Information Systems Strategic Planning HIMSS Pre ... · Information Systems Strategic Planning...

Information Systems Strategic PlanningHIMSS Pre-Conference Workshop

February 9, 2003

James B. Martin, Ph.D.PresidentHuron Systems, Inc.email: [email protected]

James B. Martin 2003C

Gilbert P. BeckerChair, Clinical Support SystemsMayo Clinicemail: [email protected]

Information Services DirectorFranciscan Skemp/Mayo Health Systememail: [email protected]

Paul T. Allen

Faculty Introductions

Jim Martin

Gil Becker

Paul Allen

James B. Martin, Ph.D.

President, Huron Systems, Inc.President, Huron Systems, Inc.Huron Systems, Inc. is a healthcare Huron Systems, Inc. is a healthcare software development and strategy software development and strategy consulting firm.consulting firm.

Professor Emeritus, University of MichiganProfessor Emeritus, University of Michigan

IME Course Director, CHIMEIME Course Director, CHIMEIME/Advanced Healthcare IT Strategies Course DirectorIME/Advanced Healthcare IT Strategies Course DirectorIME/Advanced Healthcare IT Management Course DirectorIME/Advanced Healthcare IT Management Course Director

Department of Health Management and PolicyDepartment of Health Management and Policy

Workshop ObjectivesEstablish the need for healthcare organizationsand their IS areas to think and plan strategically.Have attendees learn the essential components of IT strategic planning.Prepare participants to initiate an IT strategic planning process in their own facility. Have attendees understand the drivers of the IT strategic planning process in a leading integrated delivery system.Have attendees learn how four IT strategic plans were integrated across a major integrated delivery system.

Workshop OutlineThe importance of IT strategic planningIT strategic planning overviewPrototypical IT strategic planning processImportance of the IT strategic planning processFour case studies – Mayo Health System– Mayo Clinic Rochester– Franciscan Skemp– Mayo Foundation

Summary PointsQuestions, comments, discussion (panel format)

Workshop Theme

The basic planning steps are the same,regardless of the size of the organization.

The Importance of IT Strategic Planning

No longer “business as usual”--must think and plan for survival/prosperity.

Concepts and Terminology

– Managing IT can no longer be left only to “system professionals”.

– New IT is restructuring companies, industries, and markets.

The Importance of ITStrategic Planning (Continued)

Alignment of strategy, businessstructures, and IT has become a key management concept.

IT has taken on a strategic role, helping to enlarge the scope of business through a combination of technology push and competitive pull.


Healthcare is information intensive

Very strong pressures to increase effectiveness and efficiency

– Cost

– Quality

– Service


Rapid expansion of available technology– Hardware– Software– Communications / Networking

“How to” knowledge is growingResponses must come from:– Reengineered base processes– Integrated IT capabilities

Major Components of anIT Strategic Plan

Assessment

Vision

IT Implications of the Vision

Plan

Alternative Models ofStrategic Planning

Organizational Pull Model

Technology Push Model

Component Alignment Model (CAM)

Backplanning Approach

Component Alignment Model (CAM)

Evolved from Henderson and Venkatraman’s Strategic Alignment Model (SAM)

1. Not sufficient to harmonize business strategy with IT applications

Component Alignment Model(Continued)

2. Necessary to align:• IT infrastructure and processes• Organization infrastructure and

processes• Business strategy• IT strategy

3. IT evolves from a support role to a role that redefines the business scope


1. Continuous assessment of 7 components:– Uncontrollable components:• External environment• Emerging information technologies

– Controllable components• Mission (least controllable)• Organizational infrastructure• IT infrastructure• Business strategy• IT strategy


2. Alignment of controllable components in response to non-controllable components

3. Alignment of controllable components among themselves

Component Alignment Model

Alignment

Business Plan IT Plan

Ongoing Assessment

Alignment

EmergingInformation

Technologies

ExternalEnvironment

Non-controllableComponents

Controllable Components

MissionOrganizationalInfrastructure &

Processes

ITInfrastructure &

Processes

BusinessStrategy IT Strategy

Overview of A Prototype IT Strategic Planning ProcessA. Determine the need to develop an IT strategic plan.B. Hold a retreat to educate key players on the need

for, and expected results of, an IT strategic planning process.

C. Form a team consisting of the correctplayers.

Top managementPhysician leaders & system gurusKey usersBest thinkersTop IS personnelNecessary external consultants

Prototype Process (Continued)

D. Select a model/approach (e.g., CAM,Organization Pull, Technology Push,Backplanning).

E. Create a set of “planning categories”.- Starting point of the CAM components- Modified by organizational characteristics

and needs


F. Perform the assessment.– Utilize subcommittees to organize

and document information within the planning categories.

– Gather information through administration of questionnaires and interviews, as necessary.


G. Develop a vision of the future– Utilize subcommittees to organize and

document information within the planning categories.

– Gather information through administration of questionnaires and interviews, as necessary.

H. Specify the IT implications of the vision


I. Develop the Strategic Plan– Goals– Objectives– Strategies– Timeframes– Resource requirements– Financial requirements– Value to be received

J. Develop a 12 – 18 Month Tactical Plan– Tasks/Projects/Activities– Resource requirements– Timeframes and responsible parties

1 - Define Planning CategoriesEmerging

InformationTechnologies

ExternalEnvironment

6 - IT Tactical Plan

Strategic Planning Project MethodologyStrategic Planning Project Methodology

5 - IT Goals & Objectives

4 - IT Implications of Vision

2 - Assessment

MissionOrganizational

Infrastructure andProcesses

Internal ITInfrastructure and

Processes

BusinessStrategy

ITStrategy

Where

will

we

be

?

3 - Vision

Where

are

we

now

?

Importance of the Strategic Planning ProcessPlanning does more than allocate

resources--it also:AnalyzesEducatesSellsResolves Conflicts

Planning must be a continuous process--not a one-time project

Outcome is a “living document”

Gil BeckerMayo Clinic Rochester & Mayo FoundationAdministrator, IMT Strategic Planning SupportDivision Chair, Clinical Support Systems

Paul Allen

CIO, Franciscan Skemp Healthcare (FSH)FSH part of Mayo Health SystemNavigating the changing course

Mayo Clinic

Organizational Structure

Business Function

IT Services

Mayo Clinic Rochester

Mayo Clinic Scottsdale

Mayo Clinic Jacksonville

Mayo Foundation

Mayo Health System




Mayo Foundation

Franciscan Skemp Healthcare

Mayo Clinic

Organizational Structure

Business Function

IT Services

Business Function: Mayo FoundationOverarching governance for all Mayo entities.

Specific administrative and financial services to the Mayo entities - human resources, payroll, pension, materials management, development, electronic claims and remittance, etc.

Diversification activities - Mayo Medical Laboratories, Mayo Medical Ventures, etc.

Education - Five schools: Graduate School of Medicine, Graduate School, Medical School, School of Health Related Sciences, School of Continuing Education

Research - oversight and coordination across entities

Business Function: Mayo RochesterPrimary and specialized clinical healthcare services:– Staff physician & scientists 1,544– Residents, fellows, pre-doctoral students 2,451– Allied health staff 22,214– Unique patients 315,671– Outpatient visits 1.21 million– Licensed beds available 1,951– Operating Rooms 99– Admissions 57, 227

Clinical researchEducation

Business Function: MHS

FactsPhysicians: 590Employees: 10,620 allied health staffHospitals: 877 total beds (14 owned

hospitals, 3 mgt contracts)Nursing Homes: 8 owned nursing homesPatient Visits: 2.1 million/year

Business Function: MHS (Continued)

Administrative FunctionOversight of MHS Sites in coordination with Mayo RochesterCoordination of Administrative Services– Human Resources, Payor Relations &

Contracting, Marketing, Physician Recruitment, Systems & Procedures, IT & Systems

Sponsor of MHS Programs– Disease Management Strategies, Supply

Expense Management, Mayo Regional Medical Plan

Business Function: FSH

Facts• 138 Physicians (180 ‘providers’)• 2,200 Allied Health Staff• ~ 9,000 Annual Admissions• ~ 95,000 Hospital O/P Visits• ~ 500,000 Clinic Encounters

Business Function: FSH (Continued)

Business Functions• Community-based Primary Care

Clinics• Specialty and Subspecialty Care• General Acute Care Services• I/P & O/P Behavioral Health Services• Coordinated Services with Mayo

RochesterDialysis, Cardiology, Oncology

IMT at Mayo Foundation

Organization of 170 permanent staffInformation Services (25 “shared services”):– Software engineering - benefits, payroll,

materials management, five Mayo schools, e-commerce, general ledger, electronic messaging, radiology, etc.

– Infrastructure engineering - video conferencing, telecommunications, WAN engineering, mobile communications, mainframe engineering.

– Information Security

IMT at Mayo Clinic Rochester

Organization of 950 permanent staffInformation Services (550 staff):– Information management– Software engineering– Infrastructure engineering

Media Design and Production ServicesBiomedical Engineering Services

IT at Mayo Health System

IT Role & Services• 19.5 FTEs• Develop MHS IT strategic & annual

tactical plans • Coordinate IT between MHS sites and

MCR/Mayo Foundation• Provide technology support to all MHS

sites & provide leadership to sites without IT support

IT at Mayo Health System (Continued)

IT Role & Services (Continued)

• Oversee & facilitate Internet/intranet development • Promote IT standardization to realize economies

of scale• Provide common network infrastructure• Provide (or coordinate) shared IT services to MHS

sitesVideo conferencing, Internet Services, Laboratory System, Practice Management System, Dictation/Transcription System…

IT at Franciscan Skemp

IT Role & Services• Information Services

• 38 permanent IS staff•Operations & Help Desk•Systems and Programming•Network and Desktop Technology•User Support/Project Management

Timeframes for Four Planning Processes

Mayo Health System (August 2000 -October 2000)Rochester Group Practice (August 2000 - June 2001)Franciscan Skemp Healthcare (January 2001 - July 2001)Mayo Foundation (November 2001 -May 2002)

Mayo Health System

Information Technology Strategic Planning Process

Mayo ClinicRochester



Mayo Foundation

Mayo Health System

MHS IT Planning Background

• Initial MHS I.T. planning began in 1995-96Definition of basic infrastructure needs (e-mail, library reference, Internet)Specifications for replacement of Practice Management & Hospital Information Systems

• 1998 IT strategic focused on development of architecture necessary to share clinical information

MHS Technology Architecture Vision

Shared Applications

MHSCommon

Applications

Data

Rochester & Foundation Applications

Data

= =

= =

Common Infrastructure(networks, video, some voice)

SharedData

Repositories

MHS 2000 IT Plan Expected Process

• Interviews of physician & administrative leaders

• Identification of IT requirements• Development of gap analysis• Identification of IT projects• Prioritization of projects• 3-year project plan• Plan approval

MHS 2000 IT Plan Actual Process

Interviews of physician & administrative leaders Identification of IT requirementsDevelopment of gap analysis

The “Wall”

MHS 2000 IT Plan Actual Process(Continued)

Reasons for the “Wall”• IS-driven process• Difficulty developing links to business

initiatives• Site-specific IS priorities, concerns, &

biases• Insufficient planning structure

Starting Situation—External ViewCommittee had worked for approximately a year, hadn’t followed a defined process, and was struggling to “pull the pieces together”.Completed work was good quality, but non-coordinated.What was needed:– To complete a plan in 2 - 3 months.– To make use of work to date.– A logical segue from two previous plans.– A plan with both strategic and tactical

components.– A well-structured plan document.

Planning Process OverviewPrepared goals document (based on documentation review and discussions).

Prepared plan outline (based on existing materials, discussions, and knowledge of optimal plan structure).

Modified plan outline per MHS leader input.

Created “themes” from written materials, discussions, and gap analysis.

Planning Process Overview (Continued)Wrote draft plan using:– Knowledge of environment for assessment.– Gap analysis and themes (instead of vision).– Implications of gap analysis/themes (instead of

vision).– Implications & goals document for creating

goals/objectives.Revised plan several times based on committee meeting discussions.Created one-year tactical plan based on goals/objectives and resource availability.Struggled with common/shared definitions.Wrote executive summary & finalized plan.Total elapsed time = 2 ½ months

Planning Process Results

Strategic Goals1. Deliver integrated clinical data to all MHS

entities and physicians.2. Define & implement, as appropriate,

common systems, shared systems, and shared IT services across MHS entities, utilizing MCR and/or Foundation solutions where appropriate.

3. Assure the appropriate adoption of IT across MHS.

Planning Process Results (Continued)

Strategic Goals (Continued)

4. Develop the ability, within & across MHS, to define, collect, & report on multiple forms of standardized data for outcomes measurement & financial analysis.

5. Streamline the pre- & post-referral processes within MHS constellations, MHS entities and between MHS entities and MCR.

6. Communicate to all MHS entities the MHS, MCR, & Foundation IT plans & initiatives.


Plan Acceptance

– Plan was formally accepted by MHS administrative leadership and by individual MHS sites.

– Difficulties exist sustaining buy-in from operational units.

– Since linkage to business objectives is “weak”, IT strategies are having difficulty competing for funding and priority at some MHS sites.


What would we do differently?• Engage a consultant at beginning of process

to:• Arbitrate site-specific vs. MHS-wide

perspectives.• Provide an external perspective.

• Utilize a structured approach. • Broaden mix of participants on planning team.• Develop closer ties to business strategies.


Conclusion

– Must have a planning structure in order to have a good, timely outcome.




Mayo Foundation

Mayo Health System

Information Management and Technology Strategic Planning

Drivers– Nine years since last plan (1992) – Alignment with new Board of Governors

Strategic PlanScope

Objective– A “living” Plan describing key IMT strategies

within a 3-5 year planning horizon.

IMTISRochester/MHSFoundation

20011992

IMT Strategic Plan Organizational Structure

Information Management and Technology Committee

Information Management & Technology Committee• IT oversight committee for IMT functions at Mayo Clinic

Rochester.• Physician-led, 24 members• Reports to the Mayo Clinic Rochester Board of Governors.• Provides policy level guidance to the Mayo IT Organization• Provides funding oversight for IT infrastructure• Serves as a resource on IT to other committees• Provides institutional oversight for the development and

implementation of the IMT Strategic Plan.


IMT Strategic PlanSteering Group


Information Management & Technology Strategic Plan Steering Group

• Reported to the Information Management and Technology Committee.

• Physician-led with 16 representatives from clinical practice, research, education, administration/finance, and IT.

• Oversight of the development of the IMT Strategic Plan. • Provided guidance and counsel to the IT Coordinating

Council in the development of the content of the plan.• Ensured alignment with the Mayo Clinic Rochester Board of

Governors Strategic Plan and the Mayo Health System IT Strategic Plan.




IT Coordinating Council

• Permanent IT coordinating council made up of 35 operational managers of the Mayo Clinic Rochester IT organization and the Mayo Health System.

• Provides operational oversight and support of IT at Mayo Clinic Rochester.

• Custodian of the IMT Strategic Plan.• Responsible for development of the draft content of

the IMT Strategic Plan.• Reported to the Information Management and

Technology Strategic Plan Steering Group for the strategic plan project.






IMTStrategicPlanningSupport

IMT Strategic Planning Support

• Permanent office of the IT organization charged with supporting the strategic planning process.

• Responsible for the development of the project work plan.

• Administered the workplan and processes needed to develop the Strategic Plan.

• Comprised of 0.75 Information Technology staff members.





IMTStrategicPlanningSupport

IMT Strategic

PlanProject

Facilitator

Project Facilitator

James B. Martin, Ph.D.Worked with all components of the project organization to tailor the proposed approach to best fit the Mayo environment.Participated in all aspects of the project, including leadership interviews, meeting facilitation, and project documentation.

1 - Define Planning CategoriesExternal

InformationTechnologies

ExternalEnvironment

MedicalScientificAdvances

6 - IT Tactical Plan


5 - IT Goals & Objectives

4 - IT Implications of Vision

2 - Assessment

The Mayo MissionOrganizational



Processes

BusinessStrategy

IMTStrategy

Where

will

we

be

?

3 - Vision

Where

are

we

now

?

Strategic Planning Project Process

1 - Define Planning Categories



Internal I/TInfrastructure and

Processes

BusinessStrategy

IMTStrategy

External InformationTechnologies

ExternalEnvironment

MedicalScientific

Advances

Completed in Sept., 2000 by the Steering Group






Processes

BusinessStrategy

IMTStrategy


ExternalEnvironment

MedicalScientific

Advances

2 - Assessment

Where

are

we

now

?

Completed in January, 2001

by ITCC& Steering

Group


Input to Assessment & VisionGroup Interviews With Mayo Officers/Leaders (40):

– Clinical Practice (clinic and hospital)– Research– Education– Administration– Finance– Rochester Board Of Governors– Mayo Health System Leadership– Mayo Foundation Leadership

Input From Historical Documents (20):– Departmental strategic plans - practice, education,

research, finance– Commissioned Gartner Report– Mayo Health System IT Strategic Plan– Departmental annual operational plans

AssessmentProcess:

– Draft document created by Jim and Gil.– IT Coordinating Council reviewed and modified.– The Strategic Plan Steering Group reviewed and modified.

Assessment was presented for review and acceptance:– IT oversight committee - IMTC– Mayo Rochester Board of Governors

Benefit:– Provided engagement and ownership in the process by

ITCC and Steering Group members with many lively discussions over six weeks.

– Provided the groundwork for the development of the vision statements.

– Provided credibility for the process and the groups involved.

Assessment Results

A. External Environment– Financial pressures and opportunities– Quality pressures– Legal & regulatory requirements– Customer expectations– Workforce issues– Threats of increased competition

Assessment Results (Continued)

B. External Information Technologies– Maintenance requirements of existing/new

systems– Emerging information technologies

•Communication capabilitiesInternet-based capabilitiesWireless & hand-held end-user devicesData communication standardsVoice, data, and video convergenceExpanded bandwidth


– Emerging IT (continued)•EMR-related capabilities

Speech recognitionCMVsRules-based expert systems

•Security DevicesPKIBiometric identificationSmart Cards

•Deployment options– Market volatility/Vendor stability


C. Medical Scientific Advances– Human genomics & proteomics– Pharmacologics– Surgical interventions

D. Mission– Mission review & IT effect


D. Organizational Structure & Processes– Financial pressures & opportunities– Structural issues– Operations– Culture– Human resources


E. IS Organization, Functions, Processes– Existing functions– Existing assets & metrics– Summary assessment– Suggestions for improvements– Governance/leadership issues– Areas for additional involvement


F. Business Strategy– Business strategy review– Potential future business strategies

(based on interview results)

J. IT Strategy– Assessment of current strategy– Related strategic plan review






Processes

BusinessStrategy

IMTStrategy


ExternalEnvironment

MedicalScientific

Advances

3 - Vision

Where

will

we

be

?

2 - Assessment

Where

are

we

now

?


by ITCC& Steering

Group


Completed inMarch, 2001

by the Steering Group

Vision ProcessProcess:

– Draft document was created by Jim to initiate discussion.– The Strategic Plan Steering Group reviewed and modified over

a period of 13 weeks.– Consisted of detailed “predictions” of external planning

categories and detailed vision statements of internal planning categories.

– Summary vision statements were summarized into themes meaningful to the Mayo culture, i.e., practice, research, education, administration, finance, and the IT organization.

Benefit:– The summarized vision statements provided the basis for the

Strategic Goals.– The detailed vision statements provided the basis for the IT

implications that evolved into the Strategic Objectives.

Vision ResultsThe detailed vision statements were based on the planning categories .– Quality expectations (predicted scenario example)

• External pressures to improve clinical practice & medical education quality will grow.

• Improvements will be required in terms of:MetricsExternal reportingExternal accessCredentialingOutcomes measuresPatient safety measuresGuidelines

Vision Results (Continued)

Financial pressures & opportunities (detailed vision example)– Mayo will create a principled approach to cost

reduction.•Reengineer existing processes around IMT.•Establish partnerships between IT &

organizational areas.• Foist ROI responsibility on business units.•Perform post-implementation analyses.•Pursue concerted effort to control drug costs.

Vision Results (Continued)

The summary vision statements were based on concepts in the Mayo culture.– Information management program– Strategic advantage– Support for clinical practice– Support for education– Support for research– Support for administration/finance– Data integration, best practices, & sharable

solutions– IT policies & procedures– IT organization– Difficult times for IT investment


4 - IT Implications to Vision





Processes

BusinessStrategy

IMTStrategy


ExternalEnvironment

MedicalScientific

Advances

3 - Vision

Where

will

we

be

?

2 - Assessment

Where

are

we

now

?


by ITCC& Steering

Group




Completed inMarch, 2001 by ITCC

IT Implications to Vision

“An IMT implication is a high-level, concise statement of outcome(s) that must be achieved to realize one or more of the visions. Implications are not meant to be detailed solutions.”

IT Implications to VisionsVision:

“Due to technological advances, medical imaging will be expanded to additional areas of the practice.”

Implication:Sufficient communications bandwidth and storage capacity must be available to support this expansion.

Vision: “The IT organization will be actively involved at all levels of Mayo Clinic decision making.”

Implication:The IT organization must be represented on all appropriate organizational governance and oversight committees.

Process--IT Implications to VisionThe ITCC held a one day retreat to develop IT implications to each detailed vision statement.To prepare for the retreat, workbooks were distributed in advance that listed approximately 60 vision statements.Morning break out groups actively discussed and clarified those implications that were developed by individuals in advance of the retreat.Afternoon session was spent developing consensus agreement on which implications would drive the Strategic Plan.

5 - Information Technology Goals & Objectives







Processes

BusinessStrategy

IMTStrategy


ExternalEnvironment

MedicalScientific

Advances

3 - Vision

Where

will

we

be

?

2 - Assessment

Where

are

we

now

?


by ITCC& Steering

Group





Completed inJune, 2001

Strategic Goals and Objectives

Nine Strategic GoalsForty Strategic Objectives

Nine Strategic Goals1. Integration2. Information Management3. Infrastructure4. Organizational Performance5. Practice Integration6. Education7. IT’s Organizational Role8. IT Internal Operations9. Ongoing Leadership Support

Strategic Objectives

• Using a structured points allocation approach, the ITCC and the IMT Steering Group prioritized the Strategic Objectives.

• Criteria used:

“The more points allocated to an objective, the stronger the view that the objective should be started within one year; i.e. high positive impact and a sense of urgency.”

• Ten Strategic Objectives were selected.

Ten Prioritized Strategic Objectives1. Implement dynamic, real-time, point-of-care, rules-based clinical decision support systems. (4.1)

2. Establish a framework that includes security, integration approaches, data infrastructure, and architecture standards. (1.1)

3. Establish a shared data infrastructure that includes the identification of key institutional data items and development of consistent definitions of those data items. (2.1)

Ten Prioritized Strategic Objectives

4. Evaluate and further develop a set of education-related tools that meet the multi-faceted educational needs of Mayo. (6.1)

5. Enhance revenue capture and reduce days revenue outstanding. (4.5)

6. Engage Mayo Clinic leadership to help overcome barriers to achieving organization wide integration. (9.1)

Ten Prioritized Strategic Objectives7. Design new architecture/infrastructure to meet expanded needs, e.g. (3.1):

•The expanded requirements associated with genomics•Easy and secure access to Mayo Clinic information repositories by patients, referring physicians, students, payors, and business partners.

8. Improve and standardize the operational processes of the IT organization. (8.1)

9. Provide a reliable and efficient application infrastructure for entry, access, storage and retrieval of clinical information to support growth of the integrated practice. (5.1)

Ten Prioritized Strategic Objectives

10. Enhance the IT organization’s understanding of our customers’ needs as well as how to balance and integrate system-wide and departmental requirements, e.g. (7.1 ):

• Understanding IT’s customers’ operational processes and procedures.• Developing and maintaining an understanding of regulatory and certifying agency requirements, including HIPAA.• Maintaining currency in emerging healthcare trends, such as genomics.








Processes

BusinessStrategy

IMTStrategy


ExternalEnvironment

MedicalScientific

Advances

3 - Vision

Where

will

we

be

?

2 - Assessment

Where

are

we

now

?


by ITCC& Steering

Group





Completed inJune, 2001

6 - Information Technology Tactical Plans

Work in Progress

IT Tactical Plan DevelopmentFocus on the Ten Prioritized Strategic ObjectivesSeize opportunities to address any of the Strategic ObjectivesTactical Plan to include:

– Defined responsibilities and accountabilities (ownership)

– Defined milestones– Defined metrics to measure and monitor progress

The ITCC develops the tactical plan on a yearly cycleIMTC will monitor progress on Strategic Objectives

Strategic Planning Outcomes:Plan Acceptance

The assessment has been used as input in other strategic planning projects at Mayo - Finance DepartmentInformation Management Technology Committee carries out it’s oversight by monitoring progress on Strategic Objectives.IT funding review and approval process requires proponents to link their projects to Strategic Objectives.Strategic focus still not an inherent part of our culture, we still must work hard to keep it visual.Balanced scorecard approach to implementation is being developed.

Strategic Planning Outcomes:Lessons Learned

Limit the number of goals and objectives.Avoid “compound” objectives.Avoid the “wish list” syndrome.Encourage broad input in the development of the strategic plan to insure buy in.Keep objectives actionable and measurable.Don’t be afraid to ask for help– Internal expertise in other departments– External consultants




Mayo Foundation


History•First member corporation established in 1883 •Merger with MHS in 1995

Facilities/Services•3 hospitals•12 Clinic locations•135 employed physicians

Franciscan SkempMayo Health System

Pre-planning DecisionsWhy do we need to redevelop the IT plan?– Changes in FSH leadership – Updated FSH Strategic Plan – Previous IT plan outdated– Relationships developed with MFSS, MHS, and MCR

What should be the plan’s scope? – Focus on requirements related to FSH’s core goals &

strategies– Center on needs of hospitals and clinics

What is the planning objective?– A written plan describing key technology strategies with

a 3 to 5 year planning horizon

ITSP Organizational Structure

Management Committee

IT Committee

Information Technology Committee

Structure and Function– Physician-led oversight committee for

IT organization at FSH– Reports to the FSH Management

CommitteeCharge– Coordinating the content of the IT

Strategic Plan



IT Committee

ITSP Planning Group

ITSP Planning GroupStructure and Function– Created by and reported to the IT Committee– Included representatives from clinical

practice, administration/finance, HIMS, and ITCharge– Acted as the project sponsor and provided

oversight of the entire planning process – Ensured the plan was aligned with:

• FSH Strategic Plan•MCR IT Strategic Plan•MHS IT Strategic Plan



IT Committee

ITSP Planning Group

IS Project Planning Team


Structure and Function– Created by and reported to the ITSP

Planning GroupCharge– Drafted the IT implications of the vision that

was developed by the ITSP Planning Group

– Drafted the initial set of Strategic Goals and Objectives



IT Committee

ITSP Planning Group


MCR

MHS

ITSP

Pro

jec t

Fac

il ita

t or




The FSH MissionOrganizational



Processes

BusinessStrategy

ITStrategy


Mayo/MHS Relationship

Patient CareRequirements

ExternalEnvironment



Where

are

we

now

?

2 - Assessment

Where

will

we

be

?

3 - Vision

Input to Assessment & Vision30 Interviews:– FSH Top Leadership– Strategic Project Managers– MCR & MHS IT Leadership– IT Committee Leaders– Key Departments

Input From Historical Documents:– MHS IT Strategic Plan– Departmental annual operational plans– MCR IT Strategic Plan

AssessmentProcess:

– Draft document was created by Jim and Paul.– The ITSP Planning Group reviewed & modified.

Presented for review and acceptance:– IT Committee.– FSH Management Committee.

Benefit:– Provided engagement & ownership by ITSP Planning

Group– Provided the groundwork for the development of the

vision statements.– Provided credibility for the process & the groups

involved.

Assessment Results

A. External Environment– Reimbursement Environment– Quality pressures– Legal & regulatory requirements– Consumerism– Workforce issues– Competition


B. Emerging Information Technologies– Communication capabilities– EMR-related capabilities– Security Devices– Deployment options– Market volatility/Vendor stability


C. Mayo Health System/Mayo Clinic/Mayo Foundation Relationship

– Shared Patient Processes– Shared Best Practices– Shared Services

D. Organizational Structure & ProcessesE. FSH Mission & ValuesF. Internal IT Infrastructure and Processes

– Governance and leadership– Assets and metrics– Key IT processes


G. Business Strategy– Optimize the System– Focus

• Develop facilities plan• Reshape/restructure service lines

– Selected Growth• Cardiology, Neurosciences,Orthopedics, Oncology, & Women’s

Services– Enhance Value

• Promote system-wide, integrated approach to enhancing clinical care

• Use technology to enhance value to patients and staff• Improve staff productivity and compensation• Reconfigure regional practices to establish consistent standards

and practices


H. Patient Care Requirements– Educate organization regarding existing capabilities– Improve reporting; specialty-specific dashboard– Enhance efficiency of clinical processes– Improve access to medical documentation– Enhance clinical decision support capabilities– Enhance communication

I. IT Strategy– Review of existing IT strategy– Preliminary assumptions for plan development

Unofficial Message...

“I can’t imagine being successful in the future without a full, electronic medical record.”

-- Glenn Forbes, M.D.President and CEO Franciscan Skemp

“I can’t envision when or where we will find the money.”





Processes

BusinessStrategy

ITStrategy




ExternalEnvironment


Where

are

we

now

?

2 - Assessment

Where

will

we

be

?

3 - Vision

Developing Vision StatementsProcess similar to Mayo RochesterMuch shorter timeframe; 4 versus 13 weeksCAM required us to re-think our ideas about vision statements– Vision statements were not:

•A short, summary paragraph •A “catchy” phrase or rallying cry

– Vision statements were:•A series of short statements, identifying many,

very specific predictions within each planning category

•A foundation & discipline for subsequent steps

Detailed Vision Statements• Little capital will be available for IT…• FSH will employ a principled, effective, return-on-

investment approach to major capital project prioritization.

• The capital amounts outlined in the FSH strategic plan will be available as scheduled for IT projects.

• FSH will utilize the most effective deployment options for each of its IT solutions.

• An IS governance structure will be in place that effectively sets IT priorities which balance organization-wide and department-specific IT needs. The IS organization will efficiently allocate resources to meet the priorities.

• IT implications should be considered in all levels of FSH decision-making.

Summary Vision StatementProcesses will be developed that:• Assure appropriate capital and operational resource

allocation to information technology & its effective utilization within the organization

• Assure an appropriate balance is maintained between the prioritization of organization-wide IT needs and department-specific IT needs

• Lead to effective and efficient assignment of IT resources

• Include expectations for departments to realize projected ROI from IT investments

Detailed Vision Statements• Data definitions will be standardized on an FSH-wide

basis.

• Given the mission criticality of many of the current and future computer applications, FSH will develop an IT architecture that provides system stability and application availability

• FSH will establish a foundation of core systems necessary to support the basic clinical and business processes of the organization.

Summary Vision StatementThe evolving model of care will be supported through an enhanced, multi-disciplinary information management program, and associated IT architecture, that fully integrates all forms of information across our practice.





Processes

BusinessStrategy

ITStrategy




ExternalEnvironment



Where

are

we

now

?

2 - Assessment

Where

will

we

be

?

3 - Vision

Identifying the IT Implications

Analyze each vision statement and “tease out” how IT will be impacted– Driven by IS staff– Maybe the most intense task of entire

process – Very structured; every implication

indexed back to “its” vision statement – Large volume

IT ImplicationsDetailed Vision Statement

Data definitions will be standardized on an FSH-wide basis.

IT Implications1. Must develop common data definitions, including patient, providers,

locations, service codes, end users, payors, employers, HIPAA standards, other regulatory requirements, etc. that are controlled through single sources of truth.

– Have to have FSH MPI– Investigate integration of FSH MPI to Mayo MPII– Finish the Mayo MPII installation– Coordinate data definitions across MHS and with MCR– Data quality has to be assured so measures are valid & believable– Who will define? Where will definitions come from? Where will they be stored?

2. The patient identifier to utilize, including the MCR Clinic Number, will need to be carefully studied and selected.

– IS will need to work with HIMS to convert charts and systems to the selected patient identifier.





Processes

BusinessStrategy

ITStrategy




ExternalEnvironment




Where

are

we

now

?

2 - Assessment

Where

will

we

be

?

3 - Vision

Plan Overview

7 Strategic Goals27 Strategic Objectives

3-Year Tactical Plan

7 Strategic GoalsEnable FSH to meet its core goals & strategies and to grow the practice. [FSH Strategies]– 4 Objectives

Support clinical & operational processes by delivering high quality, timely & cost effective information, infrastructure, applications & services. [FSH Operations]– 5 Objectives

Enable FSH to become a fully integrated healthcare system, both internally & with Mayo Clinic, by delivering integrated information & promoting best practice processes. [Integration]– 3 Objectives

7 Strategic Goals (continued)

Enhance the internal operations of the IS organization. [IS Internal Operations]– 3 Objectives

Position the IS organization for a more proactive & collaborative role within FSH. [IS Role]– 5 Objectives

Fully support the IT architecture needs of FSH. [IT Architecture]– 3 Objectives

Sustain FSH leadership’s understanding & support of the organization’s IT strategic goals & objectives. [Leadership Support] – 2 Objectives






Processes

BusinessStrategy

ITStrategy




ExternalEnvironment




Where

are

we

now

?

2 - Assessment

Where

will

we

be

?

3 - Vision

6 Prioritized Objectives1. Provide a set of fully functional clinical core systems2. Integrate clinic & hospital information & processes3. Deploy clinical documentation processes & systems at

the point of service to capture, store, & retrieve critical patient information

4. Provide infrastructure & applications that fully meet the needs of the new Practice Integration Building

5. Provide the appropriate level of integration with Mayo Clinic & MHS

6. Deliver improved information to providers & managers to better analyze, understand, & manage their areas

Tactical Planning Methodology1. Develop set of clearly defined projects (24)2. Develop planning assumptions 3. Identify key resources; identify each

project’s resource requirements 4. Determine organization’s readiness5. Identify interdependencies between projects

& develop logical sequences 6. Develop timeline

Three-Year Tactical Plan

1. Resolve patient identification issues2. Define core clinical systems3. Develop long-range application plan4. Develop information management program5. Implement radiology information system

6. Select & implement a surgery/anesthesia solution

2003

2002

Three-year Tactical Plan

7. Complete implementation of Mayo Foundation ICDR making laboratory results & transcribed notes available on-line

8. Design and deploy infrastructure for Practice Integration Building

9. Respond to requirements of Radiation Oncology

10. Complete deployment of existing systems

2003 (cont.)

2004

Plan Acceptance• Acknowledged, endorsed, and recognized• IT Committee responsible for oversight• IT project review and approval process

requires proponents to link projects to strategic objectives

• Renewed/re-energized interest in ITo Asked to pursue a more aggressive

approach to meet clinical needs• IT transitioning from “cost center” to “strategic

asset”

Lessons LearnedUnderstand the commitment – both in time and resource requirements. Develop a series of 1-year, renewable tactical plans. Better prepare planning participants for the initiative; encourage out-of-box thinking.Learn to accept that many, many good ideas are going to fall off the plate.Create broad level of participation to ensure creditability.

Mayo Foundation





Mayo Foundation

Mayo Health System

A Strategic Planning VocabularyMissionA statement of purpose that answers the question of why does thisorganization exist?

Strategic PlanA dynamic set of planning documents which provide the context for allactivities within the organization.

Strategic GoalsStandards against which the organization measures success. They are notthe “how to” of an enterprise and may not be directly manageable.

ObjectivesA finite group of measurable activities which affect the accomplishment of aGoal and are directly linked with outcomes.

Tasks (or Tactics)A set of activities required to achieve an objective. Tasks tell us “how to”achieve an objective.

Strategic Plan FocusMayo Foundation Strategic Goals and Objectives:

• Objective 1.3 - Investigate and identify, through existing committees and leaders, realistic opportunities for further synergies across the Foundation.

• Objective 2.1 – Enhance the collaboration and interaction at multiple levels across Foundation sites.

• Objective 4.4 – Ensure optimal integration of clinical records and information to support research and investigation across the Foundation.

Project Team

Practice/EducationTeam

Research/Administrative Team

InfrastructureTeam

Project OrganizationFoundation

Information TechnologyStrategy Committee

FoundationInformation Technology

Committee

Clinical PracticeAdvisory Group

FoundationEducationCommittee

Foundation ResearchAdvisory Committee

System Administrative Council

FoundationInformation Management& Technology Strategic

Plan Steering Group

AssessmentDocument External and Internal Environments with Respect to

Information Technology

Strategic Planning Project Approach

Data CollectionFoundation Objective 1.3, 2.1, 4.4

MGP IT Strategic PlansMHS IT Strategic Plans

Interviews with Foundation Leadership

Strategic Plan Steering Group & Foundation Information Technology Committee

Develop Strategic Goals and Objectives

Operational Vice- Chair TeamsDevelop Draft Strategic Goals

and Objectives

Clinical Practice Advisory Group

Foundation Education Committee System

Administrative Council

Foundation Research Advisory

Committee

Foundation Information Management and Technology

Strategic Goals and Objectives

The Foundation Information Technology Organization will enhance the Mayo Mission in practice, research, and education and increase operational efficiency and effectiveness

through proactive information and technology management.

Goal 2IT

Infrastructure

Goal 1Information

Sharing

Goal 3Innovation

Goal 4Customer

Satisfaction

Strategy

Goal 5Efficiencies &Effectiveness

Operational

tactictactictactictactictactic

tactictactic

tactictactic

tactic

tactictactic

MISSION

Objective 1.4

Objective 1.3

Objective 1.2

Objective 1.1

Objective 5.2

Objective 5.1Objective 4.1

Objective 3.2

Objective 3.1

Objective 2.2

Objective 2.1

Objective 1.5

Establish Foundation-wide information sharing and exchange to support Mayo’s core principles.

1.1 Develop a framework for implementation of a Foundation-wide information management program.

1.2 Ensure patient data are available in a usable format to support the needs of the practice.

1.3 Ensure patient data are available in a usable format to support the needs of research.

1.4 Ensure data are available in a usable format to support the needs of education.

1.5 Ensure data are available in a usable format to support the needs of administration.

Objectives

Goal 1

Establish a Foundation-wide information technology infrastructure that provides a competitive edge in support of

Mayo's practice, education, research and administration.

2.1 Maintain and improve a secure, reliable, and cost effective communications infrastructure.

2.2 Maintain and improve a secure, reliable, and cost effective computing infrastructure.

Objectives

Goal 2

Promote innovative and creative information technology solutions across the Foundation.

3.1 Assess new information technologies and implement their appropriate use across the Foundation.

3.2 Educate Mayo leadership on the potential of current and emerging information technologies to improve organizational performance.

Objectives

Goal 3

Provide electronic access to Mayo services that exceed our patients' and external customers' expectations.

4.1 Develop portals to Mayo services that advance a unified view of Mayo’s multi-site organization.

Objective

Goal 4

Provide and leverage common information management and technology solutions that increase Foundation-wide

effectiveness and efficiencies.

5.1 Establish a Mayo Foundation integrated and coordinated electronic environment for selected applications in collaboration with Practice, Research, Education, and Administration.

5.2 Support the implementation of electronic delivery systems for learner access to curricula.

Objectives

Goal 5

Next Step:

Strategic PlanManagement Matrix

Foundation Information Management & Technology Strategic Management Matrix

Strategic Objectives Due Dates Accountability ResourceTargets TacticsMeasuresStrategic GoalsMission

The

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Strategic View; long-term Operational View; short-term

Strategic / LeadershipFoundation IMT Strategic Planning Steering

Group

Operational / TacticalFoundation IT Management Council

Info

-man

agem

ent




1.4 Ensure data is available in a usable format to support the needs of administration.



Infr

astr

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re

1.3 Ensure patient data are available in a usable format to support the needs of education.



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that

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Group


Info

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Infr

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Telephone Switch Replacement



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Infr

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2.2 Maintain and improve a secure, reliable, and cost effective computing infrastructure. Data Center Optimization



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Group


Inte

rnal

Pro

cess

es

4.1 Develop portals to Mayo services that advance a unified view of Mayo’s multi-site organization.

5.1 Establish a Mayo Foundation integrated and coordinated electronic environment for selected applications in collaboration with Administration, Education, Practice, and Research.

5.2 Support the implementation of electronic delivery systems for learner access to curricula.

Cus

tom

er

3.2 Educate Mayo leadership on the potential of current and emerging information technologies to improve system performance.

3.1 Assess new information technologies and implement their appropriate use across the Foundation.

Inno

vatio

n

5.1 Establish a Mayo Foundation integrated and coordinated electronic environment for selected applications in collaboration with Administration, Education, Practice, and Research.

ERP Initiative:

HR & General Ledger

Strategic Planning Outcomes:Lesson LearnedLimit size of the plan in terms of goals and objectives - most organization only have the resources to focus on a limited number of objectivesKeep objectives measurable - facilitates monitoring progress and declaring completion.Don’t word smith the goals and objectives “to death”Spend the extra time and effort to share the plan across the organization - insures buy in and understanding.

Strategic Planning Outcomes:Plan AcceptancePlan was reviewed and endorsed by the Board of Governors of each Mayo entity. Foundation Information Management Technology Committee carries out it’s oversight by monitoring progress on Strategic Objectives.IT funding review and approval process requires proponents to link their projects to Strategic Objectives.Balanced scorecard approach to implementation is being developed.

Summary Points– Need a structure and a timeline– Strategic plan timeframe = 3-5 years– Tactical plan timeframe = 12-18 months– Prioritization of strategic objectives

• 40 in MCR strategic plan; 10 prioritized• 27 in FSH strategic plan; 6 in tactical plan• 12 in Foundation plan; 5 prioritized

– Tie planning cycle to budget cycle– Detailed vision and summary vision– Detailed implications from detailed vision– Detailed implications segue to goals & objectives

Questions

Comments

Discussion

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