Question

Week 12 Discussion: Your Organization's Healthcare IT Governance Structure

Case Study p. 498

Imagine that you've been hired as the Chief Information Officer (CIO) of an academic health care system. The health care system consists of several large hospitals and several dozen outpatient clinics, all using the same EHR system. There is an affiliated but independent physician practice group as well as a School of Medicine with a strong research focus. The current health IT governance structure is as described in Figure 29.2, p. 496, except that the current committees function independently of one another, and as a result, health IT resources are being overwhelmed by requests coming from a variety of sources, each with its own priorities list.

As one of your first tasks on the job, you have been asked to lead the formulation and implementation of a new health IT governance structure. The effectiveness of the new governance structure will be critical to your success and the success of the institution as a whole.

1. How would you go about assessing the current state of health IT governance and your organization's health IT governance capabilities?

2. What issues would you need to consider in recommending improved Health IT governance at your institution?

3. How could the informatics governance at your institution be more centralized to allow an enterprise-wide approach to prioritizing informatics effort?

4. From your reading in chapter 28, outline the basic health policy competencies for health informatics leaders.

5. Describe the policy concerns regarding the use of health IT to improve healthcare quality in control costs as the American health-care system move from HITECH to MACRA.

6. Outline the process for developing and implementing informatics policy.

7. Describe four strategies for leaving policy activities through organizational work and leadership.

Answer 1

1. How to assess the current status of health IT governance?

​​​​To implement IT governance, the most commonly used frameworks are:

• COBIT: published by ISACA, COBIT is a comprehensive framework of globally accepted practices, analytical tools and models designed for governance and management of enterprise.
• ITIL: ITIL focuses on IT service management. It aims to ensure that IT services support core processes of services
• COSCO: this model for evaluating internal controls is from the committee of sponsoring organisation of the trade way commission. It's focus is less IT specific than the other framework, concentrating more on the enterprise Risk management and fraud deterrence
• CMMI: The capability maturity model integration method is an approach to performance improvement
• FAIR: factor analysis of information risk helps oraganisationd quantify risk.

According to Haseley, there are five values of IT governance:

• Strategic alignment: maximize opportunities for the business use of IT while providing transparency & assurance that IT objectives are being achieved
• Risk management: address legal and regulatory compliance needs and understand or manage key operational risks.
• Resource management: appropriately align IT capabilities with business needs
• performance management: utilize real time data to continuously improve IT delivery
• Value delivery: optimize return on IT investments

​​​​​​​2. Issues to be considered in improving health IT governance

• Difficulty in creating national health insurance system
• Addressing long standing equity issues in access
• ​​​​​​​Delivery of health care services