Friday, February 27, 2009

4 Steps to IT Alignment

Check out Hank Marquis' presentation, 4 Steps to IT Alignment, on managing IT operations based on business value to help address four of the perennial top 10 IT management goals:
  1. Aligning with the business
  2. Controlling costs
  3. Improving quality
  4. Balancing resource allocation
Business Services Management (BSM) is a term used to focus IT Service Management (ITSM) initiatives on business value. "BSM is a mindset not a product set" according to Peter Armstrong, BMC, the man who is attributed to inventing the term. I like the term BSM because of its business orientation, which is a key aspect of the approach outlined in this presentation.

Hank's recommended approach is:
  1. Define the customer facing services with the customer, in customer terms, the supporting resource facing services, and understand the business case for each service (Hank refers to the SID/eTOM model)
  2. Get the customer to value and prioritise the (customer facing) services in terms of risk to the business, taking into account confidentiality, integrity and availability (refers to CRAMM)
  3. Measure service quality starting with the most important service (refers to SERVQUAL)
  4. Justify projects in terms the business understand and follow best practice.
Keep in mind the term "IT alignment" in this presentation is about aligning IT services with business needs. This presentation is not about aligning IT strategy with business strategy or about aligning the portfolio of IT-enabled investments with business and IT goals and the business's role in this, so this approach alone is not sufficient to achieve alignment of the whole IT portfolio, but it is a good approach for getting your ITSM initiatives in tune with the business.

Saturday, February 21, 2009

District Health Board software push

I read with interest an article in New Zealand's Computerworld about the NZ Health IT Cluster’s questioning of a Request For Information (RFI) issued by seven District Health Boards (DHBs) for a single patient management system and citing the challenged NHS NPfIT project as a reason to be cautious of this approach.

A point overlooked in this debate is the role of effective governance in the health sector. The article points out that there has been a failure to achieve interoperability through architectural standards, that the RFI is pre-empting the update of the national health IT strategy, and that a single IT system is already deemed to be the only solution– these are significant governance issues. What is going to be done differently to ensure that health sector, or even the DHB collective’s, IT-enabled initiatives will be successful in creating (and not eroding) ongoing value?

Reading the background on the RFI, it is very clear that the health boards place an emphasis on an IT solution, rather than how IT will be used, to deliver benefits. In the absence of sound governance, will anyone even be held accountable for realizing the claimed benefits? Experience and research has proved time and time again that technology is only part of the equation and that desired outcomes can only be achieved with full consideration of the required changes to the business model, business processes, organisational structures and culture, the way people work, and the involvement and commitment of all stakeholders. These are the areas where DHB collaboration must occur and it must be addressed as part of a whole programme of change within a structured and integrated governance framework.


Typically IT drives these initiatives when the clinicians won’t and that should be seen as a red flag — just as it was for the ill-conceived NHS NPfIT project. IT has the potential to improve health care but IT alone will not solve the problem of adoption. A survey found that only 62% of doctors think NPfIT will improve patient care and only 20% of consultants had a card to use electronic records. A US survey of physicians' adoption of outpatient electronic health records found only 13% adoption rates. How can the claimed benefits be achieved given these adoption rates?

Research by the IT Governance Institute is very clear on how organisations successfully create value from investments in IT-enabled change – there is:

  • Strategic, leadership-sponsored commitment to IT governance—to align IT decisions with business objectives and to monitor performance with clear accountability for achieving benefits
  • Recognition that IT is not just about implementing technology—it is about unlocking IT-enabled business change
  • A structured approach to the governance of IT-enabled investments, based on proven practices for doing the right things, the right way, getting them done well and getting the benefits.