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DOI: 10.1055/s-0042-1749194
IT Department Demand Governance in Health Care: Reflections on a Case Series
Abstract
Background Little is written on how best to structure IT governance in health care organizations. Governance is challenging because these groups may contain administrators, clinicians, and staff in addition to IT employees; projects may be complex and have significant impact on the teams that provide patient care.
Methods Peer organizations in health care were purposefully selected and C-suite executives were interviewed about their IT governance. Notes taken from these conversations were analyzed for guiding principles.
Results We interviewed leaders from five peer organizations. Consensus principles included: (1) minimize unwarranted variation; (2) evolve governance with the organization but independently of projects; (3) govern all clinical applications; (4) be flexible with intake, yet clear on decision-making; (5) have a tiered approach to governance; and (6) be multidisciplinary. Emerging principles included: (1) assign an IT business relationship manager to each high priority initiative, (2) have a clear escalation path to a small number of decision-makers, (3) include analytics to inform governance, (4) leverage Informatics expertise, and (5) use structured tools to streamline the process.
Conclusion While IT governance is very different across distinct health care organizations, there are some general principles that many share.
Note
Copies of the notes from our interviews and organizational charts/other materials supplied to the authors are available upon request, pending permission from the participating organizations. Supplementary Appendixes B-D (available in the online version) include information that three organizations have allowed to be released.
Protection of Human and Animal Subjects
We are advised that the study does not meet the regulatory definition of research, as its initial intention was a quality improvement project, and the data obtained were not intended to be broadly generalizable.
b Since this interview was performed, Intermountain Healthcare changed from a regional structure to an enterprise-wide structure with two primary groups: Community-Based Care focused on wellness and primary care; and Specialty-Based Care focused on specialty and hospital inpatient care. The IT governance has evolved to reflect this change.
c Since this interview, Intermountain has integrated Business Relationship Managers as facilitators of governance processes.
d Since this interview, physician participation in IT governance has become part of the responsibility of physician leaders who are compensated for their leadership role.
Publication History
Received: 14 April 2020
Accepted: 03 February 2022
Article published online:
13 June 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
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