ITIL, Microsoft Style

After doing a bit of of reading and modeling some of our processes, I find that I prefer Microsoft's spin on the ITIL framework. Microsoft makes a point of acknowledging that their own Microsoft Operations Framework (MOF) is based on ITIL. That's a good thing because ITIL processes are based on an enormous amount of data and proven design.

There are three things I like about MOF:
1) It is more team oriented.
2) It emphasizes lifecycles.
3) It integrates with Microsoft Solutions Framework (MSF).

Microsoft's Solution Framework is a process framework for designing, developing, testing and releasing applications. Think of it as ITIL for developers. I believe that together, MSF and MOF cover more of the typical HIS IT activities than does ITIL alone.

I haven't quite figured out if Microsoft developed and published MSF and MOF out of the goodness of their hearts or if we can expect some kind of licensing model. Past experiences would point to the latter. If nothing else, perhaps a way to lock in Visual Studio developers.

In any case, I still see significant value in these frameworks and team concepts. Here are some good introductory books from Amazon on MSF and MOF.

Bling, Revisited

I've had a few folks email me and either ask how I define Bling or tell me flat out that my motorcyle is Bling and I need to step off of my soap box. Fair questions and I'll take another shot at this.

I define Bling as something you buy, not for its functional, artistic or other esoteric value to you, but for what it communicates about you. In other words, Bling is something you buy because you want to show off your current, or wished for, status in life.

Cadillacs are Bling (Let's be honest, a Buick is just as nice, just as well made, just as powerful). Hummers and Beemers are Bling, too. If you buy it for the sole purpose of impressing or showing off, it's Bling and it's wasted money. That's my definition. It's money that has a better purpose in this world. Here is a better purpose, among many others.

Back to motorcycles. My wife and I have over 30,000 miles on ours and we bought it to ride, not to impress the neighbors. That makes it a shameless toy, a luxury item. But not Bling. Here in America we're truly spoiled with our ability to buy luxury items. Enjoy and appreciate what you have, but let's not get carried away.

Let me know what you're definition of Bling is. At what point do you feel it's time to spread the wealth?

PUTN

Today I was up early to make my trek to Good Samaritan Health Center in Merrill. I stopped at McDonald's for coffee and noticed that they have a great new customer service- they'll put the cream and sugar in your coffee for you. That's really nice of them because I don't like struggling with the cup and lid with visions of stained ties, scalded genatalia and other such unpleasantries.

What I really like about this setup is that they use their current technology to provide better customer service. They do this with a new transaction code for "putting in" cream and/or sugar. The transaction code is PUTN (get it?). The use of cold transactional systems to provide cream in my coffee brought a smile to my face. McDonald's found a simply-elegant way to insert better customer service into an existing process using existing technology. And those who know me know that I absolutely love simply-elegant solutions.

As I reached for the coffee cup with "2C" (2 creamers) hand-written in silvery-ink on the lid, I thought, "Kudos McD's". However, proving there is always more room for improvement, that silvery ink on my lid left a gray smudge on the tip of my nose that I didn't notice until after my meeting with senior leadership.

Assumption Hall of Shame

Those of you who know me, know that few things get me riled up as fast as an implementation team that operates on a batch of undocumented assumptions. How many milestones have you seen blown out because someone expected something in your environment that wasn't true? Worse, the expectation was never documented and presented ahead of time? I'd like to blame vendors for this but I've seen our own internal teams make the same mistakes.

This makes me ballistic every time. Why? Because coming up with a list of expectations and assumptions is not a hard thing to do, and would go far to make implementations proceed smoothly. Sit down with your team, go through the implementation and ask, "What do we assume here?" for each step in the process and each connection to be made. It's too important to ignore, yet it all too frequently is.

Here's a few good ones by an unnamed transcription vendor that delayed go-live and required many unplanned hours of drop-everything-and-run work this week:

Undocumented assumption #1: Our Dictaphone server had a public IP address (huh?)
Undocumented assumption #2: All users have administrative rights to their pc (huh?)
Undocumented assumption #3: All users have their own pc (in healthcare?)

I've seriously considered a new blog filled with vendor names and their puzzling assumptions to post for all to see. I would call it the Assumption Hall of Shame. But I'm too nice. So far.

Site-to-Site VPN a God-send for rural clinics

One of my hospitals has three, hospital-based clinics. Of course all are rural and of the three, one of them (Victory Medical Group in Owen, WI) is just plain out in the sticks. Between the cost of WAN connections (even with USAC grants) and the lack of WAN providers in Owen, we've just never been able to justifiy a serious WAN link.

When we built the new clinic, we installed a DSL connection so that we could provide faster Internet service as well as some VPN access for Owen staff back to the hospital. This was a nice step forward but still not where I wanted to be.

Enter the Cisco 3002 VPN hardware client. This network device uses the $60/mo DSL link as a secure channel back to our regional VPN concentrator. Implementation has provided exactly what I was looking for: an affordable way to extend our network to the Owen clinic. The user experience at Owen is exactly as it would be if they were back at the hospital. Logging in is the same and accessing network resources is the same. We also have a legacy UNIX-based practice management system that will now be able to access IP-based printers at Owen through the VPN.

The 3002 is around $800. Compared to a T1 link to Owen, this solution pays for itself in about 45 days. It's not a perfect solution and I would advise anyone considering this type of solution to thoroughly analyze the risk associated with relying on the public Internet for this kind of connectivity. At Owen, patient care would not be affected if the link was inoperable.

Rural healthcare is typically very challenging financially. At the point when we wish to implement patient care IT in Owen, we will need to re-evaluate Owen's WAN connectivity. For now, however, I'm pretty pleased with this set up as it accomplishes the objectives at a price the clinic can afford.

Mixed feelings for the ASP model

Richard MacManus has a very interesting post at ZD Net about Google Office pieces, including some screen shots (here). The prospect of little 'ole Google challenging Microsoft for office apps makes for pretty heady stuff.

Where I fail to get excited though is with the whole ASP model. Why? Because a lot of the work I do is off-line. Most mornings, I work in the car on the way to the office (my lovely wife drives). I also work on weekends at my in-laws cottage on a secluded lake (take my word for it, nothing high-speed takes place at that cottage, including Internet access).

So the very times I carve out for creative development, I'm cut off from my tools in an ASP world. In the email space, Microsoft Outlook saves the day with it's offline model. What are the odds of the Googles and Intuits (Quickbase) providing offline capabilities? Slim to none I would guess.

The other issue is trusting the ASP to preserve the integrity of your data and not finding ways to use it for their own marketing or competitive advantage.

When it comes to the ASP model for critical applications, I'm still wary. I'll let you know when (if) I change my mind.

A New Philosophy

My CIO dropped a subtle pearl of wisdom at an enterprise IT leadership meeting we had yesterday. It's elegantly simple and it goes something like this:

We don't base our decisions around philosophies. We base our decisions around analysis.

The intent is that conventional wisdom should be challenged at times and reevaluated in light of current data. That strikes me as an excellent decision making philosophy.