Anticlue

Grading Healthcare IT organizations

In this month’s hfm, there is a good article for viewing how your IT department stacks up. In my opinion, the article does a great job of evaluating an IT’s department performance based upon organizational investment, organizational perception, fact based offerings, organizational planning, staffing, and organizational policies.

The article breaks the report card into six possible grades.

The first criterion examined is cost. Cost of the IT department is defined as percentage of the operating budget dedicated to IT. A side note is that operating expenses exclude capital expenditures. This means that the new PACS system acquisition cost is not included as a part of the operating budget of IT. And since capital expenditures are excluded, it also makes sense to exclude depreciation of capital expenditures as the study does.

So the grading as a percentage of total operating costs is as follows:

The next criterion reviewed is staffing. Staffing is examined based on the number of FTEs in IT per 100 adjusted occupied beds, AOB. The adjusted calculation includes the acute care, outpatient, and non-acute modalities. The type of system processing is also reviewed. There are four categories of system processing allowed, remote, in-house servers, in-house mainframes, or all of the above.

In order to grade your IT organization on staffing per 100 AOB follow the chart below:

The next grade is passed upon User Satisfaction. The survey is a mechanism to rate IT by the customers of the organization. A good approach by the article is to ensure that the clinical and financial customers are included.

The user satisfaction grading is as follows:

The next criterion was very interesting. The IT organization is grated upon Physician-friendly features and capabilities offered by the clinical systems. The features included are:

• Patient “rounding” census reports
• Graphs of patient test results
• Highlighting of abnormals
• Computerized Physician Order Entry
• Personalized Order Sets
• Knowledge searches, as an online physicians desk reference.
• Medical Alerts and reminders
• Intranet for physician policies and memos
• Face sheet retrieval for physician billing
• Support from a dedicated physician informaticist in IT.

So count the number of features offered to a physician, and grade based on count.

IT governance is also a category for grading. The grade is based upon how many of the following governance structures an IT organization has:

• To whom does IT report? Is there a position overseeing IT means a positive answer and a count of this criteria. If individual departments have siloed IT support, then this evaluation is not included in the count.
• Is an IT steering committee in place?
• Does that steering committee meet on a scheduled basis?

If you have a CIO in place with a steering committee that never meets, the IT governance count is 2.

So the governance policy grading is based on the answers:

Finally the IT strategic plan is graded based on the following criteria:

• The plan is current and has provisions for updating.
• The plan is well thought through, includes capital and operating budget, new developments within the industry, the staffing requirements and implications of staffing changes, a computer “refresh policy”, and the tactical initiatives for one to two years.
• The plan should be including executive and customer input. In other words, not written in a vacuum in IT.
• Most importantly the plan should be directly corresponding to the organization’s business plan with support of the organizations goals.

So grade the strategic plan based on the number of criteria being met

With the investment in healthcare IT, I think this grading mechanism gives an organization a good sense of their starting point, and maybe even a future state of where they want to go.