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Williams keeps tabs on the effectiveness of her alignment leaders in two ways. One is through 360-degree reviews, in which the senior officer in each business area contributes to the annual performance review of the unit's alignment leader. The other is a yearly survey of all hospital and corporate officers that seeks their opinions on the value of IT, the value of involving IT in forming strategy and how well business and IT are working together. "Before I appointed these [alignment] leaders," Williams says, "I don't know that we would have gotten as high marks from the business leaders as we do today."
Jim Gabler, a former CIO at Christus Santa Rosa Health Care Corp. in San Antonio, Texas, and now a research director at Gartner, Inc., says HCA's alignment process is an "excellent" way to avoid problems. It allows the company to recognize them early, before they flare up into major problems. "One of the best ways an organization can close the alignment gap is with what we call relationship managers," Gabler says. "That's the generic term we use at Gartner for someone who is physically working in the business unit but reports to IT. That seems to be exactly the model that HCA is following, and we have found that to be extremely effective. It's a very powerful way for IT to be very responsive to the business."
Mary Silva Doctor, a consultant with Omega Point Consulting who has worked on alignment with HCA and other companies, notes that the alignment leader concept is not new, but HCA's results, as seen in Williams' survey, are notable: HCA tries to encourage a very close working relationship among all its departments, she says. "To be able to have IT's business partners say, 'Yes, we feel like we are all 100 percent aligned,' after only two years, is a kind of change we haven't seen elsewhere."
But the use of alignment leaders isn't the only way HCA is trying to boost IT-business cooperation. Williams, for example, meets regularly with Fitzgerald and other top executives on broader company issues. And each IT project has an IT manager and a business "owner," who work independently of the alignment executives.
Can this alignment process sometimes work too well? Getting one person to conflicting meetings in two different departments can be hard. "The solution leaders are so aligned with the businesses that they sometimes forget they are really IT," Williams says. "We've had a couple of instances where we've had to say, 'Wait a minute now, you're doing such a good job representing the business, do you remember you work for IT?'"
On balance, however, the program's success has inspired Williams to take another couple of steps. Under a portfolio-management program, every IT initiative is rated on its contribution to key business priorities, such as regulation compliance and patient safety, and then given priority based on cost and other factors. Then a work-management plan allocates money and people within each project.
HCA's alignment leader concept is succeeding for Egger personally, as well. "It's a great opportunity for an IT guy such as myself to be immersed in the business side of the company," he says. "So I find it very rewarding. And for IT and the businesses, it's been a home run."
VICTOR D. CHASE is a Yorktown, N.Y.-based writer specializing in science and technology. Please send comments on this story to email@example.com.