As an IT executive responsible for technology infrastructure, one of the things that always kept me up at night was the chance that the business would scale so quickly that the existing infrastructure would not keep the pace of evolving technologies. 

My mind would race thinking that this could result in lost revenue opportunities, failure to competitively differentiate in the healthcare market and/or missed opportunities for mergers and acquisitions. If this imaginary dilemma came true, it would not be a good look for the information services team or the organization's leadership responsible for strategic planning within IT.

It was frequently top of my mind that changing and developing business requirements could result in a need for significant infrastructure investments. The investments themselves are sometimes challenging, but even more demanding is the time that is required to forklift or refresh major infrastructure components.

In some cases, these initiatives can take more than two years. Asking the business to pause for 24 months while you upgrade the technology infrastructure is unacceptable.

There are a few things that I think are key to successful posturing of service delivery in this situation. The first is that it is important to have a strategy around technology infrastructure refresh work. Understanding technology life cycles and articulating capacity and performance limitations to the senior executive team is instrumental to establishing and executing a good game plan.

Maintaining a large technology infrastructure requires constant investment just to keep the environment current, not to mention preparing for business growth. In order to foster strategic decision-making, technology leadership must have a crisp understanding of what the business is thinking in terms of growth and scale and what that means to them in terms of timing and investment requirements.

We would all like to roll out infrastructure technology with excess capacity and capability, but in the real world this is often not possible.

Next, you must have a solid team of professionals dedicated to an organization's infrastructure technology and business continuity planning. This starts with architects that really understand the need for standards and the interoperability/integration of certain platforms. These folks are critical to ensuring that the right design takes place at the right junctures.

From there, it's necessary to have a team of infrastructure engineers that is responsible for implementing and configuring the technology so that investments can be maximized. Lastly, the infrastructure operations or support teams are instrumental to keep the technology running while looking for trends that suggest problems are on the horizon.

I also believe that an organization must have strong governance in place in order to build infrastructure technology for the future. This governance ensures that prioritization and review is taking place, not only for technology investments, but for project investments that will likely require additional infrastructure technology.

Lastly, I think that having a strong relationship and partnership with the dominant players in the infrastructure space is key. This will help you better understand what other customers are doing and learn how to think about things that your organization is likely to be thinking about in the next few years. 

Similar to maintaining a relationship with the infrastructure providers, I think it also makes sense to have a strong partnership with research and advisory groups that can help you with planning efforts.

At the end of the day, technology infrastructure executives are going to have to sing for their supper. Having a solid track record of good investments and reliable/resilient technology is a good starting point to identifying and achieving goals. 

However, these folks also need to know enough about the business and how to help translate business requirements to infrastructure needs. This includes articulating risks for delaying investments or not being forward-thinking enough when it comes to designing and implementing new infrastructure technology.

As dollars get tighter and you are competing against other critical priorities, one must be very intentional around these investments that often don't have a tangible return on investment calculation.

John P. Donohue is Vice President of Information Services Enterprise Services at Penn Medicine.