Health care is undergoing a transformation in how care is delivered, measured, reimbursed, and coordinated. This transformation influences the way health care systems operate internally, coordinate with external parties, and ultimately uphold their mission for delivering care to the population they serve.

Clients often ask us, "How do I make sense of everything? Where should I be focusing my efforts?" These questions are sometimes asked with a look of anxiety. From our perspective, this time in health care can either be an exciting opportunity to improve your organization and deliver better care or a stress-inducing period of feeling like you're barely treading water. The difference between the two is usually whether you feel in control of the situation or at its mercy.

We thought it would be helpful to share our thoughts on how to gain control over the IT initiatives your organization is facing so that you find yourself in the former camp and not the later. The starting point in taking control is to organize, strategize, and prioritize.

Our intention in this post is to provide a framework for you to consider as you organize your own priorities. In follow-up posts, we will examine each of the following seven categories in greater depth.

Seven categories to consider when setting priorities

  1. Care delivery – Your ultimate mission is to provide care to the population you serve. Technology initiatives such as electronic health records (EHR), patient portals, and mobile devices should support this mission. Ask yourself: "How does this help us to deliver care?"
  2. Compliance – The effort needed to keep up with compliance requirements continues to increase. The financial and reputation hits of an event of non-compliance can be significant. Every organization is working to comply with HIPAA, ICD-10, the Affordable Care Act, and so on. Ask yourself: "What is our organizational risk? Who does this category keep up at night at our organization?"
  3. IT security – Security is ever changing, threats evolve from many directions, and the number of technology users at your organization grows every year. Whether it is the bring your own device (BYOD) efforts of your providers, an initiative to provide Internet access to patients and families, or the fact that every clinician and staff member is now using a computer as part of day-to-day operations, IT security presents an increasing challenge. Ask yourself: "What risk-tolerance level does our organization have, and how do we balance what our staff wants with the risks that technology brings?"
  4. Efficiency – The pressure to operate more efficiently comes from both internal and external sources. Whether it is payers shifting their focus to cost-effective and quality-driven reimbursement or doctors' frustration regarding too many mouse clicks in the EHR, you're being driven to examine and optimize your business processes and clinical workflow. Ask yourself: "What are the non-value-added steps in our operations, and how do we identify and measure our efficiency and performance?"
  5. Business continuity and IT operations – People are working harder, the 9-to-5 day is a relic, and patients in many care settings receive 24 by 7 care. With the use of paper-based charts shrinking and the increase in EHR adoption, the need for robust disaster recovery and business continuity practices becomes ever more important. This category is not the sexiest of IT efforts and often the easiest to put off to next year. Ask yourself: "How long would we be down if we lost our servers, and how would that impact our care for our patients?"
  6. Data and performance measurement – Much of the focus right now is to implement EHR systems, comply with ICD-10, and design the front end of how clinicians chart patient data. However, trailing those efforts is a much more exciting component to the transformation in health care—data and performance measurement. Access to data can enable your organization to examine the quality of your care at a population level or a granular level. It enables you to look for trends, identify weaknesses, and undertake measurable process improvement efforts. Ask yourself: "What are our top five hunches on areas of care we could improve?" How can you turn a hunch into a measureable process improvement initiative?
  7. People, roles, and skills – Roles and skills required are changing. As clichéd as this is, getting the right people in the right roles is a key element to implementing projects. Teamwork between clinicians, IT, and leadership remains critical for success. We see an increased focus on clinical analysis and informatics. Ask yourself: "For critical projects, do we have the right people on the team to both understand the needs of the end users and also communicate why the initiative is important?"

It will continue to feel daunting, pressures will continue to increase, and new priorities will arise. However, if you keep a disciplined approach, organize efforts into categories that support your overall mission, and keep focused, the transformation will be manageable. We hope this framework provides a starting point to develop a comprehensive IT plan that works for your organization.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.