What Enables an IT Organization to be Agile?
Years ago, healthcare organizations would develop five-year strategies and have reasonable assurance that those strategies would be viable over that period of time. The pace of change makes such long term strategies less tenable (and possibly delusional). The pace of change does not eliminate the need for strategies, but it does place a premium on agility.
An agile IT organization has means to sense changes in the environment, triage important from spurious signals, alter strategies to respond to new opportunities, and redirect resources to carry out its new plans.
There are six major steps that can be taken to improve agility.
The choice of new applications often centers on features and functions. However, those who are selecting a new application should pay equal attention to the capabilities the application has for desired changes. Is it easy to interface or integrate with other applications? Are there robust approaches that allow the organization to develop custom software that extends the application?
Rather than waiting 18 months for the organization to see the first fruits of its application implementation labors, efforts should be made to deliver a sequence of smaller implementations. Pilots, staged rollouts, or the implementation of a portion of the application are not always doable. However they enable the organization to shift resources after a specific, smaller implementation phase rather than waiting until a lengthy implementation has been completed.
Staged release of capital and new IT positions
The capital and operating budget process can result in a form of “carved in stone” commitment of resources to specific projects. In contrast, the organization can make an overall IT budget commitment based on an expected set of initiatives. However, the leadership can release that commitment quarterly following an assessment of any needed changes in direction. In effect, there is an annual authorization of the budget, but a quarterly appropriation of the capital and operating budgets.
Cross trained IT staff
Some IT staff positions require deep expertise and it is not realistic to expect that those staff are interchangeable with other expertise-based IT staff. However, there are several IT positions that have characteristics that enable some degree of interchangeability. For example, good project managers can handle financial systems and clinical systems projects. These staff can be cross-trained or cross-exposed to different applications. This cross training can enable these staff to be applied to a reasonable range of projects.
On one hand, standards would appear to constrain agility. They narrow the field of choices for an organization. On the other hand, standards improve agility. In the absence of standards, organizations often make significant investments in attempting to integrate technologies that were never designed to be integrated. The result can be an increase in IT costs (which reduces agility since the financial resources available for other initiatives are smaller) and make applications and infrastructure difficult to change (which hinders agility) because of integration complexity.
IT agility requires that the IT leadership and organization understand the organization’s strategies, challenges, and priorities. With this understanding, the IT organization is in a position to effectively engage in discussions of IT alternatives and approaches.
Related to alignment are the processes the organization uses to make decisions. Governance structures that are fuzzy, opaque, and unsupported hinder agility. Decisions can take forever and run an unacceptable risk of being poorly embraced.
Achieving agility will require tradeoffs with other organizational properties and goals. It’s hard to be agile and efficient. However, agility may be more important than other properties such as efficiency, customer service oriented, or brilliance at project execution.
John Glaser is vice president and CIO at Partners HealthCare System. He describes himself as an "irregular regular contributor" to HIStalk.