Jonathan P. DeShazo, Laishy Williams-Carlson, Rich Pollack

 Jonathan P. DeShazo, MPH, PhD, Assistant Professor, Virginia Commonwealth University, Richmond, Virginia  Laishy Williams-Carlson, Vice President and CIO, Bon Secours Health System Inc. Richmond, Virginia  Rich Pollack, MS, Vice President and CIO, Virginia Commonwealth University Health System, Richmond, Virginia

 IT Governance is no longer some stand-alone function, but is an integral part of any organization's overall corporate governance. - Deloitte & Touche

 Principles and practices in the organization of the information systems department  The role and requirements for information technology governance in the organization

 Articulate the roles and responsibilities of personnel in the healthcare information services department  Asses the structure of the organization as well as the IS management function to hypothesize variations in culture, performance, and operations  Evaluate various models of governance within the IS function based of their strengths and limitations

 Develop and maintain IS plan and strategy  Develop and/or implement user applications  Provide support and training  Security and infrastructure management  Examining emerging technologies Wager, K. A., Lee, F. W., & Glaser, J. P. (2009). Health Care Information Systems: A Practical Approach for Health Care Management (2nd ed.): Jossey-Bass.

 Operations and technical support  Applications Management  Specialized Groups  IT Administration

 Data center management  Network, server, and storage engineers  Database administrators  Security personnel  Help desk  Training

 Groups/individuals that focus on classes of applications (e.g. all financial)  Groups/individuals dedicated to a specific application (e.g. EHR)

 Research support  Process and workflow engineering  Data analysts and report writers  Health information management (medical records)

 Strategy development  Contract management  Budget and finance  Human resources  Project management

 Billing and financial General ledger  Cost accounting systems  Patient registration  Personnel and payroll  Electronic materials management

 Clinical Computerized provider order entry for drugs, lab tests, procedures  Electronic health record  Picture archiving and communication systems for filmless imaging  Results reporting of laboratory and other tests  Clinical decision support systems  Prescription drug fulfillment, error-alert, transcriptions  Electronic monitoring of patients in intensive care Units

 Desktop, laptop, cart-based, and tablet computers  Servers and networks  Wireless networks  Voice recognition systems for transcription,  physician orders, and medical records  Bar-coding technology for drugs, medical devices, and inventory control  Information security systems

 Is the decision rights and accountably framework for encouraging desirable behaviors in the use of IT. -Weill & Ross Formal structures and processes Linked to other corporate decision making processes  Without this, managers would make each decision in isolation, perhaps at odds with each other  No single best way for every organization Weill, P., & Ross, J. W. (2004). IT Governance on One Page. CISR Working Paper No. 349.

 IT principles  IT architecture  IT infrastructure  Business application needs  Prioritization and investment

 High level decisions about the strategic role of IT in the business  Examples Ensuring IT is aligned with care delivery Using IT to reduce cost and increase quality Using IT to manage performance Realizing optimal investment value in IT resources

 Integrated set of technical choices to guide organization in satisfying business needs  Examples Policies (e.g. Best of Suite vender strategy) Relationships(e.g. Billing system will generate MRN) Technical and data standards (e.g. we will use SNOMED CT for problem lists)

 Centrally coordinated, shared IT services providing the foundation of the enterprises IT capability  Examples Computing center Network Authentication & security protocols Platforms (Windows, IBM servers running VMware)

 Business requirements for purchased or developed IT applications  Examples Clinical Administrative Strategic

 Decisions about how much to invest  Where to invest in IT(what applications)  How are projects approved?

In this lecture, we discussed:  Principles and practices in the organization of the information systems department  The role and requirements for information technology governance in the organization