I am starting to study IT infrastructure frameworks such as ITIL. The idea is that you have a standard way of handling most aspects of IT service management such as change management, continuity, capacity management, incident management, etc.
In my research I found the IT Service Management Forum whose mission is to “enable member organizations to achieve measurable operational excellence by introducing, developing and promoting IT Service Management Best Practices. ” However, I wasn’t able to order any publications from them because their online ordering page is down. How ironic is that?
Still, the notion of IT frameworks is more appealing to me as Ministry Health Care begins to consolidate its IT services into a single service organization. Ideally, we will develop a framework that addresses these elements of infrastructure management from an enterpise perspective. Otherwise, they will only be as good as each person assigned to manage a specific technology. For example, we can set some standards for managing availability. Those standards will be a guide for the rollout of services at the enterprise level. When we consolidate email, the email guru will have some guidelines for addressing availability. S/he will be given direction on assessing availability requirements; develop an availability plan; monitor availability; etc.
I don’t think this apporach makes sense for most community hospitals. But for larger networks that have 10,000 plus employees there is value in this level of discipline. Especially as more mission critical applications are brought online.
Candid CIO 
Since community hospitals have revenues is the $30 to $100 million range these days, wouldn’t it be worthwhile to at least have an IT manager familiar with IT frameworks present at community hospitals? Couldn’t some of the thoughts and processes coming from a framework increase efficiency and reduce costs? Aren’t many of the best practices inherent in a framework applicable to sites with as few as 300 desktops?
INTEREISTING
ITIL is just what you stated . . . a framework. It requires significant heavy lifting by the staff to make it usable. It is adaptable to smaller shops. Try Problem Management as an initial area of implementation for the best return. I’ve been using for at least 10 years and have been dissappointed at the slow growth in the US, but then again many of the high dollar consulting shops charge for proprietary frameworks that are no better in practice. Therefore ITIL is a threat to many consulting shops just as a standard/interoperable EHR is to many HIT vendors.