Strategic Planning for Healthcare IT, Part I

Strategic planning efforts are challenging, especially in Healthcare IT, given the continuously changing environment.  Because of this, it is all too common for organizations to forgo a strategic planning exercise, maintain (or reduce) current budget levels year over year, and struggle to keep up with the next high priority request.  A significant challenge with this approach is that every request is a high priority and there are limited hours, resources, and dollars available to meet those requests.  All too often, stakeholders become discouraged and only focus on the fact that their high priority request is not getting done.

If this sounds familiar, you are not alone!  SEI recently helped a major healthcare provider to define, implement, and execute a strategic planning process.  The strategic planning process involved five phases:

1. Selection of a framework (e.g. HIMSS EMRAM Stage 7)
2. Definition of the current state in terms of selected framework
3. Definition of future state
4. Identification of gaps between current and future states
5. Definition of roadmap

This is part 1 of a 2-part series that describes the strategic planning effort.  Part 1 addresses the selection of a framework and the definition of the current state.  Part 2 will describe the future state definition, gap identification, and roadmap.

Selection of a Framework

The Healthcare Information and Management Systems Society (HIMSS) has an Electronic Medical Record Adoption Model (EMRAM) that provided an excellent starting point for defining current state.  The HIMSS EMRAM is an eight stage (0-7) model (or pathway) to realizing a fully electronic medical record system and achieving greater interoperability.  An initial unofficial assessment put the client at Stage 5/6 so we leveraged Stage 7 criteria for the framework.  Stage 7 criteria included the following areas:

1. Clinical Documentation
2. Computerized Provider Order Entry
3. Clinical Decision Support
4. Bar Code Enablement
5. Physician Documentation
6. Pharmacy
7. Clinical and Business Intelligence
8. Health Information Exchange
9. Disaster Recovery and Business Continuity
10. Blood Bank
11. Radiology Information Systems
12. PACS Review
13. Health Information Management
14. Governance

As of mid-2015, less than 4% of U.S. hospitals were assessed at Stage 7.  SEI’s primary effort was to use the Stage 7 EMRAM criteria to accomplish the following:

1. Facilitate good discussions
2. Connect the dots
3. Get people talking about the right things for the organization

Definition of Current State in Terms of Selected Framework

There is always the tendency to want to move quickly and get to the desired end state.  However, our client, like most major healthcare organizations, needed to first agree on their current state.  SEI facilitated discussions of the detailed EMRAM Stage 7 criteria with cross-functional leaders and assessed each criteria as follows:

1. Already live throughout the organization
2. Already live in parts of the organization
3. In progress but not yet live
4. Planned but not yet in progress
5. Not currently planned

SEI socialized the current state document with participants for review and they were able to comment and update it as necessary.  This process resulted with all participants agreeing on the current state.  Gaining consensus cemented a common understanding of where the organization is and provided a solid foundation for discussing the desired future state the organization wanted to achieve.

Once the organization agreed upon the current state and realized they had a voice in defining a formal future state, the real fun began.  Stay tuned for part 2 of this series that will address defining the future state, identifying the gaps, and determining the roadmap!