THE PROPOSED ENHANCED OPERATING MODEL FOR WA HEALTH

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THE PROPOSED ENHANCED OPERATING MODEL FOR WA HEALTH

PROPOSED ICT GOVERNANCE PLAN

Operating Model Enhancement

The proposed enhanced operating model for WA Health is a unified model where information sharing and management, capacities and capabilities are enhanced using well-defined standards to improve systems interoperability at WA Health while simultaneously continue with the process automation efforts in the current operating model in Section 4.2.1. A unified operating model (Figure X) will be achieved by focusing in two improvement areas from the ones described in Tables 7 and 8 from Section 4.2.1, one from a standardisation initiative and a second one from an integration initiative. By focusing first on the standardisation initiative, a replicated state will be achieved. After completion of this, the integration initiative should be completed to reach the proposed unified state. The selected initiatives were the following:

Clinical Costing Systems
o These help improve the compliance with national standards for reporting of health costs, 
but better ICT support and training are required to obtain maximum benefits from them across WA Health and improve the level of process standardisation by holding equal skillsets in the dispersed WA Health locations and centres. For this reason, staff training and performance management are suggested and will help improve the standardisation level in this area.

CredWA Medical Credentialing
o CredWA provides a single electronic database for doctor credentialing which supports 
some of the clinical workflows and aids with information sharing capabilities. Nonetheless, currently WA Health does not include other staff such as nurses and various administrative staff in such systems. This report suggests the inclusion of such roles in the CredWA system to bring WA Health’s integration capabilities to the next level. 
Implementation of the improved clinical costing systems will achieve a replicated state. Implementation of the CredWA Medical Credentialing, in addition to the previous, will achieve a unified state of the operating model for WA Health. The operating model represents the general vision of how the enterprise enables and executes its strategy (Ross et. al., 2006). In the proposed unified operating model, WA Health can focus on leveraging economies of scale from their existing health services once both process automation and integration are enhanced .

Proposed Governance Arrangements

As mentioned before, all decisions related to IT are highly centralised within the ICT Executive Board. The Clinical Reference Group & Consumer Reference Group will provide input to the ICT Executive Board on the delivery and planning of ICT across the organisation. 
The following measures were made for developing a new governance arrangement:

1. Retain centralised but reducing reliance on the executive board on decision making.
2. Assign more responsibilities to the Health Information Network (HIN) for decision making.

First, the decision making regarding IT Architecture and ICT infrastructure has been distributed between the executive board and the Health Information Network. It is important to include the senior managers in key IT decisions because one of the most important factors that distinguish top-performing companies is that senior managers take a leadership role in a handful of key IT decisions (Weill & Ross, 2002). The purpose of including the Health Information Network in the IT Architecture and ICT infrastructure decisions is to reduce reliance on the Executive Board from the current ICT governance plan. 
Secondly, more responsibilities are assigned to HIN on decision making regarding ICT Principles, Architecture and Infrastructure. The Health Information Network is composed of the different IT personnel and IT leaders of WA health and report lines direct to the CIO of the organisation. This personnel combined with the Business leaders selected from the Business User group compose the Health Information Network Steering Committee, which is chaired by the CIO. The purpose of assigning more responsibilities to the Health Information Network is to provide IT personnel and CIO a shared vision of the business strategy. This could enhance the business and IT alignment and will avoid the IT personnel to ignore business responsibilities and vice versa. In addition, this decision will establish ICT across all operating groups, encouraging competition and cooperation between them (Weill & Ross, 2006). The following matrix presented below shows the proposed changes in red.

Proposed Key IT Domains

In the proposed governance structure of WA Health, governance rights are shared by some combination of senior executives, business unit leaders, business process owners, IT executives and end users (Weill &Woodham, 2002). Business monarchy holds decision rights for investment and an IT monarchy controls decision concerning architecture and infrastructure. Also, some of the mechanisms for WA Health include Firm-wide business process teams, service levels agreements, IT investment approval processes and 
IT Working committees.

These changes compromise the whole organisation stakeholders such as the IT staff and Business staff across the enterprise. The following ICT domains are suggested considering the changes in the new ICT governance arrangements. 
ICT Principles

Decision rights for ICT Principles will be made by a federal structure so that the business take responsibility for IT’s contribution to the creation of value. The input of the ICT principles will be given by different stakeholders of WA Health such as the Clinical Reference Group, Consumer Reference Group, Project Committee, Business User Groups and the Health Information Network. The decision making regarding these principles will be entrusted to the ICT Monarchy and the Executive Board. These principles will be the key to WA Health because they describe how IT will be used to create business value

ICT Architecture

Policies and rules that govern the use of IT regarding the standards and guidelines for technology, use of data, design applications will be made by a federal structure. In this decisions, the executive board is not included to reduce reliance on the executive board in the decision making. Decisions will be held by the ICT Monarchy Health Information Network Steering Committee.

ICT Infrastructure

Decision rights regarding the approach to building the IT foundation for the firm will be made by federal and duopoly archetypes. The Executive board is included as decision maker actor because the IT infrastructure is a critical factor in determining the speed on the implantation of new business initiatives. Also, decisions for ICT Infrastructure are suggested to be made by the ICT Monarchy specialist including the Health Information Network Steering Committee. 
Business Application Needs

Decision rights for Business application needs will be made by a federal and duopoly structure so that the IT take responsibility for business contribution in the creation of value. The decisions are suggested to be made from the input of the federal archetype model of the Clinical Reference, Consumer Reference and Project Committee groups. Also, from an ICT duopoly archetype of the Business User Group and the Health Information Network Steering Committee.Decisions will be made by the Executive Board and the CIO.

ICT Investment

Finally, the input of the prioritisation of IT investment and procedures for IT projects proposals, justification, approval and accountabilities will be made by a federal structure including the Consumer Reference Group, Project Committee and the Health Information Network Steering Committee. Decisions will be made by the Executive Board and the CIO.

5.2.1 Proposed ICT Roles and Responsibilities

The suggested changes for WA Health introduce new levels of responsibility for process practices and change the roles and current structures. These changes are showed in the table B. The responsible, accountable, consulted and informed levels have been mapped against the different major decision domains IT principles, IT architecture, IT infrastructure, Business applications and IT investments.

The proposed changes include the CIO assuming accountability for ICT Principles, ICT Architecture and ICT Infrastructure and responsibilities for the Business Application Needs and ICT investments. Also, the Executive Board will be informed of the ICT Principles, ICT Architecture and ICT Infrastructure and will assume accountability for Business Application Needs and ICT investments. To reduce the reliability of the Executive Board, the CIO will share the accountability the Business Application Needs and ICT investments. 
The Business Leaders and the IT leaders will be consulted by the Health Information Network Steering Committee regarding the ICT principles, Architecture and Infrastructure. 
The proposed RACI chart presented below identifies the roles and responsibilities of the different stakeholders involved in the decision-making process as well as those who should be consulted, informed and responsible.

Proposed ICT Decision Making Structure

The proposed changes to the ICT decision making structure in accordance with the sections below are provided in Figure C. The Health Information Network, composed by the IT leaders and Business Leaders will have direct contact with the CIO. The CIO is a key player in the new structure because it will help to reduce the reliance on the Executive Board for decision-making.