| | June 20178CIOReviewIn my opinionAligning ALM Strategy with Market DisruptionsBy Robert Basham, Director - Information Management, Scripps HealthTraditional Application Lifecycle Management (ALM) modeling in healthcare has undergone a total transformation in the last eight years. Historically many organizations adopted a best of breed approach that allowed each of the organizations verticals to select the best of breed vendor that would offer the best solution for the needs of that department. Laboratory departments would advocate and select the best lab system for their needs as did radiology, pharmacy, finance and all the other departments across the organization. Healthcare information technology and the healthcare industry have been radically changed in last eight years. Many people across the Information Technology space would say that healthcare is the last to adapt to new technology and 20 years behind other industries. Healthcare has leapfrogged into the frontier. There are few industries that have been impacted by federal regulation, financial models, payer mixes, retailization of healthcare, consumerism and market competition. Each of these disruptive market forces would make any organization review their ALM strategy but their business model. Together these forces have prompted every healthcare organization across the country to reevaluate and pivot to quickly address the market changes.This has required C-suite executives and organization boards to reevaluate their business model and ensure that they have a laser sharp strategic focus to understand how to navigate the shifting healthcare landscape not only in the short term but also the long term to quantify ROI and the financial viability of the organization. I believe that Scripps Health has worked hard to balance the needs of the San Diego region to provide world-class healthcare and a sound financial model that can quickly pivot in changing times.In 2009, few people were aware that the American Recovery & Reinvestment Act (ARRA), which was meant to repair America's highways would impact healthcare. The ARRA had $19 billion earmarked for the development of healthcare information infrastructure and assistance for healthcare providers' adoption of healthcare information technology in the HITECH section of the act. The HITECH section pushed every healthcare organization in the country to review their Application Lifecycle Management (ALM) strategy for their Electronic Health Record (EHR). 2009 was the beginning of seismic changes that rocked the healthcare industry. Healthcare organizations quickly began to realize the HITECH program would not only be the carrot to change the ALM for their EHR and the stick for future Health and Human Services (HHS) reimbursement. The HITECH incentive program drove providers and hospitals to adopt and demonstrate that they "meaningfully use" certified EHR technology. In parallel HITECH drove the health information technology vendors Robert Basham
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