Reducing Complexity in Healthcare IT: Part 2…Preparing to move forward

Reducing Complexity in Healthcare IT: Part 2…Preparing to move forward

Navigating the healthcare IT landscape and its parallel progression to risk-based patient care models brings with it multiple modes of organizational preparation. Application portfolio management is one of the architecture methodologies that can be deployed to help streamline your organization to work most efficiently to achieve its business objectives.

Let’s examine some general themes to highlight in preparation for streamlining your organization’s portfolio landscape and optimizing its capabilities.

Business Objectives…

THIS IS NOT IT. This seems like a pretty basic concept but is important to always remember that the IT infrastructure’s main role in in portfolio management is enabling and supporting the capabilities needed to satisfy business objectives. This even presents itself as a paradigm shift for some leaders as healthcare organizations begin to emerge from the settling dust of increased MSO healthcare activity, a sprint to implement Meaningful Use measures, and preparing for ICD-10.


Having a well-defined and concise IT roadmap that clearly supports the organization’s core business objectives is crucial to the vision and planned execution of the business. Knowing the decisions previously made vs. the future state of the business is important to understanding what key architectural considerations need to be continuously prioritized. A major portfolio overhaul might not be as effective if it happens to cause misalignment from the overall vision.


It’s certainly not assumed or conveniently implied that the core driver contributing to the makeup of terribly complex IT infrastructures is lack of governance. There are many time-sensitive functions such as the need for mergers, acquisitions, and general integration efforts that remain aggressive over an extended period of time.

An Architecture Review Board (ARB) is an example a key governance structure through which significant infrastructure decisions are presented, discussed, and prioritized.


During the process of ramping up and structuring a portfolio management based initiative it will be clear that widespread, timely, and interdepartmental communication is a key driver to success. Both the systemic accuracy of project data and the amount of time required to gather and standardize the data for analysis and consumption are dependent on this being in place.

Data Gathering…

The data gathering process for this type of initiative can also be a learning process for the entire organization. It should also be acknowledged and accepted that this rarely happens in one fell swoop, after all, potentially years of layered integration creep can tend to erode certain elements of organizational communication in those “pockets of functionality”. Rounding up this information into one arena or a series of tools for objective decision making is an ongoing and iterative process during the project. A sample of data categories that could be initially collected might include:

  • Business objectives vs. system capabilities (a correlation or mapping)
  • Cost Data (cost of practice acquisition, current support costs, integration needs)
  • Full Application Inventory (includes all systems and metadata regarding those systems)

Be prepared to engage key resources in the organization to hunt this information down using a variety of collection techniques:

  • Direct Observation
  • Interview
  • Questionnaires
  • Database/Data Center mining

For additional information, feel free to check out Part 1, Part 3, and Part 4 of this blog series and please don’t hesitate to contact us!

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