Rethinking Team Structures for Health Information and Technology

While clinical staffing challenges often dominate the conversation, I&T faces similar pressures.  Health systems must invest in information and technology roles and staffing structures to meet ever-growing demands while providing daily operational support.  As noted in Becker’s Hospital Review Where health system leaders are doubling down — and pulling back — on hiring, “focus is on optimizing workforce strategies that enhance efficiency and improve the employee experience…it is about realigning [the workforce] in a way that allows us to deliver exceptional care today while building a more sustainable model for the future”.

To achieve this, evaluating how I&T teams are organized is crucial.  The right structure doesn’t just keep technical systems running - it drives agility, efficiency, and value across the organization.

Why Team Structure Matters

Consider a real-world example:

A health system planned a three-month implementation of an Infection Control system.  Because of its fragmented I&T structure, the project required more than 18 different I&T resources from across 13 teams (seven different technical and application teams and four informatics teams).  Plus, more resources were required for project management, regulatory, learning services, and other I&T supporting roles.  Coordination was so complex that the project stretched to nine months, and post-go-live support was chaotic, with tickets bouncing between teams because they individually did not understand all the integrated parts of the workflows and technology.

Now multiply this situation across all the organization’s active projects requiring I&T.  It’s a miracle any of their projects completed, much less on time, within budget, or delivering the expected value.

As illustrated by this organization’s experience, without a well-aligned, agile structure, I&T teams become siloed and inefficient, slowing down delivery of services, missing improvement opportunities, and limiting the return on technical investments.

A strong team structure:

• Encourages expanding skills and capabilities by fostering specialized generalists who blend breadth and depth of expertise.
• Empowers agility and efficiency by reducing the number of resources required and breaking down knowledge silos.
• Supports collaboration through transparent communication and cross-functional coordination, breaking down walls between teams.

Key Considerations for Organizing Health IT Teams

Creating an effective structure requires balancing specialization with flexibility. 

Some organizations maintain separate departments for informatics, learning services, and PMOs; others integrate them within IT.  Either way, coordination is non-negotiable -the I&T structure must cross department and division lines and incorporate these areas to prevent silos and misalignment.

Further I&T structures must evolve. Leaders must invest in professional development and cross-training; regularly reassessing team composition and rebalancing as technology evolves and organizational priorities shift. This approach builds resilience by decentralizing specialized expertise, expanding team knowledge, and ensuring staff can pivot between support and project delivery. The Demand-Talent-Team Triangle offers a practical framework for right-sizing teams based on forecasted demand.

Finally, all teams, whether they report up through the same leadership or are more cross functional, must establish role clarity. Navigating Role Clarity in Healthcare IT and Informatics Teams provides tips for crafting a collaborative team environment.

Breaking Down an Effective I&T Division

While every health system has unique needs, a forward-looking I&T division can be structured into three major verticals:

1. Patient Consumer Systems

These are the technologies directly impacting patients and clinicians, covering clinical services and patient revenue cycle systems — EHR applications, lab and imaging systems, patient portals, scheduling, billing, and care coordination applications.  Effectively organizing within this vertical means smoother workflows for providers and a more seamless experience for patients.

2. Shared Services & Infrastructure

These functions are the behind-the-scenes powerhouses that make everything else possible: project management, informatics, testing coordination, learning services, data analytics, interfaces, helpdesk, information security, networking, cloud services, etc.  Organizing these areas ensures efficiency in sharing services that are needed for almost every project and those necessary for keeping patient and business systems reliable, secure, and scalable.

3. Business Systems

These systems keep the health system business running — HR, payroll, ERP, contract management, legal compliance, and marketing platforms are examples. While distinct from clinical systems, their success is equally critical to the organization’s stability and financial health, and often have different I&T support needs. 

By organizing under these three verticals, I&T divisions maximize resource capacity, strengthen knowledge sharing, and minimize internal competition when delivering services.

Putting it into Practice

For example, all analysts should understand the regulatory and quality requirements impacting their applications and support areas rather than relying on a separate IT regulatory compliance team.  This approach increases capacity and leverages principles from Unlock IT Capacity Without Adding Staff or Capital Expense.

Finally, documenting and publishing each team’s responsibilities is also crucial to establishing expectations and communicating how I&T is supporting the organization.  

For additional simple solutions for ensuring  an effective and agile I&T support structure, see the article Organizing IT and Informatics for Today’s Healthcare System.

Building for the Future

Healthcare IT is constantly evolving, and industry demands rapidly shift - shaping how I&T teams must operate. To stay ahead, organizations should:

• Regularly reassess IT division structures and adapt it to emerging needs.
• Cultivate specialized generalists capable of supporting integrated topics and areas.
• Establish professional development plans that prepare staff to grow their talents.
• Empower cross-functional collaboration that blends clinical, technical, and operational expertise.

How MAKE Solutions Can Help

Ready to rethink your I&T division’s structure?  Connect with MAKE Solutions to learn how we can help you design for sustainable success.  Visit www.makesolutionsinc.com to get started.