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Leadership: The CIO

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Too much knowledge required for any one person. Managing and coordinating the content experts ... Y2K and HIPAA took over for a while. 4 levels of interoperability ... – PowerPoint PPT presentation

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Title: Leadership: The CIO


1
Leadership The CIO
  • HSPM J713

2
Chief Information Officer
  • This chapter was at end of 6th edition
  • Learning objectives
  • Job duties and responsibilities of CIO and CEO
    and other leaders
  • Key knowledge, skills, abilities that CIO must
    have
  • Various paths to becoming CIO
  • Organizational chart for HIT
  • Future challenges to CIO

3
Chief Information Officer
  • Leadership
  • Human resources
  • Management expertise
  • Not just running things, but also planning for
    future.
  • transitioning

4
Leadership and management
  • Too much required knowledge for any one person
  • Managing and coordinating the content experts

5
CFO and CIO
  • Years ago, the chief financial officer was chief
    information officer
  • Reflects ITs start in handling
  • Payroll
  • Accounts payable and receivable
  • Communication with payers
  • All involve money flows

6
CIO as separate job
  • New requirements beyond money control
  • Clinical information systems
  • Regulatory compliance
  • Strategic planning and decision support

7
Successful organizations do this with IT
  • Actively design governance
  • Know when to redesign
  • Involve senior managers
  • Make choices
  • Have an exception-handling process

8
Successful organizations do this with IT
  • Provide right incentives
  • Establish ownership and accountability
  • Design governance at multiple levels in the
    organization
  • Transparency and education
  • Implement common mechanisms across the six key
    assets

9
Successful organizations do this with IT
  • Actively design governance
  • Focus on goals and objectives of the
    organization, not just the IT dept.s operations

10
Successful organizations do this with IT
  • Know when to redesign
  • CIO must design procedures for reviewing what IT
    does
  • Involves teamwork outside of IT
  • Lead the review

11
Successful organizations do this with IT
  • Involve senior managers
  • Bring senior management into technology decisions
  • Bring, to senior management, technology decisions
    with strategic implications

12
Successful organizations do this with IT
  • Provide right incentives
  • Establish ownership and accountability
  • Encourage a broad view of the organization,
  • Not turf protection

13
CIOs functional responsibilities
  • Reports directly to the CEO
  • Enterprise planning
  • Leadership
  • Management oversight
  • Human resources
  • Financial management

14
CIO responsibilities
  • Careful planning process
  • Master plan
  • updated annually
  • Linked to organizations strategic plan

15
CIO responsibilities
  • User-driven focus
  • Active involvement of personnel at all levels
  • In choosing technology
  • Designing installation and transition
  • Operation
  • Evaluation

16
CIO responsibilities
  • Recruiting
  • Competent personnel
  • Vendor selection

17
CIO responsibilities
  • Integration / interoperability of
  • Data files
  • Interfaces
  • Especially tricky for complex organizations with
    subsidiaries
  • The prospects for interoperability must be
    considered for any proposed acquisition.

18
CIO responsibilities
  • Assure that legal and ethical obligations are met
  • Confidentiality
  • Patients
  • Medical staff
  • employees

19
CIO responsibilities for new projects
  • Establish interdisciplinary teams to design new
    systems
  • Systems analysts and computer programmers fit in
    here
  • CIO doesnt have to have their expertise, but has
    to be able to understand them
  • User-driven focus rather than technology-driven
    focus

20
CIO responsibilities for new projects
  • Careful systems analysis must precede
    implementation
  • Preliminary design specifications for technology
    applications must fit with master plan
  • Lay out all details before implementation starts

21
CIO responsibilities for new projects
  • Careful scheduling of all activities
  • Periodic progress reports
  • Plan for training of personnel on new system

22
CIO responsibilities for new projects
  • Always test system before going live
  • Test must be comprehensive
  • Software and procedures
  • Personnel training
  • User reaction
  • Effectiveness at meeting stated objectives
  • Cost in practice compared with initial projections

23
CIO responsibilities for new projects
  • Maintenance
  • Must be planned for

24
CIO responsibilities for new projects
  • Audits and formal evaluations

25
What makes a successful CIO
  • Skills in
  • Business
  • Clinical processes
  • Leadership
  • Administration
  • Communication
  • technical savvy downplayed? Or is this
    reacting to past tendency to promote a geek to
    CIO?

26
What makes a successful CIO in practice
(well-regarded within organization)
  • Business basics
  • Getting things done on time and on budget
  • Involvement in broader goals less often cited
  • Successful CIOs have active support and
    involvement of CEO.
  • Work experience in health care IT cited
  • geek with management training and experience?
  • Clinical experience less often found

27
Organization of IT department
  • This book advocates that the CIO should report to
    the CEO directly
  • Broadening responsibilities, centrality of IT
  • A survey finds, however, that only 37 of CIOs
    report to CEOs.
  • 38 report to CFOs (reflecting old IT focus)
  • 25 report to COO, chief medical officer, or other

28
Organization of IT department depends on
  • Centralization/decentralization of computer
    systems
  • Book seems to advocate centralization for
    interoperability
  • Systems developed in-house vs. purchased software
    or systems developed by outside application
    service providers
  • In-house vs. outsourced functions

29
IT organizational chart
30
IT organizational chart
  • In large organizations, each block is a manager
    with staff
  • In small organizations, each block may be one
    person. One person may share functions.

31
Info Systems Operations functions
  • Systems
  • Maintenance
  • Analysis
  • Programming
  • Software evaluation
  • User support
  • Operations
  • Computer
  • Network
  • Data preparation

32
IT organization
  • In many organizations, IT people lower in the
    organization chart report to clinical departments
    rather than, or in addition to, up the ladder to
    the CIO.
  • Thats how USC operates
  • Complicates leadership role of CIO
  • Departmental decisions affect the whole
  • But the responsibility is local

33
Staffing the IT department
  • Taking qualifications seriously. For example,
    the head of health information management should
    be experienced and certified http//www.ahima.org/
    certification/
  • With broad knowledge of information flow and
    electronic health records

34
Professional personnel
  • Systems analysts
  • Tech knowledge
  • Must be able to deal with people
  • Human-machine interaction
  • Computer programmers
  • More technically focussed
  • Shifting from mainframe to networks with
    distributed computing
  • Highly creative processes

35
Technical personnel
  • Technical leadership
  • Up on latest technical developments
  • Financial manager
  • Interpersonal relationships
  • Professional and technical staff have grown and
    are expected to grow more

36
Budgeting and IT
  • Direct spending 2.5 of budget, typically
  • But impact is much broader
  • Labor costs table of 2006 typical salaries
  • CIO 150,000
  • Info Sys director 104,000
  • Systems analyst 63,000
  • Help desk operator 46,000

37
Outsourcing vs. in-house
  • When you read those requirements for personnel
    and expected salaries, staffing that IT
    organizational chart can look daunting.
  • Buy better than Make?

38
Benefits of outsourcing
  • Less in-house staff
  • Less in-house capital equipment investment
  • More flexibility as requirements and technology
    change
  • Youre not stuck with old stuff
  • Faster to get a solution thats already developed
  • Predictable costs

39
Dangers of outsourcing
  • Dependent on vendor, who may go broke or make
    changes to meet other market demands
  • Vendors can charge
  • Especially once your business model depends on
    them
  • Contractors not intimately familiar with your
    organization

40
One authors suggestions
  • Seek long-term commitment from vendor
  • But there goes your flexibility
  • Require relevant experience
  • Develop performance measures
  • In general, outsourcing is more manageable if
    the product is well-specified.
  • Dont jump at the low bid.

41
Accounts receivable as candidate for outsourcing
  • Outsourcing doesnt reduce costs, but outsources
    are more ruthless and more consistent at
    collecting
  • Collecting is outsourcers business, so they have
    more specialized expertise
  • Collecting is outsourcers business, so they have
    more appropriate technology
  • You can focus on health services, rather than
    bill collecting

42
Outsourcing example
  • Jefferson Regional Medical Center (Pittsburgh)
    and Siemens Medical Solutions
  • Billing and clinical support
  • Worked with functional departments as an in-house
    IT operation would
  • PDAs for physicians
  • Technology changing fast

43
Outsourcing survey
  • gt30 outsourced
  • Web site
  • Dictation and transcription
  • lt20 outsourced
  • Project management
  • Help desk
  • Database management
  • telecommunications

44
Near-term issues for CIOs
  • Low hospital budgets for IT
  • Particularly regarding electronic medical records
    and clinical applications
  • Need to argue for increased budgets based on
  • Accountability measures that need to be designed
    and implemented

45
Near-term issues for CIOs
  • Changing technologies
  • Radio identification (RF) replacing bar codes
  • smart phones replacing PDAs

46
Near-term issues for CIOs
  • Interoperability
  • Standardization, driven by national policy, is
    coming.
  • Confusion meantime, because we can only guess
    what the standard will be

47
Near-term issues for CIOs
  • Ambulatory settings
  • Integration of electronic medical records

48
The CIO in the organization
  • CIOs do not directly use technical skills, but
    probably need technical skills to go up the
    ladder.

49
The CIO in the organization
  • Up
  • Relations with CEO and Board of Directors
  • Horizontal
  • Relations with Chief Financial Officer, Chief
    Medical Officer, head of nursing
  • Internal
  • Management of the IT unit

50
The CIO in the organization
  • Responsibility shifting back to CFO because of
    Sarbanes-Oxley reporting requirements?

51
Near-term application development
  • Reduction of medical errors and enhancing patient
    safety
  • Computerized physician order entry
  • Computer-based records
  • Patient-provider communications
  • Information
  • Monitoring systems for patients at home
  • New national priorities
  • Y2K and HIPAA took over for a while

52
4 levels of interoperability
  • Data not in electronic form (must be read or
    spoken)
  • Word-processor data (must be read by people)
  • Data files with incompatible formats (require
    conversion that never works 100 automatically)
  • Data files with different formats (require
    translation)

53
Other coming challenges
  • Security
  • Breaches and leaks
  • Regional information exchange
  • With public agencies and other providers
  • Web-based applications
  • Outsourcing

54
Big points
  • The CIO position has evolved into a top executive
    position
  • Broad organizational skills required
  • IT has broadened in its reach. Internal and
    external pressures increase ITs role.
  • CIO must work up, horizontally, and internally
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