A SYSTEMS APPROACH TO PLANNING BIOMEDICAL INFORMATION SERVICES Joan Ash, M.L.S., M.S., M.B.A., J. Robert Beck, M.D. Biomedical Information Communication Center, Oregon Health Sciences University 3181 S.W. Sam Jackson Park Rd., Portland, OR 97201 ABSTRACT A systems approach to planning was applied within the Biomedical Information Communication Center at Oregon Health Sciences University when its User
Schools of Medicine, Dentistry and Nursing; the Vollum Institute for Advanced Biomedical Research;
University Hospital; the Child Development andon Rehabilitation Center; the Center for Research Toxicology; and the Occupational and Environmental Center. Communication Biomedical Information in the institutions eiaht of is one Oregon OHSU State System of Higher Education, and is governed by the Oregon State Board of Higher Education.
Services division launched a strategic planning effort. By looking at the choice subsystem, the structure, and the behavioral organ subsystem, those engaged in planning attempted to assure that desired change would permeate the entire system. The challenge of applying a theoretically ideal planning model within an environment averse to planning is delineated.
The BICC consolidates the activities of the health sciences libraries, academic and research
computing, telecommunications, microcomputer ft-aining and support, a microcomputer store, medical audiovisual and television units photography, and the ent of health into one institute. In addition, a informatics does research and development in areas of health sciences information handling and computer science. With funding from the Department of Energy and the National Institutes of Health, a 69,000 square foot building has been constructed to house the BICC. Completed in June, 1991, the building's core will be the Info Center, a workstationbased 5,000 sq. ft area where the user can experience one-stop shopping" for information seances. The BICC as an Integrated Academic Information Management System William Stead has written,"A strategic to guide planning process provides the opportunity decisions about individual projects so as to bring them together as an applied IAIMS laboratory." [2] IAIMS grants are awarded for Phase I studies, which are planning grants; for Phase 2, model development; and for Phase 3, full implementation. Institutions must reapply for each phase since the grants are extremely competitive. OHSU is presently in the implementation phase, with somewhat over $5 million to spend over a five year period. The IAIMS concept mirrors the systems approach with integration of technology, organizations, and human factors a prime goal. Sound IAIMS planning is good systems planning. BICC Planning at OHSU The campus began its official planning phase for the BICC in 1984 when it was awarded a planning contract by NLM. The president of the university formed two committees to assist in the effort: a National Technical Advisory Committee made up of experts in business, information technology, and informatics, and a Faculty Advisory
Intmduction
Purpose
The purpose of this study was to apply a
systems approach to the planning process in the User
Services division of the Biomedical Information Communication Center (BICQ at the Oregon Health Sciences University. The User Services division was formed in September, 1989 when the Biomedical Information Communication Center began. After some strategic planning was accomplished for the Center as a whole during the BICC's first year, it became apparent that more detailed planning at the division level was needed. At that time, those who had more intimate knowledge of user needs and expectations were charged with using their expertise to help chart the future course of the organization.
Systems Approach The situation in BICC User Services was ripe for the systems approach to planning: the organization is complex and there are numerous elements of uncertainty. Change was required because the BICC organization was new and those elements that were pre-existing could no longer continue to function in the old way. To change, the organization must look at all three components of systems theory as outlined by Benton: the choice system represented by systems analysis, the system's structure, and the behavioral system. [1] Benton's basic idea is that an organization cannot be changed by attending to only one aspect of the system, such as organizational structure, but that change needs to permeate the entire system.
Background Environment of OHSU and the BICC The Oregon Health Sciences University is a century-old institution made up of eight units: the 0195-4210/91/$5.00 C 1992 AMIA, Inc.
481
Committee of campus individuals. After creating some initial directions, the committees proliferated under the guidance of a new acting president in 1987 to become eleven different groups totalling nearly 100 people. There was an Interdisciplinary Oversight Committee similar to the National Technical Advisory Committee and a Planning Committee made up of chairs of nine task forces plus the task forces themselves. Each task force generated a report on a specific area of planning (telecommunications, databases, vendor unities, etc.) and these were molded into an IAIMS Phase 3 proposal submitted to NLM in 1988 and awarded in June, 1989.
Planning is generally recognized as useful but avoided at all cost. It is easier to fight fires as they come up and put off planning for fire prevention. It is also more rewarding to be the person who dramatically puts out the fire than it is to be the one who quietly and methodically makes sure a fire will not star The fire fighter is the one who gets the kudos. Planning should identify opportunities, avoid disasters, set priorities and identify a sequence of events. It should also make everyone involved contemplate their value systems. "It can be shown that behind every system is a set of ethical presuppositions." [3] A principle of planning of utmost importance and often overlooked is that the morals, ethics and values of individuals blend and permeate the plan and give it conviction. Method Systems Approach. The systems approach emphasizes looking at the total system rather than just one part of the system. For the purpose of this study, Benton's three factor approach was chosen. The Benton methodology was selected from among other systems approaches because it de-emphasizes systems analysis in the classic sense. It has been used successfully in other public sector organizations. The systems approach originated in the military "where dollars counted, technical performance parameters were paramount, and the soft elements were just less important " [4] When applied to service organizations, the more restricted systems approach has been "at best marginally successful." [5] Benton maintains that three aspects of the system deserve equal consideration: the choice system, which equates with decision making and analysis; organizational structure; and the behavioral system.
BICC Goals Initial planning efforts within the BICC defmed the BICC's mission. It was determined that the strategic intent of the BICC is to support the provision of top notch, cost effective care in Oregon by making information systems and services available to all who contribute to the health of its citizens. The four highest level goals of the BICC are summarized as Inreach, Outreach, Outcomes and Support: the outreach goal is to provide the electronic highway between OHSU and health professionals throughout the state; the inreach goal is to provide the electronic information delivery infrastructure to OHSU; the outcomes goal reflects the BICC research and development effort to eventually be able to track the health of all Oregonians over their lifetimes; the support goal is to provide information services to health professionals both on and off the OHSU campus. In order to address the goals, the BICC has been organized into three divisions: Technology Services, User Services, and Research and Development. Each area has a mission which supports that of the BICC. User Services will provide a comfortable bridge between users and information. Technology Services will provide the technological backbone of the systems which provide the information. Research and Development, which also has an educational component, will investigate how health care information is and should be used.
Choice System. Benton uses this term to mean the process of decision making. It defines what should be done, how it should be accomplished, and what resources and methods should be used to accomplish planned tasks. Support Services Planning. The planning process was launched in non-library areas first because they were admittedly easier. These included microcomputer support and training, the Instructional Media Department, which provides public use microcomputers and individual instruction on their use, the Medical Photography Department, and the AV/TV Services Department. Planning goals were 1) to determine the best administrative structure for these areas under the present budget realities, and 2) to balance their budgets. Format for the Plans. A standard format for all of the plans was developed to meet the specific needs of these departments and of the
User Services This division includes the library, microcomputer support, training and sales, photography, AV/TV, and the Instructional Media Department which provides public use microcomputers and consulting. In addition, a library outreach activity to serve health professionals throughout Oregon was renamed ORHION (Oregon Health Information Online) and is part of User Services. Planning
482
FIGURI' 1. OTrLr.INEI OF' PLANS
Administrative Officer who oversees the BICC's finances (see Figure 1). BICC Administration wanted to see "business plans" and the departments desired "strategic plans", so the format was designed to cater to both needs. The format was to be the same for everyone so it would be a simple matter to compare and contrast deatments and eventually integrate plans. The format for written plans provided a stepping off point for the process. It was carefully designed by the Planning Coordinator with the help of Systems Science and Management faculty specializing in the planning process. The first section of each plan is a "situation analysis." The systems approach emphasizes looking at the background of the organization. The history and tradition of each department, as well as its culture, must be considered. Competitive position is important in these areas which are more entrepreneurial in nature than, for example, the Library. Environmental trends had to be looked at carefully because technology is moving fast and the higher education environment is complex and changing as well. Finally, lists of issues and problems which needed to be addressed in the plan
I. SITUATION ANALYSIS
A. Unit definition B. Products provided to whom
C. Strengths and weaknesses D. Competitive position
Competitor description Pricing Table of important competitive qualities and rating of unit vs. the competition on them E. Environmental trends Predicted demand, etc. F. Educational role G. Issues/problems to be addressed by plan II.
FINANCIAL ANALYSIS A. B. C. D. E.
m.
Past and present budget vs. expenditures Sources of income Level of cost recovery Prcing policy Billing system
PLAN A. Assumptions B. Objectives C. Options for strategies D. Recommended strategic direction E. Recommended strategies and tactics
IV. BUDGET AND RESOURCE ALLOCATION FOR NEXT THREE YEARS
FIGURE 2 MORPHOLOGICAL MODEL
provided a suitable cap to the situation analysis and lead-in to the following sections. The financial analysis section was designed to survey how present finances of each department
Biomedical Information Communication Center Organizational Units Voice
appear.
The plan itself is divided into sections which summarize a great deal of discussion and consensus-
/ fifiz~io~st
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building. The list of assumptions upon which the plan is based is followed by objectives. Objectives were generally limited to around ten, since strategies and tactics would have to be developed for each. In most cases, a general strategy could be selected from among several, so the plan was to select and recommend one. The budget and resource allocation for the next three years would be developed once specific strategies for reaching each objective were drawn up. Schedule. A planning schedule was drawn up as a result of a meeting where the Planning Coordinator was introduced by the Associate Director as a boQna fide helper and process person to the support services department heads. The schedule included meetings on an individual basis with the Planning Coordinator primarily to gather information for the Situation Analysis parts of the plans. After that, all members of the department gathered in a retreat setting to identify issues and objectives and begin action planning. Once the plans were completed for each department, umbrella planning for all of Support Services began. Model Building When it became apparent that User Services as a whole should be included in the planning process, a retreat was
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such information, they looked at the BICC from a number of metaphorical viewpoints. For example, they described the BICC as a machine, a living organism, a political system, a culture, etc. Their final report discussed only the most applicable metaphors. Their conclusion was that several different cultures existed in the organization and that ways should be found to communicate different points of view so that the various elements could learn to understand one another. The "images report" recommended a series of sategies for breaking down barriers among BICC divisions. Two of the major recommendations, appointment of a Human Relations Committee and hiring a consultant, have now been implemented. Human Relations Committee. This committee was appointed by the BICC Director to follow up on the recommendations in the Images Report The committee is made up of representatives of all three BICC divisions. Over the past year, it has developed a mechanism for poane appraisal and objectives reviews. The intention is to implement a type of management by objectives system which will require supervisors to communicate with their staffs. An important point is that the committee has union members and a union steward on it as well as supervisors and coordinators. It is not a system being imposed from above, but is being requested from the bottom up. Development of the system has been prolonged by asking all 150 staff members to review the documents and procedures, but this means little training will be necessary later on. Organizational Development Consultant. The BICC recently contacted with an organizational development specialist as a follow-up to the Images report It would have been advantageous if he had been brought on board immediately after the report was issued, but one faction in the organization was not convinced of the cost effectiveness of this approach. There are doubters of the organizational development model in most organizations and the consultant set as a personal goal the winning over of these managers. Deeper issues of culture clashes and territorial antagonisms have caused serious impediments to planning . As strategic planning continues and as User Services restructures, the consultant is involved. He is also playing the role of management consultant to the BICC Director, so he can also be seen as insurance that the behavioral system will not be forgotten and will in fact be considered of primary importance to the survival of the organization.
scheduled for all administrative staff in the division. They were prepard with copies of all of the unit plans, which were at least in draft form at that poinL The emphasis was on building a conceptual model of User Services, resulting in a graphic rpresentation of what it is and what it should become. A model is "a conceptual surrogate for some other thing," and a structurl model facilitates the integration of ideas. [6] Hall's three dimensional morphology of systems engineering [7] inspired a similar look at User Services and the BICC. In essence, the BICC has thre dimensions (as shown in the model figure 2): the media with which it deals, the functions which organize and access the media, and the different dea ents as they are presently structured. Each box of the morphology deserves close inspection and may offer insights into how the BICC as a whole and User Services specifically should be structured to best meet the needs of users. The group decided to develop another model outlining core services which are in some way madated, either by the state or accediting agencies. Other services were judged on their ability to serve the mission of the BICC and University. A bull's eye was suggested as a format, with core services in the center and less critical services radiating from the core. After two hours, the group had developed a model of what User Services does now and what it should be doing if services could be somewhat enhanced (see Figure 3). The model has been useful as a starting point for looking at restructuring.
Organizational Structure Study Benton's second component of the systems approach is organizatonal structure. While the BICC was initially organized with care [8], a year and a half had passed and the structural organization needed to be revisitd In accordance with the iterative nature of systems theory [9], the structure should change naturally to adapt to a changing environment. In this case, moving to a new building and integrating functions as a result of cutbacks are reasons for changing the structure once again. This is a stated goal for User Services planning efforts, but will not be accomplished until June, 1991. Behavioral System The third component of the systems approach according to Benton is the behavioral system. This has been studied in depth in the BICC using another systems-oriented methodology, the study of metaphors. Following the approach outlined in Images of Organization by Gareth Morgan [10], a three month study by three graduate students was conducted in the spring of 1990. They interviewed administrators and selected opinion leaders among staff in all areas, read documents and reports, and talked to users of BICC services. After gathering
RESULTS Choice System Suprasystem Level. Planning for smaller units within the organization has had little impact on the BICC as a whole. Each unit knows
484
where it wants to go but has little authority and dwindling resources to get there. Bottom up and top down planning should take place simultaneously. If the highest level managers have an agenda, it needs to be clearly articulated before subsystems begin a planning process. System Level. The system is User Services. Analysis of each department from varying viewpoints has given those in and within the departments respect for one another and an undersLanding of how they are alike and different. Subsystem Level. The subsystems are the depnents in User Services. At this level, sevenl positive results were forthcoming from the planning effort First, involving all staff in most departments resulted in creative solutions to problems which would not have come about if only department heads were involved. For example, the manager of Medical Photography is a talented manager but not a photographer herself At her request, the whole department had a brainstorming session about the future of the technology in photography. Not only did the scenario which was produced aid in their strategic planning, but the Instructional Media Deparmet and AVtfIV Services saw benefits from that brainstorming. The latter departments will feel the impact of further development of electronic photography and had not been as aware of the possibilties for the future as the photographers. Second, joining forces by having two or tareeaeparunents plan together served to help the planning and to develop teamwork. The team building will be more important as the move to the new building is now imminent. Some of these dePartments will be sharing functions and space and their ability to work together will affect users
direcdy.
Third, it became clear early in the process that the User Services division is being led by someone who understands the systems approach and has been using it without knowing it for many years. His management methods have developed staff members who are used to being involved in the decision making process, who communicate openly and readily, and who have a vision of where their deparnments should be in three years.
CONCLUSION AND RECOMMENDATIONS This is just the beginning of the planning effort. The more planning the BICC does, the more it seems to need at different levels. There is a definite need to plan at the BICC, or suprasystem, level. User Services techniques for strategic planning will be adopted by Technology Services and Research and Development. There is also need for further planning at the subsvstem and individual level as implementation strategies become more clearly delineated and as performance review and management by objectives systems are implemented. What Was Learned From the Systems Method First, planning is an iterative process.
After User Services did some initial planning, to change course because of budget cuts. Afterit had evaluation takes place, changes will again be made. Second, structure follows function. As models plamning strategies developed, it became clearer and the organization should be stiuctured. Third, it ishow worth the extra time it takes to involve as staff as possible. Better decisions and views of many the future result and there is grer acceptance of the stategic
plan.
Planning needs to emanate from the highest level of the organization. The planning facilitator should ideally come from outside the organization. In any organization rift with political wrangling, an insider would need more authority than generally given to internal planning specialists to make an organization-wide impact. Benton maintains customers, or those receiving services, shouldthat be included in planning. That recommendation was ignored in this case in the interest of but inclusion of a broader base might haveexpediency, put more "teeth" in the plans.
REFERENCES [1] Benton, JB, Managing the Orgranizational DecisionQPces , Lexington Books, 1973. t2] Stead, WW, et al., "IAIMS--The Role of Strategic Planning," SymDosiumon Computer ADplications in Medical Care. eedings, EEE Computer Society Press, 1989, pp. 345-349, p. 349. [31 Mitroff, II, Turoff, M, Forecasting and Assessment:"Technological Science and/or Mythology?" Vol. 5, Technological Forecastingand S.ocial Change, pp. 113-134, p. 127. [4] Benton, JB, -Managing the Organizational D&isiQn Process, Lexington Books, 1973, p. 35.
[5] Ibid, p. 35. [6] Warfield, JN, SocietaLSystem, Wiley, 1976. [7] Hall, A, "Three Dimensional Morphology of Systems engineering," EEEE Transactions SS&C, Vol. SSC-5, No. 2, April, 1968. [8] Ash, J, Pyle, K, Beck, JR, "The Biomedical
Information Communication Center: Information Services for TechnologicalOrganizing Change," Proceedings of the Fourteenth Annual Syosium Computer Applications in Medical Care, IEEE on Computer Press, 1990. [9] Benton, JB, Managing the Organizational Decision Process, Lexington Books, 1973, and Warfield, JN, Societl Systems, Wiley, 1976. [10] Morgan, G, Images of Organization, Sage Publications, 1986. This work was supported, in part, by contract N011m93516 (J. Ash) and grant LM00086 (Dr. Beck)
from the National Library of Medicine. Special thanks to Dr. G. Lendaris, Systems Science Program, Portland State University, for his Doctoral assistance.
Schools of Medicine, Dentistry and Nursing; the Vollum Institute for Advanced Biomedical Research;
University Hospital; the Child Development andon Rehabilitation Center; the Center for Research Toxicology; and the Occupational and Environmental Center. Communication Biomedical Information in the institutions eiaht of is one Oregon OHSU State System of Higher Education, and is governed by the Oregon State Board of Higher Education.
Services division launched a strategic planning effort. By looking at the choice subsystem, the structure, and the behavioral organ subsystem, those engaged in planning attempted to assure that desired change would permeate the entire system. The challenge of applying a theoretically ideal planning model within an environment averse to planning is delineated.
The BICC consolidates the activities of the health sciences libraries, academic and research
computing, telecommunications, microcomputer ft-aining and support, a microcomputer store, medical audiovisual and television units photography, and the ent of health into one institute. In addition, a informatics does research and development in areas of health sciences information handling and computer science. With funding from the Department of Energy and the National Institutes of Health, a 69,000 square foot building has been constructed to house the BICC. Completed in June, 1991, the building's core will be the Info Center, a workstationbased 5,000 sq. ft area where the user can experience one-stop shopping" for information seances. The BICC as an Integrated Academic Information Management System William Stead has written,"A strategic to guide planning process provides the opportunity decisions about individual projects so as to bring them together as an applied IAIMS laboratory." [2] IAIMS grants are awarded for Phase I studies, which are planning grants; for Phase 2, model development; and for Phase 3, full implementation. Institutions must reapply for each phase since the grants are extremely competitive. OHSU is presently in the implementation phase, with somewhat over $5 million to spend over a five year period. The IAIMS concept mirrors the systems approach with integration of technology, organizations, and human factors a prime goal. Sound IAIMS planning is good systems planning. BICC Planning at OHSU The campus began its official planning phase for the BICC in 1984 when it was awarded a planning contract by NLM. The president of the university formed two committees to assist in the effort: a National Technical Advisory Committee made up of experts in business, information technology, and informatics, and a Faculty Advisory
Intmduction
Purpose
The purpose of this study was to apply a
systems approach to the planning process in the User
Services division of the Biomedical Information Communication Center (BICQ at the Oregon Health Sciences University. The User Services division was formed in September, 1989 when the Biomedical Information Communication Center began. After some strategic planning was accomplished for the Center as a whole during the BICC's first year, it became apparent that more detailed planning at the division level was needed. At that time, those who had more intimate knowledge of user needs and expectations were charged with using their expertise to help chart the future course of the organization.
Systems Approach The situation in BICC User Services was ripe for the systems approach to planning: the organization is complex and there are numerous elements of uncertainty. Change was required because the BICC organization was new and those elements that were pre-existing could no longer continue to function in the old way. To change, the organization must look at all three components of systems theory as outlined by Benton: the choice system represented by systems analysis, the system's structure, and the behavioral system. [1] Benton's basic idea is that an organization cannot be changed by attending to only one aspect of the system, such as organizational structure, but that change needs to permeate the entire system.
Background Environment of OHSU and the BICC The Oregon Health Sciences University is a century-old institution made up of eight units: the 0195-4210/91/$5.00 C 1992 AMIA, Inc.
481
Committee of campus individuals. After creating some initial directions, the committees proliferated under the guidance of a new acting president in 1987 to become eleven different groups totalling nearly 100 people. There was an Interdisciplinary Oversight Committee similar to the National Technical Advisory Committee and a Planning Committee made up of chairs of nine task forces plus the task forces themselves. Each task force generated a report on a specific area of planning (telecommunications, databases, vendor unities, etc.) and these were molded into an IAIMS Phase 3 proposal submitted to NLM in 1988 and awarded in June, 1989.
Planning is generally recognized as useful but avoided at all cost. It is easier to fight fires as they come up and put off planning for fire prevention. It is also more rewarding to be the person who dramatically puts out the fire than it is to be the one who quietly and methodically makes sure a fire will not star The fire fighter is the one who gets the kudos. Planning should identify opportunities, avoid disasters, set priorities and identify a sequence of events. It should also make everyone involved contemplate their value systems. "It can be shown that behind every system is a set of ethical presuppositions." [3] A principle of planning of utmost importance and often overlooked is that the morals, ethics and values of individuals blend and permeate the plan and give it conviction. Method Systems Approach. The systems approach emphasizes looking at the total system rather than just one part of the system. For the purpose of this study, Benton's three factor approach was chosen. The Benton methodology was selected from among other systems approaches because it de-emphasizes systems analysis in the classic sense. It has been used successfully in other public sector organizations. The systems approach originated in the military "where dollars counted, technical performance parameters were paramount, and the soft elements were just less important " [4] When applied to service organizations, the more restricted systems approach has been "at best marginally successful." [5] Benton maintains that three aspects of the system deserve equal consideration: the choice system, which equates with decision making and analysis; organizational structure; and the behavioral system.
BICC Goals Initial planning efforts within the BICC defmed the BICC's mission. It was determined that the strategic intent of the BICC is to support the provision of top notch, cost effective care in Oregon by making information systems and services available to all who contribute to the health of its citizens. The four highest level goals of the BICC are summarized as Inreach, Outreach, Outcomes and Support: the outreach goal is to provide the electronic highway between OHSU and health professionals throughout the state; the inreach goal is to provide the electronic information delivery infrastructure to OHSU; the outcomes goal reflects the BICC research and development effort to eventually be able to track the health of all Oregonians over their lifetimes; the support goal is to provide information services to health professionals both on and off the OHSU campus. In order to address the goals, the BICC has been organized into three divisions: Technology Services, User Services, and Research and Development. Each area has a mission which supports that of the BICC. User Services will provide a comfortable bridge between users and information. Technology Services will provide the technological backbone of the systems which provide the information. Research and Development, which also has an educational component, will investigate how health care information is and should be used.
Choice System. Benton uses this term to mean the process of decision making. It defines what should be done, how it should be accomplished, and what resources and methods should be used to accomplish planned tasks. Support Services Planning. The planning process was launched in non-library areas first because they were admittedly easier. These included microcomputer support and training, the Instructional Media Department, which provides public use microcomputers and individual instruction on their use, the Medical Photography Department, and the AV/TV Services Department. Planning goals were 1) to determine the best administrative structure for these areas under the present budget realities, and 2) to balance their budgets. Format for the Plans. A standard format for all of the plans was developed to meet the specific needs of these departments and of the
User Services This division includes the library, microcomputer support, training and sales, photography, AV/TV, and the Instructional Media Department which provides public use microcomputers and consulting. In addition, a library outreach activity to serve health professionals throughout Oregon was renamed ORHION (Oregon Health Information Online) and is part of User Services. Planning
482
FIGURI' 1. OTrLr.INEI OF' PLANS
Administrative Officer who oversees the BICC's finances (see Figure 1). BICC Administration wanted to see "business plans" and the departments desired "strategic plans", so the format was designed to cater to both needs. The format was to be the same for everyone so it would be a simple matter to compare and contrast deatments and eventually integrate plans. The format for written plans provided a stepping off point for the process. It was carefully designed by the Planning Coordinator with the help of Systems Science and Management faculty specializing in the planning process. The first section of each plan is a "situation analysis." The systems approach emphasizes looking at the background of the organization. The history and tradition of each department, as well as its culture, must be considered. Competitive position is important in these areas which are more entrepreneurial in nature than, for example, the Library. Environmental trends had to be looked at carefully because technology is moving fast and the higher education environment is complex and changing as well. Finally, lists of issues and problems which needed to be addressed in the plan
I. SITUATION ANALYSIS
A. Unit definition B. Products provided to whom
C. Strengths and weaknesses D. Competitive position
Competitor description Pricing Table of important competitive qualities and rating of unit vs. the competition on them E. Environmental trends Predicted demand, etc. F. Educational role G. Issues/problems to be addressed by plan II.
FINANCIAL ANALYSIS A. B. C. D. E.
m.
Past and present budget vs. expenditures Sources of income Level of cost recovery Prcing policy Billing system
PLAN A. Assumptions B. Objectives C. Options for strategies D. Recommended strategic direction E. Recommended strategies and tactics
IV. BUDGET AND RESOURCE ALLOCATION FOR NEXT THREE YEARS
FIGURE 2 MORPHOLOGICAL MODEL
provided a suitable cap to the situation analysis and lead-in to the following sections. The financial analysis section was designed to survey how present finances of each department
Biomedical Information Communication Center Organizational Units Voice
appear.
The plan itself is divided into sections which summarize a great deal of discussion and consensus-
/ fifiz~io~st
df124-0
building. The list of assumptions upon which the plan is based is followed by objectives. Objectives were generally limited to around ten, since strategies and tactics would have to be developed for each. In most cases, a general strategy could be selected from among several, so the plan was to select and recommend one. The budget and resource allocation for the next three years would be developed once specific strategies for reaching each objective were drawn up. Schedule. A planning schedule was drawn up as a result of a meeting where the Planning Coordinator was introduced by the Associate Director as a boQna fide helper and process person to the support services department heads. The schedule included meetings on an individual basis with the Planning Coordinator primarily to gather information for the Situation Analysis parts of the plans. After that, all members of the department gathered in a retreat setting to identify issues and objectives and begin action planning. Once the plans were completed for each department, umbrella planning for all of Support Services began. Model Building When it became apparent that User Services as a whole should be included in the planning process, a retreat was
~Text
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Technologies
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such information, they looked at the BICC from a number of metaphorical viewpoints. For example, they described the BICC as a machine, a living organism, a political system, a culture, etc. Their final report discussed only the most applicable metaphors. Their conclusion was that several different cultures existed in the organization and that ways should be found to communicate different points of view so that the various elements could learn to understand one another. The "images report" recommended a series of sategies for breaking down barriers among BICC divisions. Two of the major recommendations, appointment of a Human Relations Committee and hiring a consultant, have now been implemented. Human Relations Committee. This committee was appointed by the BICC Director to follow up on the recommendations in the Images Report The committee is made up of representatives of all three BICC divisions. Over the past year, it has developed a mechanism for poane appraisal and objectives reviews. The intention is to implement a type of management by objectives system which will require supervisors to communicate with their staffs. An important point is that the committee has union members and a union steward on it as well as supervisors and coordinators. It is not a system being imposed from above, but is being requested from the bottom up. Development of the system has been prolonged by asking all 150 staff members to review the documents and procedures, but this means little training will be necessary later on. Organizational Development Consultant. The BICC recently contacted with an organizational development specialist as a follow-up to the Images report It would have been advantageous if he had been brought on board immediately after the report was issued, but one faction in the organization was not convinced of the cost effectiveness of this approach. There are doubters of the organizational development model in most organizations and the consultant set as a personal goal the winning over of these managers. Deeper issues of culture clashes and territorial antagonisms have caused serious impediments to planning . As strategic planning continues and as User Services restructures, the consultant is involved. He is also playing the role of management consultant to the BICC Director, so he can also be seen as insurance that the behavioral system will not be forgotten and will in fact be considered of primary importance to the survival of the organization.
scheduled for all administrative staff in the division. They were prepard with copies of all of the unit plans, which were at least in draft form at that poinL The emphasis was on building a conceptual model of User Services, resulting in a graphic rpresentation of what it is and what it should become. A model is "a conceptual surrogate for some other thing," and a structurl model facilitates the integration of ideas. [6] Hall's three dimensional morphology of systems engineering [7] inspired a similar look at User Services and the BICC. In essence, the BICC has thre dimensions (as shown in the model figure 2): the media with which it deals, the functions which organize and access the media, and the different dea ents as they are presently structured. Each box of the morphology deserves close inspection and may offer insights into how the BICC as a whole and User Services specifically should be structured to best meet the needs of users. The group decided to develop another model outlining core services which are in some way madated, either by the state or accediting agencies. Other services were judged on their ability to serve the mission of the BICC and University. A bull's eye was suggested as a format, with core services in the center and less critical services radiating from the core. After two hours, the group had developed a model of what User Services does now and what it should be doing if services could be somewhat enhanced (see Figure 3). The model has been useful as a starting point for looking at restructuring.
Organizational Structure Study Benton's second component of the systems approach is organizatonal structure. While the BICC was initially organized with care [8], a year and a half had passed and the structural organization needed to be revisitd In accordance with the iterative nature of systems theory [9], the structure should change naturally to adapt to a changing environment. In this case, moving to a new building and integrating functions as a result of cutbacks are reasons for changing the structure once again. This is a stated goal for User Services planning efforts, but will not be accomplished until June, 1991. Behavioral System The third component of the systems approach according to Benton is the behavioral system. This has been studied in depth in the BICC using another systems-oriented methodology, the study of metaphors. Following the approach outlined in Images of Organization by Gareth Morgan [10], a three month study by three graduate students was conducted in the spring of 1990. They interviewed administrators and selected opinion leaders among staff in all areas, read documents and reports, and talked to users of BICC services. After gathering
RESULTS Choice System Suprasystem Level. Planning for smaller units within the organization has had little impact on the BICC as a whole. Each unit knows
484
where it wants to go but has little authority and dwindling resources to get there. Bottom up and top down planning should take place simultaneously. If the highest level managers have an agenda, it needs to be clearly articulated before subsystems begin a planning process. System Level. The system is User Services. Analysis of each department from varying viewpoints has given those in and within the departments respect for one another and an undersLanding of how they are alike and different. Subsystem Level. The subsystems are the depnents in User Services. At this level, sevenl positive results were forthcoming from the planning effort First, involving all staff in most departments resulted in creative solutions to problems which would not have come about if only department heads were involved. For example, the manager of Medical Photography is a talented manager but not a photographer herself At her request, the whole department had a brainstorming session about the future of the technology in photography. Not only did the scenario which was produced aid in their strategic planning, but the Instructional Media Deparmet and AVtfIV Services saw benefits from that brainstorming. The latter departments will feel the impact of further development of electronic photography and had not been as aware of the possibilties for the future as the photographers. Second, joining forces by having two or tareeaeparunents plan together served to help the planning and to develop teamwork. The team building will be more important as the move to the new building is now imminent. Some of these dePartments will be sharing functions and space and their ability to work together will affect users
direcdy.
Third, it became clear early in the process that the User Services division is being led by someone who understands the systems approach and has been using it without knowing it for many years. His management methods have developed staff members who are used to being involved in the decision making process, who communicate openly and readily, and who have a vision of where their deparnments should be in three years.
CONCLUSION AND RECOMMENDATIONS This is just the beginning of the planning effort. The more planning the BICC does, the more it seems to need at different levels. There is a definite need to plan at the BICC, or suprasystem, level. User Services techniques for strategic planning will be adopted by Technology Services and Research and Development. There is also need for further planning at the subsvstem and individual level as implementation strategies become more clearly delineated and as performance review and management by objectives systems are implemented. What Was Learned From the Systems Method First, planning is an iterative process.
After User Services did some initial planning, to change course because of budget cuts. Afterit had evaluation takes place, changes will again be made. Second, structure follows function. As models plamning strategies developed, it became clearer and the organization should be stiuctured. Third, it ishow worth the extra time it takes to involve as staff as possible. Better decisions and views of many the future result and there is grer acceptance of the stategic
plan.
Planning needs to emanate from the highest level of the organization. The planning facilitator should ideally come from outside the organization. In any organization rift with political wrangling, an insider would need more authority than generally given to internal planning specialists to make an organization-wide impact. Benton maintains customers, or those receiving services, shouldthat be included in planning. That recommendation was ignored in this case in the interest of but inclusion of a broader base might haveexpediency, put more "teeth" in the plans.
REFERENCES [1] Benton, JB, Managing the Orgranizational DecisionQPces , Lexington Books, 1973. t2] Stead, WW, et al., "IAIMS--The Role of Strategic Planning," SymDosiumon Computer ADplications in Medical Care. eedings, EEE Computer Society Press, 1989, pp. 345-349, p. 349. [31 Mitroff, II, Turoff, M, Forecasting and Assessment:"Technological Science and/or Mythology?" Vol. 5, Technological Forecastingand S.ocial Change, pp. 113-134, p. 127. [4] Benton, JB, -Managing the Organizational D&isiQn Process, Lexington Books, 1973, p. 35.
[5] Ibid, p. 35. [6] Warfield, JN, SocietaLSystem, Wiley, 1976. [7] Hall, A, "Three Dimensional Morphology of Systems engineering," EEEE Transactions SS&C, Vol. SSC-5, No. 2, April, 1968. [8] Ash, J, Pyle, K, Beck, JR, "The Biomedical
Information Communication Center: Information Services for TechnologicalOrganizing Change," Proceedings of the Fourteenth Annual Syosium Computer Applications in Medical Care, IEEE on Computer Press, 1990. [9] Benton, JB, Managing the Organizational Decision Process, Lexington Books, 1973, and Warfield, JN, Societl Systems, Wiley, 1976. [10] Morgan, G, Images of Organization, Sage Publications, 1986. This work was supported, in part, by contract N011m93516 (J. Ash) and grant LM00086 (Dr. Beck)
from the National Library of Medicine. Special thanks to Dr. G. Lendaris, Systems Science Program, Portland State University, for his Doctoral assistance.
