Part B - Information Systems and Information Technology Solutions

B.4.7. Requirements for a Successful Health Services

Information Systems Implementation
Health services institutions, when considering the implementation of information systems, must
consider a number of system-wide implementation factors that cross application boundaries. These
include:

Organization mission, strategies, and scope of services

Who are the customers and the targeted population

Value of health and healthcare to the individual and community

Current ways to assess individual and collective health problems (community health)

Needs of the individual, community, and nation

Institutional user needs and commitments

Organization competencies.

By analyzing the strengths and weaknesses of the organization, the implementation team can
determine the organization's core objectives, clients, and competencies in terms both of health
service provision and information capabilities. The following areas must be closely examined:
Organization governance is the collection of rules and policies that control the organization operation.
It is linked to the social, economic, political, and legal ownership choices made by the organization.
The governance choices are directly related to the scope and competencies. It involves:

Organization Structure

Administrative Infrastructure and management structure, roles, responsibilities, and authority

required to execute the defined business strategy

Should the organization be centralized, with minimal authority and responsibility delegated to
the local level?

Organization Processes

Which of the organization's processes are going to be affected?

Employee Skills

What are the new skills required to satisfy the organization strategy and structure?

Part B - Information Systems and Information Technology Solutions

Can the existing employees be trained to perform the new activities?

Information Technology Strategy involves determining which information technology the organization
needs to best support its organizational strategy:

Does the organization require more IT to make it productive and effective?

Does the organization have to significantly enhance the employees' skills?

Can the organization use the existing IT to enhance its scope of business or competencies?

How can IT be used to improve the organization processes?

Should the organization get involved in the development of applications?

Information Technology Scope involves examining the array of available information technologies in
the IT marketplace and choosing those that enhance the organization's strategy:

What level of sophistication and range of IT (LAN, Internet, document processing) would
provide the organization with the best support to meet its needs?

Does it make sense to outsource IT services, given the level of IT required to support the
organization strategy?

Information Technology Competencies enable the organization to use the information technology it
has chosen to be productive in the sector. Rules and standards governing the IT operation must be
set so that the technology meets everyone's expectations and delivers what was promised.
Information Technology Governance is the set of policies an organization must establish to control
ownership decisions, set rules and standards for, and regulate the use of IT. The decisions made for
IT scope and competencies affect these policies.
Information Technology Administrative Infrastructure determines the management structure, roles,
responsibilities, authority, and technical considerations required to execute the defined IT strategy:

What are the information and IT technical architectures required?

What hardware and software should be installed?

What level of decentralization should be adopted for the utilization of IT?

Focus on Standards - The Information Services organization needs to be customer oriented with a
focus on standards. These include:

Standards for technology selection (application and hardware)

Part B - Information Systems and Information Technology Solutions

Standards for communication protocols for all systems

Standard processes for requesting services

Standard approaches to reporting problems

A methodology for managing projects with a project team concept

Standards for accomplishing various activities such as computer and telecommunications

hardware installation.

Information Services Budget is a critical component of the administrative infrastructure. The budget
needs to be developed and evaluated at three levels:

Maintenance of current systems (hardware and applications)

Information Services staff salaries

Planned capital expenditure and operating budget.

Information Technology Processes - The set of activities required to analyze a healthcare institution
system or process, design an IT-based solution, program and test the solution, develop user
manuals, and maintain the system.
Information Technology Skills - Staff IS&T skills require strong communication and project planning
skills. Given the institution's IT strategy and structure, what are the new skill sets required? It is
important to evaluate the current skills of information services staff with a focus on their ability to learn
and support new applications and technologies. It may be required to develop a human resource
development plan to support the training existing information services staff on new technologies, or
recruit additional staff with the specific skill sets in the new technologies. Employees must have
knowledge of:

Rapid application development tools

Knowledge of networking and interface standards