Arthur Harvey, Vice President and Chief Information Officer at Boston Medical Center, talked about how efficient portfolio management creates time for innovation and keeps executives and employees happy.
Harvey began his keynote presentation at the 2017 Chief Information Office Leadership Forum—Data Strategy and Innovation—held on May 16 in Boston by stating he’s very proud to work for Boston Medical Center, but what he wasn’t so proud of was the organization’s IT governance. “If you don’t do portfolio management right, you’re going to have problems. Everybody thinks we, in IT, spend a little bit of time doing routine work and a whole lot of time doing innovation. What we actually do is a lot of other stuff—including new payment models, mergers and acquisitions, and regulation. So, we’re going to look at how to get the work of the institution done while looking at doing things in the future.”
“Everybody thinks we, in IT, spend a little bit of time doing routine work and a whole lot of time doing innovation. What we actually do is a lot of other stuff—including new payment models, mergers and acquisitions, and regulation.”
Harvey outlined these goals for a new portfolio management process:
• Get senior management involved in decision-making. “This is the most important of all these goals. If IT is making the decisions on what projects IT is doing, you’ve lost. The senior leaders of the organization, not IT, determine the company’s path and goals, so they need to participate in making these decisions.”
“If IT is making the decisions on what projects IT is doing, you’ve lost.”
• Ensure that the projects undertaken are important to the overall organization.
• Hold everyone accountable for their part in projects. “With certain exceptions—such as purely technical things that only IT knows and cares about—no project is an IT project. It’s an organization project, and the end users have to help us with requirements and testing.”
• Get more stuff done. “Notice this doesn’t say, ‘Get more stuff started.’ Do fewer projects better, faster, and don’t have to redo them.”
• Provide a view into the process for all stakeholders. Be transparent. Admit when you make a mistake, and share your solution to remedy it.
• Reduce the burden on IT staff to decrease burnout. “The turnover rate when I started was 35%. I can’t replace people that fast. Most of these people were specialized, so I had to find a way to decrease the burnout. The answer was…
• “Free up time for innovation. If you can free up more time for innovation, burnout will drop like a stone.”
“The turnover rate when I started was 35%. I can’t replace people that fast. Most of these people were specialized, so I had to find a way to decrease the burnout.”
Harvey presented his IT governance model. “The two key items are the IT governance committee and the IT portfolio management committee, which is internal to IT. This committee comprises operational senior vice presidents, and I sit on it. IT staffs this committee, but we don’t run it,” he explained.
The middle level of the governance model is interdisciplinary committees, which, at Boston Medical Center, comprise administrative applications, RCM (reliability-centered maintenance), infrastructure, security and privacy, research, and clinical. These committees handle requests. “You need to have the right amount of committees so the number isn’t unwieldy but everyone in the committee is engaged.”
The interdisciplinary committees:
• Comprise operations and IT leaders in a relevant area.
• Meet on a routine basis to evaluate and prioritize requests within a given area.
• Provide recommendations to the IT portfolio management group as well as to people making requests.
“Most portfolio management efforts fail not because people don’t want them to work or don’t have a good idea but because people try to make them perfect. If one VP can get another VP to agree a project is a good idea, you can fast-track it and avoid interdisciplinary committees,” noted Harvey.
Harvey reported that, as a result of the transformations in portfolio management at his organization, project completion was up 78% from fiscal year 2014 to 2016, and there was an additional 36% increase from 1H FY 2016 to 1H FY 2017. Annual IT employee turnover rate is down from 35% in FY 2015 to less than 11% currently. “I can live with that,” stated Harvey. “The best part is that my colleagues—the other executives at the hospital—are happy, because they have transparency (everything is written down) and they know if what they want is important to the hospital, it will get done.”
In summary, these were the lessons learned:
• Transparency is key. Report both good and bad news.
• Support and participation from the executive team is essential.
• There must be reasonable cycle times.
• Provide a proper level of detail for the audience.
• Trust the process. Don’t change it willy-nilly but monitor for real problems and be willing to evolve.
• Provide a path for exceptions, but provide transparency for that as well.
ABOUT ARTHUR HARVEY:
Arthur W. Harvey III, MS, CPHIMS, has 30 years of experience in the healthcare informatics field with a particular focus on building high-performing HIT teams at provider organizations. He currently serves as Vice President and Chief Information Officer at Boston Medical Center and as Program Chair for the Health and Medical Informatics Graduate Program at Brandeis University. Arthur holds a BA in Economics and Computer Science from Boston College as well as an MS in Information Technology Management from Brandeis University. He's a Certified Professional in Healthcare Information Management Systems and serves as chair of the HIMSS Professional Development Committee.