Health care is changing rapidly and the role of the chief information officer (CIO) as we knew it is over. IT is becoming central to healthcare delivery and the focus is now on prevention and continuity of care, rather than treating individual health episodes.
In the Middle East, there are added pressures, such as the higher incidence of lifestyle-related illnesses such as diabetes and heart disease, patient demands for better quality care, and an uneven distribution of expert resources. The challenge facing CIOs is defining the role they need to play as active participants in improving patient care and reducing costs.
Today, hospital CIOs are already responding by abandoning their traditional role of order-takers fulfilling requests for clinical and business operations. They are instead becoming strategic enablers of the hospital enterprise. This means becoming innovators and entrepreneurs who exploit IT to improve their hospital's financial and operational performance and patient care.
This new responsibility does not come easily. To fulfil this new role, CIOs have to abandon their previous reactive mindset and start thinking strategically. A laundry list of capital projects is not enough any more.
They now have to propose a comprehensive IT strategy that will ultimately deliver improved health outcomes while confronting the particular difficulties of upgrading hospital IT.
This is a complex endeavour, as hospitals have legacy systems and switching costs can be excessive. In addition, regulations, laws and guidelines from external stakeholders, such as governments and regulatory agencies, are changing, creating new demands for patient privacy and the retention of health records.
CIOs need to start thinking early about this transformation. This is when the foundations are laid for a process that will last many years and encounter multiple obstacles. This is when mistakes which affect delivery and the budget are more easily avoided.
The CIO can use the strategy formulation process to muster support from the hospital board and other colleagues, to identify the resources needed for the transformation and provide objectives that are clear and easy to measure.
We have seen the best CIOs use five key principles known as "Boost" when putting together their strategy. These determine the Baseline; align with business Operations; build up Organisational capability; create a Strategic implementation office; and Track costs during and after implementation.
Effective CIOs evaluate the current baseline of IT capabilities in the whole organisation from the perspective of technology, organisation, processes and governance. This allows them to decide which systems require correcting and which demand complete change. Attention has to be paid to anything that prevents a close alignment between business and clinical requirements. For example, electronic medical records, laboratory information systems (that enable the communication of blood test results), and picture archiving and communications systems (for medical imaging) are often difficult to integrate.
The CIO then aligns with business operations to ensure the IT strategy meets business users' needs as well as those of clinical users. This keeps the IT transformation in line with the hospital's operating strategy. It also avoids the unnecessary costs of buying the best available IT solutions for different business users. Instead, by understanding actual user requirements, the CIO can customise and reconfigure off-the-shelf software, which is cheaper than the "made to measure" approach.
The next part of the Boost approach involves building up the organisational capabilities that allow business and clinical users to handle the changes wrought by IT transformation. Without this, transformations can fail because of over-reliance on technology and insufficient consideration of the impact that IT changes have on an organisation, the operating model, and business processes.
The CIO also needs a strong governance mechanism that keeps the IT transformation intact and on track. The mechanism should be a strategic implementation office that thinks holistically about IT issues and has strong functional expertise. In particular, the office defines principles of IT design so that the many software solutions used in the hospital will work together.
The final element of Boost is to track costs and budget so that the hospital board is fully aware of the financial commitment of an IT transformation. The cost of IT changes goes beyond procuring technology, it also includes the equally costly system design and implementation phases. Understanding these costs allows a hospital board to prioritise IT projects by business need.
A well-defined strategy, crafted by the CIO in coordination with clinicians and administrators and consistent with the hospital's medical and business goals, will deliver improved health outcomes. Technology is important, but strategy makes all the difference.
Ramez Shehadi, partner, Dr Walid Tohme, principal, Jad Bitar, principal, and Emile Salhab, senior associate at Booz & Company
