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STRATEGY, IMPLEMENTATION AND EVALUATION 161 PRIORITIES FOR THE INFORMATION MANAGEMENT AND FINANCIAL PRECONDITIONS The previous paragraph listed what should happen as far as ambition and necessity are concerned. This deliberately did not consider the financial aspects. Neither was a ranking of importance made for the desired projects and activities. In all probability, however, an initial tally of the necessary manpower and finances for executing the projects and activities will produce figures above those reserved by the health care organization for information management. Two questions then arise: how large should the health care organization’s expenditure be on information management, and what ranking principle can be applied to the sequence of projects and activities? Financing, not budgeting How large the expenditure on information management should be, should ideally be determined by the expected returns. The tally of business cases (determined per project/activity) determines the IT expenditure in a multi-year estimate. Unfortunately, the returns of PCISs can only partly be expressed in economic terms. Benefits include the increase in effectiveness of care, and the satisfaction of patients and care professionals (see also Chapter 11). The quality, speed and scope of information provision should improve, after all. Also, there are intangible benefits, such as being a front-line organization, and/or being an attractive organization for care professionals and researchers to work. In addition, the organizational impact and process changes associated with IT implementation make it difficult to calculate a simple economic yield (see Chapter 11). Listing the tangible and intangible information management benefits must be undertaken, however. No matter how imperfect, it provides a footing for the discussion on the funds to be channelled to information management. Simultaneously, comparative data from other information-intensive industries are helpful in the strategic discussion on the percentage of the budget that should be devoted to information management. <strong>Information</strong>-intensive, for-profit companies currently spend approximately 12 per cent of their annual costs on IT. The expenditure by hospitals, for example, is far below this; between 2 per cent and 4 per cent. For other health care organizations, these numbers are generally even lower. These figures make clear that health care organizations—a highly information-intensive industry, after all! —can benefit from pro-actively drawing up a multi-year budget that takes account of rising expenditures for information management. (The expectation of a rise in expenditures can also be built bottomup, by making a forward projection based on the expansion of the number of users, expansion of functionality, and replacement of existing systems.)
162 DEVELOPING THE INFORMATION STRATEGY Figure 8.9 Ranking principle for projects. Ultimately it is up to the health care organization’s BoD to agree on expenditure on information management in a multi-year framework, in line with the ambition, the strategy and the expected yields. Prioritizing projects and activities to be carried out The projects and activities that stem from the IT ambition level, in conjunction with the guidelines, can usually not all be carried out concurrently. A ranking principle needs to be agreed to determine the sequence. Figure 8.9 shows the outline for such a ranking principle. The starting point is that available resources (both manpower and financial resources) are introduced from top to bottom. Each project is added to the project list (projects are proposed by line managers). Projects which do not fall within the previous categories are placed ‘below the line’. The priority 1 projects are first subtracted from the total available budget. A percentile division for priorities 2, 3 and 4 is then made from the remainder. For priority 5 ‘projects below the line’ no budget will be available in the relevant time frame. Priority 1 are the information management infrastructure projects and activities. This refers to the ‘fundamental’ infrastructural projects, both organizational as well as hardware and software, which are preconditions for the other projects, ambitions and guidelines. For example the elaboration of the guidelines for standardization, or the addition of key-users, etc. Priority 2 are the projects and activities within the priority areas. These are the projects and activities required for fulfilling the ambition. The health care organization needs to make a ranking of the ambition per sector from the conceptual model. Derived from this is a ranking of the projects within the sector areas. The ranking determines the sequence of diminishing importance and cuts
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Health Information Management In al
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Health Information Management Integ
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Contents List of illustrations vii
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Illustrations FIGURES 3.1 Medicatio
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Contributors Marc Berg is a physici
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Series preface In almost all Wester
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Acknowledgements I would like to th
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Chapter 1 Introduction In all Weste
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INTRODUCTION 3 touch upon the deplo
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INTRODUCTION 5 can draw upon to mai
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INTRODUCTION 7 Physician Order Entr
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Part I Starting points Understandin
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WAITING FOR GODOT 11 KEY TERMS ■
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WAITING FOR GODOT 13 Netherlands an
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WAITING FOR GODOT 15 facts to show
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WAITING FOR GODOT 17 (Lewinski-Corw
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WAITING FOR GODOT 19 In most cases,
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WAITING FOR GODOT 21 (Anonymous 191
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WAITING FOR GODOT 23 Because of the
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WAITING FOR GODOT 25 they simply sa
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WAITING FOR GODOT 27 expected. Stil
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WAITING FOR GODOT 29 organize their
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WAITING FOR GODOT 31 performance in
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WAITING FOR GODOT 33 different HIS
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WAITING FOR GODOT 35 CONCLUSION: TH
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WAITING FOR GODOT 37 assumption tha
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WAITING FOR GODOT 39 Anonymous (191
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WAITING FOR GODOT 41 Berg, M. (1997
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Chapter 3 Health care work and pati
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HEALTH CARE WORK AND INFORMATION SY
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THE CONTEXTUAL NATURE OF INFORMATIO
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Chapter 5 Meeting the challenge Int
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STARTING POINTS 81 ‘gender, race,
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STARTING POINTS 83 Now, imagine an
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STARTING POINTS 85 organization,
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STARTING POINTS 87 Figure 5.2 Incre
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STARTING POINTS 89 already overflow
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STARTING POINTS 91 responsibilities
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STARTING POINTS 93 answer the quest
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STARTING POINTS 95 Kohn, L.T., J.M.
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Chapter 6 Designing interactions En
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DESIGNING INTERACTIONS 99 the way t
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DESIGNING INTERACTIONS 101 1 Identi
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DESIGNING INTERACTIONS 103 the deve
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DESIGNING INTERACTIONS 105 communic
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DESIGNING INTERACTIONS 107 Figure 6
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DESIGNING INTERACTIONS 109 ■ Figu
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STRATEGY, IMPLEMENTATION AND EVALUA
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Index accumulation 53-4, 61, 73-4,
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INDEX 223 contingent and emergent c
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INDEX 225 satisfaction 176 patient
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INDEX 227 support 164 technology de
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