Management and Leadership
What the exam tests
This domain tests how health IT work is governed, funded, staffed, and delivered. Know project management fundamentals-scope, schedule, budget, risk, quality, and change control-and the difference between predictive/waterfall and adaptive/agile approaches. Understand business-case development, ROI and total cost of ownership, capital versus operating expense, vendor selection through requirements and RFP processes, and contract and service-level management. Governance topics include steering committees, prioritization, portfolio management, and ITIL-style service management with incident, problem, and change processes. Leadership content includes stakeholder engagement, communication planning, team development, organizational change models, training and adoption, benefits realization, and regulatory risk management.
Traps
Candidates confuse capital and operating expense, or project, program, and portfolio. A project is temporary and produces a unique result; a program coordinates related projects; a portfolio is the prioritized collection. Agile does not eliminate documentation or governance-it changes cadence and artifacts. Another trap is assuming a go-live equals benefit realization; adoption and workflow redesign are required. Do not treat change management as a communication email.
Rule of thumb
Use the “people, process, technology” lens, and remember that no benefit is realized without adoption. Worked example: a CIO requests funding for a new patient portal. The business case should state the problem, options, total cost of ownership, expected benefits and measures, risks, and adoption plan. Classify the spend as capital or operating, identify the executive sponsor and steering committee, and define how success will be measured after go-live.