Introduction Only the most progressive organizations are adopting best practices in IM/IT service management, while many IM/IT departments continue to rely on informal, “seat of the pants, “ error-prone processes. This leads to reactive “fire fighting” operating norms within IM/IT departments, when formal, proactive approaches would be more effective. Recent studies suggest that one of the most accurate indicators of IM/IT departmental effectiveness in delivering quality services is the percentage of unplanned work in which the departments is engaged (Glandon, Smaltz, and Slovensky, 2008, p. 170).
Why does unplanned IM/IT work increase costs? Glandon et al. (2008) describes unplanned work as any activity in the IM/IT organization that cannot be mapped to an authorized project, procedure, or change request. While unplanned work can never be entirely eliminated from an IM/IT department, the nature of the unplanned work is very different for high- and low- performing IM/IT departments. In a low performing IM/IT department, low-performing unplanned work includes the following: 1) Failed changes: The production environment is used as a test environment, and the customer is the quality assurance team. 2) Unauthorized changes: Engineers do not follow the change management process, making mistakes harder to track and fix. 3) No preventive work: Failing to conduct preventive work makes repeated failures inevitable. Mean time to repair may be improving, but without root-cause analysis, the organization is doomed to fix the same problems over and over. 4) Configuration inconsistency: Inconsistencies in user applications, platforms, and configurations make appropriate training and configuration mastery difficult. 5) Security-related patching and updating: Inadequate understanding and inconsistency of configuration make applying security patches extremely dangerous. 6) Too much access: Too many people have too much access to too many IM/IT assets, causing preventable issues and incidents (170). In contrast, high-performing IM/IT departments had very different types of unplanned work, such as product failures, release failures, and human/user errors. Regarding of the performance level, many IM/IT departments will continue to have high levels of costly, unplanned work, resulting from poor adoption rates of leading-practice process frameworks (Glandon et al., 2008, p. 171). These will be more clearly defined in the following question. Ultimately, unplanned work increases cost as correction and rework must be done. If properly planned, many of the failures or configuration issues could have been potentially prevented as the “what ifs” would have been initially addressed.
Identify some process improvement frameworks that are applicable to an IM/IT department. What are the advantages and disadvantages of each? Process improvement frameworks that are applicable to an IM/IT department include Capability Maturity Model (CMM), Control Objects for Information Technology (CobiT), ISO 9000, and Information Technology Infrastructure Library (ITIL) (Glandon et al., 2008, p. 172). A more detailed description of each will be provided below to include the advantages and disadvantages of each. CMM is an IM/IT process improvement framework best suited to process improvements surrounding the application development and maintenance domain. It is based on five levels of maturity and describes what characterizes an organization at each level. However, it does not describe how to get there (Glandon et al., 2008, p. 172). CobiT is an IM/IT governance, oversight, and process audit framework recently linked to Sarbanes-Oxley Act of 2002 corporate compliance reporting law. It is made up of four areas of control objects. Like CMM, CobiT tends to describe what characterizes an organization that has solid internal control mechanisms in place but falls short of “how to” descriptions (Glandon et al., 2008, p. 172). From manufacturing, ISO 9000, requires that organizations become accredited or registered, thereby, assuring customers that the organization adheres to the ISO quality assurance standards. Some of the criticisms of this framework is that it (1) requires a great deal of administrative overhead to employ ISO 9000 standards and become registered and (2) may not be well suited to hospital IM/IT departments that tend to implement vendor applications, rather than develop their own applications (Glandon et al., 2008, p. 173). Last, ITIL, is an IM/IT process improvement framework centered on seven main IM/IT management domains. ITIL is well suited to organizations whose CIO or IM/IT leader are championing process improvements. As opposed to some of the other process improvement models, ITIL provides high-level “how to” guidance via its many generic ITIL process flow diagrams and descriptions (Glandon et al., 2008, p. 173).
Describe the five IM/IT service support processes and how they are interrelated. The service support process as describe in the text by Glandon et al. (2008) includes, service desk, incident management, problem management, change management, release management, and configuration management (p. 177). These processes are heavily related and will be described in detail below. The service desk is the single point of contact for users to report incidents and seek troubleshooting resolution. Almost all hospitals or healthcare service delivery organizations provide this service in which users call or access online to obtain assistance with computer-related problems. This service is likely the most misunderstood and underappreciated service provided by the IM/IT department (Glandon et al., 2008, p. 176). Incident management on the other hand, is the process by which “troubled calls” or incidents are managed to resolution. The goal of incident management is “to restore normal service operation as quickly as possible with minimum disruption to the business, thus ensuring that the best achievable levels of availability and service are maintained.” In most organizations with a central service desk function, all incidents are channeled through the service desk. Typically, central IM/IT service desks are organized to provide three levels of support. These levels of support include first-level support services, second-level support services, and third-level support services (Glandon et al., 2008, p. 179-180). Process management is the process by which recurring incidents are analyzed to determine and provide permanent solutions for root causes. The goal of problem is “to minimize the adverse effect on the business of incidents and problems caused by errors in the infrastructure and to proactively prevent the occurrence of incidents, problems, and errors. Problem management is focused on determining the underlying root cause of incidents (Glandon et al., 2008, p. 182-183). Change management is the process by which changes are introduced into the computing environment of an organization. To effectively administer needed changes to the IM/IT infrastructure, organizations generally have in place a change review or committee or change advisory committee. Request for changes can come from the business or clinical units, can come from incidents, or can be necessitated by a problem management process that has recommended changes to alleviate root causes to identified problems. Additionally, change management process must also ensure that ongoing changes are documented in the organization’s configuration management database, which serves as the IM/IT department’s central knowledge base to inform all of the processes within the ITIL framework (Glandon et al., 2008, p. 184). Release management is the process by which major new releases of application or operating system software are implemented. The purpose of release management processes is to ensure that either new software or new hardware being added to a live environment has been built and tested in such a way that it is put into service without causing negative impacts. This process is closely tied to both change management and configuration management (Glandon et al., 2008, p. 184-185). Configuration management is closely tied to all of the aforementioned support services. It is the process by which the computing environment is documented, typically in a configuration management database. All of the IM/IT service support processes can have an effect on IM/IT asset configuration settings (Glandon et al., 2008, p. 186).
What is a CMDB, and why is it an important component of IM/IT service support? A CMDB is a configuration management database that contains all of the relevant information about the components of a IT system used in an organization’s IT services and the relationship between these components. It is important to service support as it can provide a powerful means of dynamically documenting change states in asset configurations as well as serving as an up-to-date tool to plan changes and releases (Glandon et al., 2008, p. 186).
Describe the five IM/IT service delivery processes and how they are interrelated. Service level management is the process by which service levels are negotiated with end users and tracked for performance adherence. The purpose of service level management is to proactively review, with the IM/IT department’s customers, the value of the services being delivered (Glandon et al., 2008, p. 177, 187). Capacity management is the process focused on ensuring that the IM/IT infrastructure has the processing capacity needed by the business functions. It can further be described as “the process of monitoring, analyzing and planning the effective use of computer resources.” The definitive goal of capacity management is to consistently and accurately predict and implement needed changes in the computer resources of an organization to ensure that sufficient capacity exists within the computing resources for unimpeded business and clinical operations (Glandon et al., 2008, p. 177, 189). Availability management is the process focused on ensuring that the IM/IT infrastructure and support services are available to the business functions. Availability management is closely related to capacity management in its focus on ensuring that computer resources are available when end users need them. Its process focus on measuring system downtime, network downtime,, average time it takes to resolve an incident, and other metrics that describe when systems and services are not available to users (Glandon et al., 2008, p. 177, 190). Financial management for IM/IT services is the process of accounting for the complex nature of IM/IT services, understanding the cost by unit of service, and assisting in management decisions relating to IM/IT services. Therefore, this delivery service level is related to each of the others. The accounting of all of these processes lies here (Glandon et al., 2008, p. 177). The service continuity management process, formerly known as the “disaster recovery” or “business continuity planning,” is the process by which organizations identify their most critical applications and design, test, and maintain alternatives for providing IM/IT services in the event of a major service interruption. It is the process for restoring the healthcare organization’s IM/IT services as quickly as possible after a service interruption. With this being said, all of the other service delivery processes will be relevant and utilized (Glandon et al., 2008, p. 177, 191).
Conclusion
Mainstream healthcare administrators have long recognized the need for efficient and effective operations throughout the healthcare enterprises that they led. However, since few senior executives have come from IM/IT backgrounds, the internal workings of the IM/IT department have often been a “black box” to mainstream senior leadership. (Glandon et al., 2008, p. 194-195). As more and more healthcare enterprises are becoming automated, demands on professional IM/IT department services will continue to increase. IM/IT departments that have implemented, or are implementing, formal processes improvement frameworks like ITIL will create greater efficiencies and thereby leverage IM/IT resources toward more strategic initiatives. References
Glandon, G. L., Smaltz, D. H., & Slovensky, D. J. (2008). Austin and Boxerman's: Information systems for healthcare management (7th ed.) Chicago, Health Administration Press.