Anticlue

Priorization: The art of choosing what not to do

Let's take a couple of moments discussing how budget and resource capacity drives the need for a prioritization and selection process for IT project request. Over the years, IT has been viewed as a utility in some hospital environments, even has a logistics group. The problem is that there is simply not a backup generator to switch over for power, when there is an IT event. The response time for your disaster depends several factors. IT is the coordination of multiple pieces parts from the department's workflow to the wireless network. We are in a state of high interdependence.

This level of high interdependence causes simplistic requests at time to have the coordination of several individuals. For example, let's say we have an upgrade to an existing system. One way to do the upgrade is to just apply it to the production environment and hope for the best. Most professionals are now feeling that disconcerting shiver run up and down their spine. The common practice is to do the following.

1. Establish a test system which is a mirror of production.
2. Apply the upgrade
3. Test the upgrade for functionality, integration, data migration, and regression testing. I'd also recommend load testing.
4. Prepare the deployment package for the client deployment.
5. Train on new features/functions
6. Schedule Deployment
7. Deploy
8. Support / Resolve Issues
9. Move to production support.

Now within these steps, resources from client server, integration, desktop, and all impacted integration parts are needed along with the analyst responsible for the application. This simple upgrade has now become a 120 - 160 hour project. This project is operation keep the lights running work, necessary to keep operations current.

Add in a couple of items around procuring and installing equipment, redesigning workflow, and other testing components, and the project has increased in effort and duration. So if you have several departments or expansion, the truth is there aren't enough resources to support all requests. In a hospital setting, the demand for IT services always over exceeds the supply available.

One can definitely reprioritize the work efforts, and focus on the strategic must do activities at the cost of the operational duties. One item becomes lighter, the other item becomes fragile. The fragility equates into unexpected outages or poor service for needed operational support. Needless to say the tightline is tough to walk.

In order to resolve these obstacles, healthcare organizations need to change their tactic in the future. Strategic endeavors should be resourced with people and funding as a part of the investment capital request. Secondly a resource management plan should be in place looking at the current resource utilization, and the upcoming demand. Finally, capital commitments, should include continuing withdrawals when equipment is now at EOL. For example, the OR equipment should look to have an end of life and that a prior capital commitment to bring in the new replacement, versus competing in the capital allocations versus other strategic items. A key to success is establishing programs for the long haul as your key strategic enabler and then continuing to invest within the program as such with equipment and operational support resources as the benefits continue to be realized. Additionally along with the capital governance is the governance of the IT investments decided upon by senior leadership.