Organizational Challenges and Barriers to Implementing "IT Governance" in a Hospital

This paper describes the challenges and barriers to the introduction of into a Hospital environment. It further addresses the relationship between corporate governance (hospital strategy and organization) and the role of IT Governance in managing new services deployment. Both ITIL and COBIT are introduced as a best practice for supporting Hospital Information Systems (HIS) management. IT Governance is an extensive framework; therefore we focused our study on ITIL Assessment combined with COBIT. The assessments were centered on IT Service Management, which, according to our findings, is being carried inefficiently in Hospital Sao Sebastiao (HSS). We used both COBIT and ITIL assessment to audit and identify IT Governance weakness. These processes revealed a way to assist the organization at becoming aware about IT improvement priorities. The results were used to rethink HIS strategy in order to properly address the need to develop new health services like ambulatory surgery and connecting with out-patients services. We used the IT Governance standard ISO/IEC 38500 to provide guiding principles for the effective use of IT according to Calder-Moir framework. Starting with a COBIT assessment we identified IT management priorities and metrics, then we focused on the ITIL assessment steps. Finally, we applied the framework on both Service Desk and Incident Management processes. We analyzed the level of IT governance maturity and produce some recommendations to improve IT Service Management practices. The ITIL assessment identified existing gaps between the current organization practices and how the organization should perform according to ITIL, and what key actions need to be taken to close those gaps. At the end disclosed that IT Governance inefficiency is an important barrier to HIS management, mostly in IT service management which has a direct impact in users' daily work flow, and therefore on Healthcare services delivery.