How NY's Visiting Nurse Service Prioritizes IT Projects

By Lafe Low
Wed, October 15, 2003

CIO — When CIO George Germann joined the Visiting Nurse Service (VNS) of New York in November 1997, the process for selecting and approving IT projects was simple and straightforward, much as the business itself was back then. "We had a project request process, but it was largely ad hoc," Germann says. He and his staff would sift through requests, balance available resources, and then Germann would present a list of recommended projects to VNS CEO Carol Raphael for final approval. That process was effective when the VNS’s business was simpler, but as the agency grew in size and complexity, it was no longer sufficient.

Since then, the New York City-based home health-care agency has added new lines of business and new services, acquired other agencies, and coped with a flood of projects that were sidelined as the VNS prepared for the Y2K transition. "We’ve grown more rapidly in the last 10 years than [at any other time] in our 110-year history," says Germann. The convergence of rapid growth, the skyrocketing level of project requests and the agency’s conscious decision to balance future technology initiatives against strategic objectives led Germann and his executive colleagues to impose a better mechanism for determining value and funding IT projects.

A New Method

Germann considered several established valuation methods, including Balanced Scorecard, total cost of ownership and a methodology developed by Gartner. But he decided that their cost and complexity did not suit the VNS’s current needs. So Germann incorporated elements from those methodologies into a customized method.

The primary benefit of formalizing a valuation methodology is to maximize the value of every IT dollar by avoiding costs and increasing productivity. "Our strategy is to take on more projects [but not to] increase our staff," Germann says.

IT project proposals go through a rigorous three-stage process. First, the project sponsor completes a request form and submits it to IS. Next, the project sponsor works with the IS staff and members of the IS steering committee (a seven-member group set up as part of the new approach; it includes representatives from IS, finance, business development and operations) to refine the project benefits, costs and risk analysis. Then the steering committee and the CEO evaluate and recommend projects for approval and funding to the VNS board of directors on a monthly basis. Once the board authorizes a project, IS works with the project sponsors to develop a charter—a guideline for the IS team and the sponsors to ensure that they’ve allocated the necessary resources to deliver the project within the specified time and budget parameters.

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