where does the organization do it? 4. When does the organization do it? 5. Why does the organization do it? 6. How does the organization do it? Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Well-Developed HIT Infrastructure, Architecture, and Policies: HIT Development Priorities 2012 • Servers/virtual servers • Mobile devices • Desktops/virtual desktops • Security systems • Storage and backup • Wired/wireless networks 2018 • Patient safety • Privacy security and cybersecurity • Process improvement and workflow • Data analytics and clinical and business intelligence • Clinical informatics and clinical engagement Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Well-Developed HIT Infrastructure, Architecture, and Policies: Data Standardization • System integration vital in future • Can’t share information without data standardization • Facilitate exchange within and outside organization • Multiple projects underway to develop and distribute standards • Standards adoption is work in progress Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Well-Developed HIT Infrastructure, Architecture, and Policies: Hardware and Software Standards Steering committee and CIO standards, such as central review and approval of purchases: • Ensures compatibility with enterprise-wide data standards • Terminals and workstations use common operating systems • Cost advantages through purchase of site licenses • Eases technical support capacity • Prevents illegal use of unlicensed software Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Well-Managed HIT Project Priorities and Investments • Capitalize on specialized skills of HIT staff in selecting and purchasing hardware and software • HIT management must manage competing priorities Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Documented HIT Value or Benefits Value of investment needs to be documented to justify ongoing organizational support • Financial • Cost reductions • Revenue enhancements • Productivity gains • Clinical • Service delivery • Outcome measures • Organizational • Risk reduction • Stakeholder satisfaction Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Governance Plan Data governance has proven a challenge for organizations. The Data Governance Institute (http://www.datagovernance.com/) provides support for efforts as presented in three major components: • Charter • Representation and Decision Rights • Accountability Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Governance Plan: Charter • Goals such as better decision-making reduce operational friction and build standard repeatable processes. • Guiding principles include integrity, transparency, auditability, accountability, stewardship, checks-and-balances, standardization, and change management. • Benefits of process include enabling the organization to effectively decide how best to manage data, realize value from it, minimize complexity, manage risk, and assure compliance with legal and regulatory requirements. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Governance Plan: Representation and Decision Rights • Data Governance Participants – all institutional stakeholders • Data Governance Definitions – the exercise of decision-making and authority for data-related matters • Need for Data Governance – large, complex, organizations with horizontal functions that don’t work well together • Location of Data Governance Programs – many options available that enable senior-level support • Operations of Data Governance – follow five action steps Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Governance Plan: Accountability Data or rights to data governance do not reside with individuals or particular groups, but with the organization as a whole • Assign clear responsibilities to implement data governance • The Data Governance Office • Assign responsibilities at multiple organization levels • Data owner • Business data steward • Technical data steward • Gatekeeper Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Organizing HIT Strategic Planning Effort • General Approach • Elements of an HIT Strategic Plan • Review and Approval of HIT Strategic Plan Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press General Approach • Core assignment of responsibilities for HIT management • Strategic domains • Steering committee Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press General Approach (cont.) • IT governance helps the organization make business decisions more accurately and in a more timely manner. • Core responsibilities for HIT management: • Board delegates to CEO • CEO delegates to CIO • Important due to expanding size and complexity of healthcare organizations Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Planning Domains • Strategic alignment • Risk management • Resource management • Performance measurement • Value delivery Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Steering Committee • HIT steering committee • Designed to engage key user groups • Ensures diversity of input to governance function • Steering committee assumes responsibility for HIT plan that addresses: • Priorities for new and replacement systems • Specifications for IT infrastructure • Capital and operating budget Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Steering Committee Membership • Executive management (CIO) • Medical staff • Nursing staff • Financial management • Clinical support services • Planning and marketing • Other major system users Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Major Elements of HIT Technology Plan: 1. Statement of corporate/institutional goals and objectives 2. Statement of HIT goals and objectives 3. Priorities for the applications portfolio 4. Specification of overall HIT architecture and infrastructure 5. Software development plan 6. HIT management and staffing plan 7. Statement of resource requirements Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Review and Approval of HIT Strategic Plan • Submit to executive management and board prior to implementation • Dynamic document with expected changes • Common challenges Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Importance of System Integration • The What • Systems theory • Management control and decision support systems • The Why Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press The What: HIT and Systems Analysis • Systems analysis is the process of collecting information about functional information system requirements and the environment in which the system will operate. • Systems analysis is needed regardless of whether the system will be developed in-house or will be implemented using vendor software. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT: System Characteristics • Unity or integrity—unity of purpose • Healthcare systems are complex • Complex systems contain hierarchical structure • Most possess stability and equilibrium • Deterministic or probabilistic • Simple systems with feedback • Closed or open Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press HIT Systems Management control and decision support systems: • Inputs • Conversion process • Outputs • Sensor • Monitor (standards) • Control process (corrective action) Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Useful Management Information • Information, not data driven • Relevant and sensitive • Unbiased • Comprehensive • Timely • Action oriented • Uniform (for comparison) • Performance targeted • Cost-effective Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press The Why • Complex interdependent, geographically and organizationally separate systems need data integration for quality clinical care. • “The foremost challenge in realizing this highly interconnected ideal is getting the disparate units in the organization to communicate with one another and share clinical information.” Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Suggested Readings • Wayland, M. S., and W. G. McDonald. 2015. Strategic Analysis for Healthcare Concepts and Practical Applications. Chicago: Health Administration Press. • Harris, J. 2017. Healthcare Strategic Planning, 4th ed. Chicago: Health Administration Press. • Harrison, J. 2016. Essentials of Strategic Planning in Healthcare, 2nd ed. Chicago: Health Administration Press. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Web Resources: Data Standards and Consulting Data Standards and Data Sets • The American National Standards Institute’s X.12 Group (ANSI; see www.ansi.org) works on specifications for transactions involving the processing of health insurance claims. • Department of Health and Human Services Office of the Chief Technology Officer (see https://healthdata.gov/content/about) has vast arrays of data sets related to healthcare that are available and accessible to the public. • The Environmental Protection Agency (EPA; http://enviro.epa.gov) maintains Envirofit, another federal source for data warehousing. Consulting Organizations • Accenture (www.accenture.com/us-en/services/health/health-consulting) • CentraForce Health (centraforcehealth.com/) • CharlesRiver Advisors (www.charlesriveradvisors.com) • Health Management Technology magazine (www.hcinnovationgroup.com) • Klas Consulting (klasresearch.com/best-in-klas-ranking/healthcare-managementconsulting/2019/313) Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Web Resources: Data Governance • Data Governance Institute: http://www.datagovernance.com/ • Erwin: The Data Governance Company: https://erwin.com/blog/healthcare-datagovernance/ • EHR Intelligence: https://ehrintelligence.com/news/data-governance-best-practices-forhealthcare-health-it • Varonis, Inc.: www.varonis.com/blog/data-governance-in-healthcare • KPMG on data governance: https://assets.kpmg/content/dam/kpmg/xx/pdf/2018/06/data-governance-drivingvalue-in-health.PDF • HealthIT.gov provides a broad overview of governance and planning activities at: www.healthit.gov/playbook/pddq-framework/data-governance/governancemanagement and even tools for evaluating organizational performance at www.healthit.gov/playbook/pddq-framework/worksheet • HL7 (www.hl7.org) is a standard for healthcare electronic data transmission. Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale. Health Administration Press Web Resources: Strategic Plans • Centers for Disease Control and Prevention strategic plan: file:///C:/HOME/BookGLG/Version2019/Chapter%204/CDC-IT-StrategicPlan20172021.pdf • CEB CIO Leadership Council strategy: https://img.en25.com/Web/CEB/CEB_CIO__IT_Strategy_on_a_Page.pdf • CIO Index strategic planning template: https://cioindex.com/reference/it-strategytemplate • The Joint Commission: www.jointcommission.org • University of South Florida IT strategic plan 2018–2022: www.usf.edu/it/documents/informationtechnologystrategicplan022018submittedbot.p df • Harvard University IT strategic plan: https://huit.harvard.edu/files/huit/files/final_2018_itstrategicplan.pdf • Indiana University School of Medicine strategic plan 2018–2022: https://medicine.iu.edu/about/strategic-plan Copyright 2021 Foundation of the American College of Healthcare Executives. Not for sale.