By JOHN MOORE
Before entering the convoluted healthcare IT sector, I had worked in the manufacturing sector both as an IT analyst and in corporate strategy for Europe’s second largest enterprise software company. In those many years I learn quite a bit about not only how to effectively deploy large enterprise software systems (SAP, PeopleSoft, i2, PTC, SSA, Dassault Systemes, etc.) but how to create models that would guide clients in a methodical manner in IT adoption. A common model used was the five stage Maturity Model, which was originally developed at Carnegie Mellon University.
The beauty of the maturity model is its simplicity and focus on process change. This proved very effective in educating all stakeholders within a manufacturing company, from the C-suite on down, as to how they needed to think about their internal processes, the technology they were preparing to deploy and the final end-point that they should strive towards. But one should not look at maturity models as completely static for the technology does change overtime and subsequently what is possible.
In doing research for the HIE Market Report I was surprised to not find a maturity model for HIEs (heck, it was hard to find much of anything with regards to maturity models in HIT). This puzzled me greatly for if any sector of the HIT space needs a maturity model, it certainly is the HIE sector. This pushed me to create the five stage HIE maturity model shown below. In viewing this model, keep in mind that the model is not meant to be an exhaustive list of all that is possible but simply describe what are the natural characteristics of an HIE as it matures over time. As in the models I created for the manufacturing sector, this one is designed to assist those who are planning to deploy an HIE, or may be operating one now, on what they need to think about in mapping out their future strategy. For this particular model, I used three instead of the customary two columns with the third column (Characteristics) providing guidance as to the IT capabilities that would be required to meet the Objectives of that particular Stage.
What’s next?
Ideally, this maturity model sees wide adoption and use by both public and enterprise HIEs. Honestly, that is why I’m pulling it out of the HIE Market Report and putting it out here in the public domain for part of the mission here at Chilmark Research is to indeed facilitate the effective adoption and use of HIT by ALL stakeholders in the healthcare sector.
Secondly, this is being released to get the feedback of those in the field that are deploying HIEs, running HIEs, providing HIE solutions. Please provide your views, your perspectives on this model. Is it logical? Does it make sense? Is there anything missing?
I look forward to your critque.
John Moore is an IT Analyst at Chilmark Research, where this post was first published.
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The biggest problem that I have with Maturity Models is that they assume there is one best way to implement IT and that you must complete the early steps before later ones. However, the real world does not work that way. Maturity models tend to lump disparate functions into “stages” but in the real world, institutions may implement these functions “out of order” depending on their needs and capabilities. For instance, in your model above, an institution may implement “Decision support at point of care” (Stage 5) before “Improve referral process” (Stage 3).
Also, I note that you have lumped “Enhance referral and order flow” (Stage 2) together when these are separate (although related) processes.
My point is that implementation of health IT functions is not a standardized hierarchical process that can be specified as a general case. It is a non-linear parallel process that is unique to each organization and this does not fit into a standard maturity model except as a generalization with many exceptions.