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Strategic Planning and Strategic IT Planning for Long-Term and Post-Acute Care (LTPAC) Providers: A “How To”

CENTER POST
Table of Contents
1. Introduction and Executive Summary
1.1. Introduction
1.2. Executive Summary
2. Overview of Strategic Planning and Strategic IT Planning
2.1. Definition of Strategic Planning
2.1.1. Purpose of Strategic Planning
2.1.2. Characteristics of an Effective Planning Process
2.1.3. Keys to Success
2.2. Definition of Strategic IT Planning
2.2.1. Technology as a Strategic Asset
2.2.2. Linking Technology with the Strategic Plan
2.3. Importance of Technology Investments
3. Governance Structure and Role of the Chief Information Officer
3.1. Governance Structure
3.2. Role of the CIO
3.2.1. CIO’s Duties and Accountability
3.2.2. Realities of Aging Services
3.2.3. Options for Smaller Organizations
3.3. Best Practices from Aging Services
4. Strategic Planning Approaches and Steps
4.1. When to Conduct Strategic Planning
4.2. The Strategic Planning Team
4.3. Common Models and Approaches to Strategic Planning
4.3.1. Vision or Goal-Based Planning
4.3.2. Issues-Based Planning
4.3.3. Alignment Model
4.3.4. Scenario Planning
4.3.5. “Organic” (or Self-Organizing) Planning
4.3.6. Real-Time Planning
4.4. High-Level Strategic Planning Resources
4.5. 10-Step Vision/Goal-Based Strategic Planning
4.5.1. Step 1: Agree on a Strategic Planning Process
4.5.2. Step 2: Carry out an Environmental Scan
4.5.3. Step 3: Identify Key Issues, Questions and Choices
4.5.4. Step 4: Define/Review the Organization's Values, Community Vision and Mission
4.5.5. Step 5: Develop a Shared Vision for the Organization
4.5.6. Step 6: Develop Statements Describing the Organization’s Goals and Future Status
4.5.7. Step 7: Agree on Key Strategies
4.5.8. Step 8: Develop an Action Plan
4.5.9. Step 9: Finalize a Written Strategic Plan
4.5.10. Step 10: Build in Procedures for Monitoring and Modifying Strategies
4.6. Strategic Planning Resources
5. Strategic and Operational IT Planning Steps
5.1. Understanding Organizational Direction, Business Objectives and Strategic Plans
5.2. Understanding the Existing IT Infrastructure
5.2.1. IT/Technology System Inventory
5.2.2. Staff IT Competencies
5.3. Understanding the Need to Update/Upgrade Technology Applications
5.3.1. Assessing the Needs of all Existing and New Business Units
5.3.2. Assessing Internal Interfacing, Connectivity, Integration and Interoperability Needs
5.3.3. Assessing the IT Needs of Strategic/External Partners
5.3.4. Assessing the Needs of Management
5.3.5. Implications for the Selection of Technology Applications
5.3.6. Implications for the Information and Communication Infrastructure
5.4. Create the Strategic IT Plan
5.5. Phasing of Planning and Implementation
5.6. Strategic IT Planning Resources
6. IT Infrastructure
6.1. Virtual Cloud Servers vs. Local Server
6.1.1. Dedicated Server
6.1.2. Cloud Computing
6.1.3. Comparison
6.2. Networks and Their Architecture
6.2.1. Basic Data Network Topologies and Their Attributes
6.2.2. Basic Network Standards and Classifications
6.2.3. Wired vs. Wireless Networks
6.2.4. Recommended Minimum Bandwidth Speeds
6.3. Technology Applications in Senior Living
6.3.1. Administrative and Business Back-Office Applications
6.3.2. Clinical and Care Services Documentation
6.3.3. Safety and Security Systems
6.3.4. Health and Wellness Applications
6.3.5. Resident Connectivity, Entertainment and Social Connectedness
6.3.6. Campus/Facility Management
6.4. Data Backup, Disaster Recovery and Off-Line Operation
6.4.1. Data Backup
6.4.2. Disaster Recovery Plan
6.5. Support of the IT Infrastructure: In-House vs. Outsourcing
6.5.1. In-House IT Support
6.5.2. Outsourcing IT Support
6.6. Interconnectivity, Interoperability and Exchange of Information
6.7. IT Infrastructure Resources
7. Overview of Operational Planning, Selection, Implementation and Support
7.1. Project Planning
7.1.1. Project Team
7.1.2. Goal Setting
7.2. Understanding the Impact on Workflow and Operations
7.2.1. Workflow and Process Redesign
7.3. Identifying Desired Functionality and Features
7.4. Comparing Products to Create a Shortlist of Vendors
7.5. Vendor Evaluation and Selection
7.5.1. Objective Scoring
7.5.2. System Demonstration
7.6. Shortlisting and Requests for Proposals
7.6.1. Creating an RFP
7.7. Infrastructure Implications
7.8. Implementation, System Integration, Data Migration and Change Management
7.8.1. Implementation Phase
7.8.2. Post-Implementation Phase
7.8.3. System Integration and Interoperability
7.8.4. Data Migration
7.8.5. Change Management
7.8.6. Success Factors for any Project
7.9. Training and Support
7.9.1. Training
7.9.2. Support
8. Acknowledgements
8.1. Writing Sub-Workgroup
8.2. Workgroup
1. Introduction and Executive Summary
1.1 Introduction
Every organization, regardless of type or size, should have a strategic plan in place. Strategic planning is an organization's process of defining its strategic direction and making decisions about how it will allocate its resources to pursue this direction. In short, the purpose of strategic planning is to help an organization establish priorities to better meet its mission.
Information technology (IT) is a business imperative in this day and age. Technology has changed every sector, and the aging services field is no exception. Hence, strategic IT planning must be an integral part of an organization’s strategic planning and enterprise governance.
Strategic IT planning encompasses an organization’s leadership, organizational structures and processes. This planning can help ensure that the organization achieves its strategic goals and objectives.
The strategic IT plan should reflect the relevance of technology to each of the organization’s strategic business goals, and changes the organization will need to make to its information and communications infrastructure.
An organization’s technology environment must be aligned with its long-term strategic plan, goals and objectives. An organization’s management and governance board must recognize the critical role of technology in laying the foundation for and enabling its strategic direction and operational goals.
For this reason, technology governance is ultimately the responsibility of the board and executive management. This is a piece that is often overlooked. Yet, it is essential to implementing a successful long-term technology plan. Strategic thinking about technology has never been more critical for aging services providers that are seeking to define their role in the face of a shifting reimbursement landscape, increasing demand for doing more for less, rising consumer expectations for quality, and an increasing need to demonstrate excellence through objective data.
1.2 Executive Summary
LeadingAge CAST’s strategic IT planning initiative has 4 objectives:
Raise awareness about the importance of strategic planning and the need to incorporate technology into the strategic plan, and regularly update and adapt this plan.
Provide the executive leadership of aging services organizations with an overview of and guidance about approaches to incorporating technology and strategic IT planning into their strategic plans.
Provide detailed guidance, tools, recommendations and resources to help an organization’s IT leadership conduct strategic and operational IT planning.
Share case studies from providers that have successfully conducted strategic IT planning.
This workbook is the first component in a multi-phased initiative that will also include online interactive educational modules and a set of provider case studies. We hope you find this resource helpful in your strategic planning and strategic IT planning endeavors.
The workbook contains 8 sections, including this introduction. The other sections explore a variety of topics, as outlined below.
Section 2 of this workbook provides a definition and a high-level overview of strategic planning, strategic IT planning and operational planning.
Section 3 focuses on governance structure and the role that chief information officers (CIO) play in strategic planning and strategic IT strategic planning. It also presents options for smaller organizations that do not have a CIO, and presents an example of best practice in IT governance from a LeadingAge member.
Section 4 provides an introduction to strategic planning, starting with questions like:
When should an organization consider embarking on strategic planning?
Who should be involved in the process?
What are the common approaches to strategic planning?
This section also presents a deep dive into the vision/goal-directed strategic planning model, which is the most commonly used approach among aging services providers. This model calls on organizations to develop a vision about a future state, and then work backwards to identify what goals are needed to achieve that vision.
Section 4 emphasizes that technology should be incorporated into the organization’s strategic plan from the beginning. An organization should identify a range of technology applications that are relevant to each strategic goal.
This technology can help the organization achieve its vision by facilitating strategies designed to help the organization meet each goal efficiently and cost-effectively.
This section concludes by identifying strategic planning resources, including resources from CAST, which will help an organization navigate the strategic planning and strategic IT planning process.
Section 5 provides an overview of strategic IT planning, which builds on an organization’s strategic goals and the technology applications that are relevant to each of those goals.
This section provides strategic IT planning steps to help an organization assess:
The existing IT infrastructure and how it supports current operations.
Existing technology applications and future technology-related needs.
IT competencies among staff and IT teams.
The need for an IT team to update/upgrade technology applications in order to support new business models and operations, as identified in the strategic plan.
This assessment should include interoperability, integration, interfacing and health information exchange (HIE) needs, including the HIE needs of strategic partners.
Once the assessment phase of the strategic IT plan is completed, the executive team, with the help of IT leadership, should formulate a plan to update the IT infrastructure.
That infrastructure should support all potential technology applications needed now and in the future, including applications that support staff, operations and management, as well as those that serve residents/clients.
Applications serving residents/clients might include Internet access, telephone, television, social connectedness technology, concierge services, energy management, and maintenance requests.
The strategic IT planning process will provide the organization with guidelines it can use to develop detailed specification for the IT infrastructure, as well as for the selection of, and operational planning for, specific technology applications.
Section 5 references templates, tools and resources on strategic IT planning that providers may find helpful.
Section 6 provides an overview of current IT infrastructure trends, including cloud computing, wired and wireless IT network topologies, media, speeds and best practices.
The section then provides an overview of technology applications commonly encountered in senior living, and covers topics like data backup, disaster recovery, and options for IT infrastructure management and support.
This section concludes with relevant IT infrastructure resources from CAST Associates.
Section 7 dives into operational planning and ex*****on of the strategic IT plan, emphasizing the planning and selection of specific technology applications.
The section underscores the importance of engaging an array of stakeholders in the planning and selection process, as well as setting measurable project goals and operational objectives.
The section also:
Explains the importance of engaging stakeholders in identifying desired functionality and key features of a technology application.
Reviews workflows and process redesigns, as well as technology selection and implementation. This information will help organizations prepare a request for proposals (RFP).
Emphasizes the need for ongoing training and support for the new technology applications. This training and support, which must extend beyond the implementation phase, will ensure that the organization successfully meets its strategic goals.
References a number of templates and practical tools that providers can use, including a variety of Technology Selection Tools developed by CAST.
Section 8 acknowledges the workgroup members who contributed to this work, and the writing sub-workgroup who assembled this workbook.
2. Overview of Strategic Planning and Strategic IT Planning
Contributors
Roberto Muniz
President and CEO
The Francis E. Parker Memorial Home, Inc.
Piscataway, New Jersey
Donna Lazartic
Chief Operating Officer
The Francis E. Parker Memorial Home, Inc.
Piscataway, New Jersey
Rick Mallia
Senior Director, Support Services
The Francis E. Parker Memorial Home, Inc.
Piscataway, New Jersey
Audience
General readership, including boards and executive leadership.
2.1. Definition of Strategic Planning
Every organization, regardless what type or size, should have a strategic plan in place.
Strategic planning is an organization's process of defining its strategic direction and making decisions about how to allocate its resources to pursue that direction.
In order to determine the direction of the organization, it is necessary to understand its current position and the possible avenues through which it can pursue a particular course of action.
Generally, strategic planning deals with at least one of three key questions:
What do we do?
For whom do we do it?
How do we excel?
n many organizations, answering these questions is viewed as a process for determining where the organization is going over the next year or, more typically, over a longer period of 3 to 5 years. Some organizations extend their vision to 20 years.
2.1.1. Purpose of Strategic Planning
The purpose of strategic planning is to help an organization establish priorities to better meet its mission. Strategic planning allows an organization to collaboratively align with its mission in a high-quality, meaningful way in order to create a strategic vision of what the organization is, what it wants to be, and how it can change with times.
In short, strategic planning helps an organization project its desired future. An organization’s mission is its purpose and reason for being. It serves as a guiding light.
It has no timeframe. If crafted correctly, it can remain the same for decades.
An organization’s strategic vision is an image of the future that the organization seeks to create. It is a graphic statement of what the organization wants to be and how it will get there.
The strategic vision should reach beyond the organization’s current grasp. Yet, it should be concrete enough that the organization can use it to take action.
The strategic vision should be revisited regularly.
2.1.2. Characteristics of an Effective Planning Process
An effective strategic planning process should not be rushed. The planning process could be simple, but it must also be practical. It should:
Result in a flexible, sustainable and integrated strategic vision framework for the years ahead.
Develop a defined list of strategic goals and objectives, as well as initiatives to position the organization for the near-term and long-term.
Be an inclusive, collaborative and outside-in exploration and decision-making process.
Generate high-impact strategic vision, goals and objectives to which the team is strongly committed and aligned.
Illustrate the organization’s strategic vision and objectives through data-driven strategic business plans.
very strategic planning process is uniquely designed to meet a specific need. Good strategic planning develops through an outside-in process, during which the organization moves from “divergence” to “convergence.”
Divergence includes the following:
An external environmental scan, which identifies trends and uncertainties, as well as external forces of change.
An analysis of market groups, customer characteristics and competitive structures that includes benchmarking of the organization’s key competitive capabilities.
An “as is” assessment of the organization’s current competencies/strengths, culture and values.
Articulation of key success factors and opportunities/capabilities required to help the organization bridge gaps and become a successful, high-quality service provider to the targeted population in the future.
Divergence is followed by convergence, a process that includes:
Generating a strategic vision for the future, as well as near-term, mid-term, and long-term strategic options to achieve that vision.
Synthesizing and clarifying the organization’s direction by identifying strategic initiatives that provide a framework for moving forward.
Developing a detailed business plan for each initiative. These business plans should estimate the magnitude of the economic opportunity, resources, investment and timeframe required to execute the strategic initiative.
Prioritize and approve the strategic initiatives. Identify resource investments and integrate these investments into the organization’s operating and capital budgeting processes.
2.1.3. Keys to Success
As you embark on your strategic planning process, keep these 5 keys to success in mind.
Involve your CIO. Strategic technology and IT planning must be an integral part of strategic planning. For this reason, the organization's chief information officer (CIO) must be a key member of the strategic planning team. The CIO must be involved in the organization-wide strategic planning process so he/she can anticipate how the organization’s strategic goals will impact its strategic IT plan.1
Take one step at a time. When developing the strategic plan, be sure to recognize the organization’s capacity to lead, fund and implement the prioritized initiatives, as well as the effort required to complete these tasks. Strategic planning is a learning and building process; one step leads to another.
Enlist the help of others. Since the planning process is an outside-in effort, most organizations engage an outside consulting firm/consultant to lead the effort.
Keep an eye on the external environment. Organizations need to keep tuned to how changes in the external environment will impact their strategic planning efforts.
Revise periodically. The strategic plan needs to be revisited and evaluated periodically to make appropriate changes and adjust the course of action as necessary.
2.2. Definition of Strategic IT Planning
Strategic IT planning is an integral part of your organization’s strategic planning and enterprise governance. It encompasses your organization’s leadership, organizational structures and processes.
The planning process must ensure that your organization's technology sustains and extends your organization's strategies and helps the organization achieve its strategic goals and objectives.
The strategic IT plan should reflect the relevance of technology to each of the organization’s strategic business goals. It should outline changes that the organization will need to make to its information and communications infrastructure.
The plan should include:
A list of all the technology applications needed to carry out each of the organization’s strategic goals, objectives, initiatives or innovative business models/operations efficiently, cost-effectively and securely.
Updates to the existing information and communications infrastructure that will be needed to support the identified technology applications.
Business and operational priorities, including a roadmap for technology projects that delineates the resources required for each project.
Continuing education and talent management initiatives that will be designed to ensure consistency of IT skills and delivery of customer-focused tech support.
A Security Management Plan for your technology infrastructure that aligns with the guidelines outlined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the National Institute of Standards and Technology (NIST).
2.2.1. Technology as a Strategic Asset
There is a growing recognition that providers of aging services need a robust technology environment to meet the changing needs of residents/clients and provide quality of care and quality of life for those residents/ clients.
Technology adoption must be viewed as a strategic asset, especially in light of the changing consumer landscape. Aging baby boomers -- the future consumers of aging services -- are living longer and using more complex health services than former generations.
They also tend to be educated, tech-savvy and demanding consumers.
Multiple forces -- including heightened government oversight, the patient safety movement, value-based reimbursement, and consumer expectations -- are driving the need for aging services organizations to improve their care delivery and performance.
Additional forces, including health care reform, have steered the field of aging services toward a vision featuring quality, coordinated care that promotes prevention, achieves population health and cost-containment, and maintains client satisfaction.
Achieving this vision of coordinated care requires that organizations put into place a data-driven framework for quality improvement.
This framework should include technologies like interoperable electronic health records (EHR), telemonitoring, and health information exchange. These and other technology applications need an appropriate and robust IT infrastructure if they are going to help the organization achieve its strategic objectives, goals, mission and vision efficiently and cost-effectively.
Aging services providers have traditionally underinvested in technology, compared with other health care and information-intensive industries. But this investment pattern will need to change. Providers can no longer be satisfied with investment levels that allow them simply to “keep up.”
Instead, they need to view technology as a key enabler of the organization’s strategic goals, and plan their technology investments accordingly.
Most organizations pursue technology investments without a guiding road map or strategic IT plan. Creating that plan requires top-down critical thinking about what is appropriate for the setting, and what is important to the organization and its strategic vision, goals and objectives.
Engaging the leadership team, staff and other key stakeholders throughout the entire planning process is essential. So is searching out and investing in leaders with strong technology expertise.
An organization’s technology environment must be aligned with its long-term strategic plan, goals and objectives.
The organization’s management and governance board must recognize the critical role of technology in laying the foundation for and enabling the organization’s goals, strategic direction and operational objectives.
2.2.2. Linking Technology with the Strategic Plan
How does an organization go about linking technology with the strategic plan and business operations goals?
Here are some key steps:
Establish clear objectives and define the role of technology for the organization. Does the organization want technology to be just a utility-like service with a short-term value? Does it want technology to enable business opportunities that add value to its services over the long term? Or does the organization want technology to be an integral part of its business success and long-term strategic planning?
Begin this discussion by conducting some initial benchmarking of your technology strategies and spending levels with peers that are leaders in technology adoption.
Articulate a “future state” technology vision. This vision should be aligned with your strategic plan and should map out which technology areas need to mature in order for your organization to reach its desired “future state.” Those areas might include infrastructure (data, voice and networks); applications (clinical, financial, service and administrative); and training.
For example, replacing current applications could provide an opportunity to re-evaluate, standardize and redesign clinical, financial, service and administrative processes to take advantage of the technology’s capabilities. In addition, training should become part of the organization’s culture as it prepares the workforce for change.
Identify IT process/services and IT governance. You may want to identify a professional organization to select, implement and maintain your complex portfolio of technology solutions.
In addition, decide on the process you will use to make informed decisions and assure the disciplined, effective and efficient implementation of your technology investments, direction and utilization. It is very important that the organization’s board/governing body is committed to making required IT investments.
Assess gaps in technology. Thoroughly evaluate the organization’s current state of technology and the gaps that exist between this current state and the organization’s desired “future state.”
Identify strategic options for filling the gaps. Make a qualitative assessment of these gaps using specific criteria. Those criteria might include your desire to:
Provide strong support for unmet user needs
Assume minimum risk.
Achieve a reasonable time-to-value ratio.
Experience minimum conversion trauma.
Incur the lowest possible cost.
Select your best options and outline implementation projects. Estimate onetime and ongoing costs. Map projects over a multiyear timeframe with the understanding that investment budgets and decisions would come in multiple “leaps.”
Foundational.
Operational excellence.
Innovation.
Set guidelines for software initiatives. Broadly define your guidelines for building software initiatives internally or buying them externally. Factors influencing this decision:
For example, it’s necessary to build a foundational infrastructure (Leap 1) before investing in operational excellence (Leap 2) or implementing technology innovations to differentiate yourself in the market (Leap 3). Your 4-year technology roadmap should be organized into 3 leaps:
For software solutions, you’ll need guidelines to help you determine if the system should be housed in the organization’s internal data environment or a web-hosted (cloud) environment. A number of factors will influence this decision, including:

Staff capabilities.
Customization needs.
Development vs. procurement costs.
Implementation timeframe.
Support needs.
Maintenance costs.
1.The stability of internal environment.
The criticality of the application.
The redundancy and stability of Internet data lines.
Measure the benefit. The governing board should have a comprehensive discussion about how to measure the benefit of technology investments. Numerous studies identify three factors that are needed to realize economic value from technology:
IT should not be an end in itself. Instead, it should enable strategic goals and objectives.
Technology must have an added value. It should not be pursued if the organization’s strategic goals can be achieved in an unplugged, paper-based environment without such added value.
It is critical to measure strategic goals and objectives before and after technology deployment and to hold management accountable for results.
Most aging services organizations engage an outside consulting firm/consultant to lead them through the eight steps described above.
Providers are advised to engage firms that have strong IT expertise, knowledge about aging services, and a track record in long-term and post-acute care.
2.3. Importance of Technology Investments
Technology investments enable efficiency and effectiveness of the organization’s core business, while helping it expand into new directions.
The Journal of Health Care Information Management discourages providers from postponing IT initiatives.
Postponing IT initiatives “will have a negative, long-term impact on a provider’s ability to deliver safe, effective and reliable care,” writes journal editor Richard D. Lang. “In an environment where less cost and more service seem to be the common public cry, the effective use of IT is the only way organizations can meet these lofty demands.” 2
3. Governance Structure and Role of the Chief Information Officer
Contributors
Jonathan Jedeikin
Business Director
DaVinci Digital
Portland, Oregon
Majd Alwan
Executive Director
LeadingAge Center for Aging Services Technologies (CAST)
Washington, DC
Roberto Muniz
President/Chief Executive Officer
The Francis E. Parker Memorial Home, Inc.
Piscataway, NJ
Donna Lazartic
Chief Operating Officer
The Francis E. Parker Memorial Home, Inc.
Piscataway, NJ
Rick Mallia
Senior Director, Support Services
The Francis E. Parker Memorial Home, Inc.
Piscataway, NJ
Audience
General readership, including boards and executive leadership
3.1. Governance Structure
Technology governance is often overlooked, but it is essential to successful long-term implementation of a technology strategy. This governance is ultimately the responsibility of the organization’s board and executive management.
Why is technology governance so important? Any organization making technology investments is always challenged by project outcomes, timelines and expenditures. A robust technology governance structure is critical to maneuvering through these challenges.
The Francis E. Parker Memorial Home, Inc., currently uses this technology governance structure:

Putting a strategic IT plan into practice requires an investment in the organization’s IT capability and capacity. This investment could involve tapping into a combination of in-house staff and outsourced resources.
An organization’s IT capability should include the following functions:
Vendor management. Most organizations have relationships with a complex network of vendors, suppliers, customers and business partners. Staff members with expertise in purchasing, contract compliance and coordinated project management should be responsible for managing these relationships.
Project management. This function encompasses enterprise-wide project planning support, project tracking, resource planning and coordination, measurement against the project plan, and project reporting. These roles may, or may not be, formally defined within the organization.
Technology business consulting. The internal technology consulting function involves staff and teams specializing in emerging technologies. These team members work with and offer consulting services to the organization’s business units. They also conduct training, facilitation and skills transfer. The team may procure consulting services from outside the organization.
Business systems management. Managing an organization’s software applications involves maintaining and enhancing systems, conducting new software development, procuring application packages and managing application vendors.
Technology environment management. This function involves managing an organization’s physical hardware and related software platforms, including a data center and related facilities, networks, system software, help desk and communications systems. It also includes the oversight of all security functions linked to the IT environment.
Technology champions: Having a board member who understands and appreciates technology may help an organization’s leaders garner board support for technology initiatives during the strategic planning, strategic IT planning and budget processes. A technology champion on the board may be best equipped to lead the board’s technology steering committee.
3.2. Role of the CIO
The role of the Information Technology (IT) Department has been evolving within organizational structures for many years.
In most organizations, technology started out as an innovation that warranted a “Research and Development” line item in the annual budget. Technology has since evolved into a critical part of an organization’s day-to-day operations.
With this evolution came the decision, on the part of many organizations, that the IT department would report directly to the Chief Financial Officer (CFO). Depending on the size of the organization, the leaders of different IT teams (commonly referred to as IT Directors) would report directly to the CFO.
Once it became evident that the life cycle of purchased hardware was dictating capital expenditures, the CEO and CFO decided they needed an executive strategic analyst who had fiduciary accountability for the enterprise’s technology vision.
Enter the Chief Information Officer (CIO).
This role is sometimes interchangeable with the Chief Technology Officer (CTO). However, most CTOs have a hands-on role on developing, programming or building on a technology of the enterprise.
The typical CIO is a former System Administrator who developed his or her skills in the areas of executive management and worked up the chain of command after showing consistent, successful results.
In many organizations, the CIO still reports to the CFO. This reflects the role’s financial emphasis, along with its focus on strategic process implementation and management.
In some organizations, the CIO and Chief Operating Officer (COO) report directly to the CFO. Other organizational charts display a dotted line between the CIO and the CEO. This line will depend on the CEO’s technical prowess.
3.2.1. CIO’s Duties and Accountability
The CIO is charged with helping the CEO and CFO understand all technology considerations and how they will impact processes and costs in each part of the organization.
Additionally, the CIO is responsible for providing the organization with a strategic vision, creating IT goals, and developing a path for the organization to reach those goals. Concurrently, the CIO is accountable for the day-to-day operations of IT support for the enterprise.
The CIO, along with other technology professionals, plays a significant role in setting the organization’s strategic direction helping it reach operational success.
Accordingly, the CIO is a “must-have” for aging services organizations interested in elevating the technology conversation to a strategic level with both the board and the rest of the executive team.
Any long-term, broad organizational strategy must take into consideration this larger technological vision.
3.2.2. Realities of Aging Services
Most aging services provider organizations conduct strategic planning. However, conversations with providers and their strategic planning partners indicate that not many provider organizations incorporate strategic IT planning into the strategic planning process.
Only a small portion of the LeadingAge membership has a CIO or CTO who leads their strategic IT efforts.
When a technology professional becomes a member of the leadership in an aging services organization, he or she often oversees the implementation of specific and narrowly focused projects or manages a small IT department tasked with keeping the IT infrastructure and day-to-day operations running and in compliance.
Only on rare occasions do aging services organizations give technology professionals a meaningful role in the organization’s strategic discussions.
Of course, there are exceptions to every rule. A few of the larger multi-site organizations have CIOs who have significant strategic-level responsibilities and conduct strategic IT planning.
Some of these CIOs have advanced IT capabilities and occasionally lend strategic planning help, as well as ongoing support, to other providers through outsourcing or shared services programs.
3.2.3. Options for Smaller Organizations
Smaller organizations, including single-site communities, may not see the need for, or have the financial resources to hire, a full-time CIO.
These organizations have a number of options for bringing a CIO’s expertise to the executive team. They can:
Pool resources with a number of other aging services organizations to share a CIO or an IT Support Department.
Contract with an IT firm to provide a part-time CIO. The level of the CIO’s engagement can change according to the needs of the organization, phases of strategic IT planning, or ex*****on of the strategic plan.
A few CAST Supporters and Business Associates offer CIO services, IT support, and strategic IT planning services.
3.3. Best Practices from Aging Services
It is not uncommon for nonprofit aging services organizations to be 10 to 20 years behind in their IT solutions. In organizations that are behind the curve, the CIO must continually research new practices and systems, and educate the CFO, CEO and the board.
This process involves a complex series of tasks to assess the current IT infrastructure, identify what’s not working, and build a long-term strategy for retrofitting the IT infrastructure, all while keeping the existing system online and planning for smooth transitions to newer systems.
In larger national organizations, it is the corporate practice to restrict the IT infrastructure to business administration, while decentralizing and localizing IT services for residents. This is the approach followed by LeadingAge Member American Baptist Homes of the West (ABHOW).
Founded in 1949, ABHOW operates 44 communities in California, Arizona, Nevada and Washington, where more than 5,500 older residents live.
4. Strategic Planning Approaches and Steps
Contributors
Majd Alwan
Executive Director
LeadingAge Center for Aging Services Technologies (CAST)
Washington, DC
Ravi Bala
Chief Operating Officer
HealthSignals
King of Prussia, PA
Audience
General readership, including boards and executive leadership
Strategic planning helps an organization establish priorities to better meet its mission. Traditionally, strategic planning allows an organization to create a strategic vision by projecting a desired future.
An effective strategic planning process can be simple, but it must be practical. It should:
Generate a flexible, sustainable, and integrated strategic vision to which the team is strongly committed.
Develop a defined list of short-term and long-term strategic goals, objectives and initiatives.
Feature an inclusive, collaborative, outside-in exploration and decision-making process.
Contain data-driven, quantitative strategic business plans that manifest the organization’s strategic vision and goals.
Every strategic planning process is uniquely designed to meet a specific need, according to Carter McNamara, a strategic planning expert with Authenticity Consulting in Minneapolis, MN.
In his online guide to strategic planning models, McNamara suggests that good strategic planning starts with the selection of a planning approach that fits the organization and its reason for planning.3
The approach you choose, says McNamara, will depend on a number of factors including:
The organization’s previous experience with strategic planning. If the organization has not conducted strategic planning before, or if it has not revisited its strategic plan in a long time, then it should start the process by focusing on its vision, mission and value statements.
The purpose of strategic planning. If the organization is adding a new product, service or a campus, then market research is an imperative step in the planning process.
The culture of the organization. Some organizations prefer linear, goal-based planning that comes from vision, mission, values, quantified goals, strategies, action plans, and financial analysis, says McNamara. Others prefer plans that are unfolding and organic.
The organization’s planning environment. If the environment is changing rapidly, or if a previous long-term plan was not successful, then the organization should focus its efforts on short-term planning, advises McNamara.
4.1. When to Conduct Strategic Planning
Carter McNamara advises an organization to conduct strategic planning:4
When it is just getting started. At this stage, says McNamara, the organization’s strategic plan, marketing plan, financial plan and operational/management plan will all be part of its overall business plan.
When it is embarking on a major new venture, like developing a new service program or business line.
At least once a year. The planning process should be designed to help the organization get ready for the coming fiscal year, says McNamara. Planning that takes place before the fiscal year begins can help the organization identify goals for the coming fiscal year, and the monetary resources needed to achieve those goals. These funds should be included in budget planning for the coming fiscal year.
McNamara notes that not all phases of strategic planning have to be completed each year. Most organizations will conduct a full strategic planning process every 3 years and do incremental planning annually.
If the organization is experiencing tremendous change, it should conduct a full strategic planning process every year.
Action plans should be updated each year. In addition, please note that the organization’s progress in implementing the plan should be reviewed by the board at least on a quarterly basis.
The frequency of that review will depend on the extent and rate of change in and around the organization.
4.2. The Strategic Planning Team
A planning team should conduct strategic planning. That team should include the chief executive officer, board chair, board members, and a host of organizational stakeholders, as outlined below.
The organization’s Chief Information Officer (CIO) should be a member of the strategic planning team to insure that technology and information technology (IT) are considered during the planning process.
Having a technology champion on the board may help insure that technology is ingrained in the strategic planning process. That board member may also oversee the strategic IT planning process.
Carter McNamara recommends that organizations follow these guidelines when creating their planning team:5
Include the chief executive and board chair on the planning team. These individuals should drive development and implementation of the strategic plan. In addition, make sure that members of the board are strongly involved in planning. Strategic planning is a primary responsibility of a board of directors and is key to effectively leading the organization.
Establish clear guidelines for selecting other members of the planning team. For example, you may want to include staff members who are directly involved in organizational planning, or individuals who can provide key information to the process. Be sure to involve both board and staff planners in all phases of planning, says McNamara. This helps board members understand the day-to-day issues of the organization, and helps staff understand the organization’s top-level issues.
Make sure the planning team is representative of the organization’s residents/clients and surrounding community. If board members don’t bring enough diversity to the planning team, bring other people into the planning process, says McNamara. Involve as many stakeholders as possible.
Make sure the planning team includes several key members. At least one person should have ultimate authority to make strategic decisions for the organization, advises McNamara. You should also involve individuals who will be responsible for composing and implementing the plan. Finally, involve someone who will administer the planning process. That person will be responsible for arranging meetings, helping to record key information, and monitoring the status of workgroups.
McNamara suggests that different types of team members may be needed at different times in the planning process. For example, board members may play a large role at the beginning of a planning process, when they will set the organization’s strategic direction by developing or revising its mission, vision and values statements.
Later on, staff members will ramp up their involvement as they conduct a variety of analyses designed to identify the organization’s current issues and goals, and suggest strategies to address those issues and meet those goals.
Have doubts about whether to include specific individuals in the planning process? McNamara suggests that you err on the side of inclusion. “It's worse to exclude someone useful than it is to have 1 or 2 extra people involved in planning,” he says.
4.3. Common Models and Approaches to Strategic Planning
Carter McNamara outlines 6 models and common approaches to strategic planning.
4.3.1. VISION OR GOAL-BASED PLANNING
Goal-based strategic planning is the most common model of strategic planning. But, it is not suited to every organization, says McNamara. Organizations using this model will develop a vision of the organization’s desired “future state.” Then, they will identify the goals that are needed to achieve that vision.
McNamara recommends the vision-based model for organizations that do not have a large number of current issues to address, have sufficient resources to focus on an ambitious vision, and have external environments that are not changing very rapidly.
The goal-based strategic planning process includes 7 steps, according to McNamara:
Identify your purpose. The board and top-level managers at the organization should work together to develop a mission statement describing the basic purpose of your organization. The statement should describe the needs of residents/clients and how you intend to meet those needs.
Establish your vision. The vision statement describes the desired “future state” of your organization and the residents/clients you serve.
Select your goals. Goals are general statements about what you need to accomplish in 3-5 years in order to fulfill your mission, achieve your vision and address major issues facing the organization.
Identify strategies for reaching each goal. Technology may be one of the strategies the organization uses to achieve certain goals. Or, it could be used as an enabling tool within certain strategies. Note that small organizations might skip this step entirely and move directly to identifying action plans for each goal.
Develop action plans for each strategy. Action plans outline specific activities or objectives that each major department must undertake to implement each strategy or achieve each goal. Objectives should be clearly worded so the organization can assess if they have been met. Ideally, top management will create specific committees and give each committee a work plan or set of objectives. These committees can identify specific technology applications and the required IT infrastructure for each objective.
Compile the strategic plan document. The plan is composed of the work completed in steps 1-5. Upper management should approve the plan at this stage.
Monitor implementation of the plan and update the plan as needed. It’s important to reflect on how well you are meeting goals and implementing action plans, says McNamara.
4.3.2. ISSUES-BASED PLANNING
While vision-based planning works from the future to the present, issues-based strategic planning works from the present to the future. The organization identifies issues that affect it today and then devises strategies for addressing those issues.
McNamara recommends issues-based planning for organizations that have very limited resources, several current and major issues to address very soon, little success with achieving ambitious goals, and/or or very little buy-in for strategic planning. An organization that undertakes issues-based planning for a year may want to undertake vision-based planning after it strengthens its internal operations, he says.
The issues-based strategic planning process includes 4 steps, according to McNamara:
Identify major issues that the organization is currently facing. Include 3-to-5 major issues that you’d like to address in the next 9-12 months.
Identify reasonable approaches to addressing each major issue. “It's not important that the ideas be the perfect ideas,” says McNamara.
Compile the strategic plan document. Include each issue and each approach. Upper management should approve the plan at this stage.
Monitor implementation of the plan and update the plan as needed. It’s important to reflect on how well you are meeting goals and implementing action plans, says McNamara.
4.3.3. ALIGNMENT MODEL
The alignment model is designed to ensure that the organization’s mission and its resources are in sync so the organization can operate effectively.
McNamara recommends the alignment model for organizations that need to fine-tune their strategies

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