Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...
IT Management in Healthcare Organizations: Part 2
1. IT Management
in Healthcare Organizations (2)
นพ.นวนรรน ธีระอัมพรพันธุ์ุ
หลักสูตร Healthcare CIO
ู
โรงเรียนบริหารงานโรงพยาบาล คณะแพทยศาสตร์ รพ.รามาธิบดี
17 ธันวาคม 2553
Except where citing other works
Cited works are copyrighted by their owners and reproduced here under fair use
2. Part
P t2
Moving
M i organizations with IT
i ti ith
- IT Strategy
- Project Management
- Change Management
- Knowledge Management
3. IT As A Strategic Advantage
Sustainable
Yes
competitive
advantage
Yes Inimitable ?
Yes Rare ?
No
Preemptive
Yes Non-Substitutable?
Non Substitutable? No advantage
Competitive
Valuable ? parity
No
Competitive
No necessity
Competitive
Resources/ Disadvantage
capabilities
From a teaching slide by Nelson F. Granados, 2006 at University of Minnesota Carlson School of Management 3
4. 4 Quadrants of Hospital IT
Strategic
Administrative
d st at e Clinical
Operational 4
5. IT & Business
Vision
Business Strategies
IT Strategies Business Operations
IT IT Other
IT Projects
Operations Operations Operations
5
6. Class Exercise: Part 6
Creating IT Strategy
Group discussion: เสนอ 1-2 IT strategies และ IT
p g
projects ที่จะนําพา รพ. ไปสู่ vision ที่ตั้งไว้
11. IT Project Management
• A project: “a temporary endeavor undertaken to
accomplish a unique purpose”
purpose
• Project management: “the application of
knowledge, kill t l d t h i
k l d skills, tools, and techniques t to
p j
project activities in order to meet or exceed
project requirements”
Marchewka (2006) 11
12. The Project Management
Body of Knowledge (PMBOK ®)
1.
1 Project I t ti M
P j t Integration Managementt
2. Project Scope Management
3. Project Time Management
4. Project Cost Management
5. Project Quality Management
6.
6 Project Human Resources Management
7. Project Communications Management
8.
8 Project Risk Management
P j t Ri k M t
9. Project Procurement Management
Marchewka (2006) 12
13. Class Exercise: Part 7
The Importance of Project Management
Group discussion: ถ้าขาด P j t Management
G di i ถาขาด Project M t
ที่เหมาะสม จะเกิดอะไรขึ้นได้บ้างกับ IT Projects?
j
(What can go wrong with the IT projects?)
16. The CHAOS Report
Among the IT projects studied:
• 31% were cancelled before completion
• 53% were completed but over budget, over schedule, and
did not meet original specifications.
The Standish Group (1995) 16
18. New Top Ten Factors for IT Project Success
Rank
R k Success F
S Factor
1 Executive Support
2 User Involvement
3 Experienced Project Manager
4 Clear Business Objectives
5 Minimized Scope
6 Standard Software Infrastructure
7 Firm Basic Requirements
8 Formal Methodology
9 Reliable Estimates
10 Other
Table 1.3 Source: Extreme Chaos. The Standish Group International, Inc. 2001.
http://www.standishgroup.com/sample_research/index.php
Marchewka (2006) 18
28. Measurable Organizational Value (MOV)
• The project’s goal
• Measure of success
• Must be measurable
• Provides value to the organization
• Must be agreed upon
• Must be verifiable at the end of the project
• Guides the project throughout its life cycle
• Should align with the organization’s strategy and goals
Marchewka (2006) 28
30. A Good Project Goal
“Our goal is to land a man on the
moon and return him safely
to the earth by the end of the decade.
to the earth by the end of the decade ”
John F. Kennedy (1961)
Marchewka (2006) 30
31. Metrics: Financial
• Payback Period = Initial Investment
Net Cash Flow
• Breakeven Point = Initial Investment
Net Profit Margin
o g
• Project ROI = (Total Expected Benefits - Total Expected Costs)
Total Expected Costs
Marchewka (2006) 31
32. Metrics: Scoring Method
Criterion Weight
g Alternative A Alternative B Alternative C
ROI 15% 2 4 10
Financial Payback 10% 3 5 10
Net Present Value (NPV) 15% 2 4 10
Alignment with strategic
objectives 10% 3 5 8
Organizational
Likelihood of achieving
project’s MOV 10% 2 6 9
Availability of skilled
team members
team members 5% 5 5 4
Maintainability 5% 4 6 7
Project
Time to develop 5% 5 7 6
Risk 5% 3 5 5
Customer satisfaction 10% 2 4 9
External
Increased market share 10% 2 5 8
Marchewka Total Score 100% 2.65 4.85 8.50
(2006) Notes: Risk scores have a reverse scale – i.e., higher scores for risk imply lower levels of risk 32
53. Project Risk Management
Risk = f(likelihood x impact)
Risk S
Ri k Strategies
i
• Accept/ignore
• Avoid completely
• Reduce risk
likelihood or impact
• Transfer risk to
someone else (e.g.
insurance)
Marchewka (2006) 53
54. Class Exercise: Part 11
Risk Assessment
Group discussion: ระบุ risks สําคัญๆ ที่อาจเกิดขึ้นใน
ระหว่างการดําเนิน IT Project ที่เสนอ และวิธีจดการ
ั
risks เหล่านัน
เหลานน ้
55. Gartner s
Gartner’s Sourcing Life Cycle
Strategic Tactical
Sourcing Strategy Evaluation and Selection
g Alignment g Identification
g Organization assessment g Criteria development
g Core competencies g Organization fit
g Market scan g Selection process
g Make‐or‐buy decisions g Partnership opportunities
g Risk analysis
Sourcing
Contract
Management
Development
g Relationship
g Governance model
g Performance
g Metrics
assessment
g Payment models
g Goals: reach business
objectives, efficiency, g Terms and conditions
q
quality, innovation
y g Provision
g Transition for changes
From a teaching slide by Nelson F. Granados, 2006 55
56. IT Outsourcing Decision Tree
Keep Internal
No
Is external delivery
No reliable and lower cost?
Does service offer Yes OUTSOURCE!
competitive advantage?
titi d t ?
Yes Keep Internal
From a teaching slide by Nelson F. Granados, 2006 56
57. IT Outsourcing Decision Tree:
Ramathibodi’s Case
External delivery unreliable
• Non‐Core HIS,
External delivery higher cost
• ERP maintenance/ongoing
customization
Keep Internal
No
Is external delivery
No reliable and lower cost?
Does service offer Yes OUTSOURCE!
competitive advantage?
titi d t ?
ERP initial
implementation,
Yes Keep Internal
PACS, RIS,
PACS, RIS,
Core HIS, CPOE Departmental
Strategic advantages systems,
• Agility due to local workflow accommodations
Agility due to local workflow accommodations IT Trainingg
• Secondary data utilization (research, QI)
• Roadmap to national leader in informatics
57
58. Gartner Hype Cycle
Image source: Jeremy Kemp via http://en.wikipedia.org/wiki/Hype_cycle
http://www.gartner.com/technology/research/methodologies/hype-cycle.jsp 58
60. Class Exercise: Part 12
Change Management
Group discussion: เสนอวิธีบริหารการเปลี่ยนแปลง
ใน user แต่ละกลุ่มใน Rogers’ Adoption Curve
61. Unified Theory of Acceptance and Use
of Technology (UTAUT)
Performance
Usefulness Expectancy
p y
Effort
Ease of Use Expectancy
Behavioral
B h i l Use
Intention Behavior
Social Norm Social
& Opinions
p Influence
Facilitating
IT Support Conditions
Voluntariness
Gender Age Experience
of Use
Venkatesh et al. (2003) 61
62. Adoption Strategies:
“The Tipping Point” Version
The Three Rules of Epidemics
• The Law of the Few Change Agents
Change Agents
– Connectors Opinion Leaders
– Mavens Super‐Users
– Salesmen Champions
• The Stickiness Factor Ease of Use
• The Power of Context Social Norm
& Opinions
p
IT Support
Gladwell (2000)
62
63. Factors Related to Hospital IT Adoption
• Communications of project plans & progresses
• Workflow considerations
• Management support of IT projects
• Common visions
• Shared commitment
• Multidisciplinary user involvement
• Project management
• Training
• Innovativeness
• Organizational learning
Theera-Ampornpunt (2009) [Unpublished] 63
65. Class Exercise: Part 13
Change M
Ch Management t
Class discussion: จะทําอย่างไรเมือเกิดเหตุการณ์ต่อไ ้
ไ ่ ไปนี
- แพทย์ 1 ใน 3 ไม่ใช้ IT ที่เพิ่ง go-live
แ ย ไมใช go l e
- พยาบาล by-pass บางกระบวนการ กลับไปใช้ manual
- ผู้ป่วยรอตรวจเป็นเวลานาน จํานวนมาก ในสัปดาห์แรก
็ ใ ์
- หลังใช้งานได้ 8 weeks สถิติ preventable ADRs สงกว่าก่อนใช้ระบบ
p ู
- ทีประชุม CLT/PCT หลัง go-live 2 weeks มีการโต้แย้งอย่างกว้างขวาง
่
และรุนแรงเกยวกบความรบผดชอบของแตละวชาชพ
ร ร ี่ ั รั ิ ช ่ ช ชี
ิ
66. The KM Aspect of Project Management
Nonaka SECI Model
After Action
During Review (AAR) /
Implementation, Postmortem
Near Go-Live &
Go Live Meeting,
Meeting
Post Go-Live Project Evaluation
During
D i Before & After
Implementation, Project Kick-off,
Near Go-Live During Project
Training Planning
Image source: Senoo et al. (2007) http://dx.doi.org/10.1108/14601060710776725 66