A couple of years ago we separated our “technology division” into two groups: IT Engineering and IT Operations. The dividing line between the two is the production environment. Any new technology is architected by our Engineering group before it goes into production. Once something is in production it belongs to IT Operations and it cannot be touched without going through the change management process.
Here is an example of the IT Engineering group doing a good job:
All IT organizations are seeing a mounting desire for employees to use their own devices (especially iPads) in the workplace. When I recognized that this demand would be huge, I began advocating to connect Android and iOS devices to our Exchange Server via AtciveSync I went to the Engineering team, who is charged with evaluating new technologies before they go into production.
To their credit they said that the vanilla approach to device connectivity would not meet our security expectations. They told me that the only way we could safely manage employee owned devices would be through a device management system that would sandbox the organization’s data, protecting it from security flaws, malware and poor user security practices. They also told me that this would only cover the Exchange connectivity use case and that any other use cases would require further analysis (and perhaps additional expense).
I was disheartened to learn about the added cost, but I would much rather surface that with our executives so we can make a fully informed decision rather than spring a surprise expense on them later.
Candid CIO 
It is a good division of labour, but often the Operations team is also responsible for the lower environments (dev, qa etc) and causes the push-pull b/w the two groups. Conceptually, DevOps is supposed to bridge the gap b/w IT Engineering and Operations ?
Can you comment on general Healthcare IT structure philosophy? Where do you see the grayer items such as DBA, Interfacing, BioMed, PACS, HIE Engineering? Ops? Apps? Dev?
Probably not, there is no one-size-fits-all. It depends on a number of factors, size being one of the most important. For an organization over 100 FTEs I would suggest separating Operations and Engineering. Most healthcare IT organizations do very little Development.
Today we use a remote service for our DBAs (remoteDBA – they are great). Our Business Intelligence team (in the Applications division) manages the DBA service. The interface group is also in the applications division.
Biomed is entirely dependent. I need to find ways to work more closely with them.
What ended up doing? Did you get the funding to sandbox exchange?
No John, at this point we are not connecting iOS or Android devices to our email server or other network assets. Our organizational and IT priorities lie elsewhere now. We plan to revisit this in the Spring. As an iPad owner I would love to be able to easily access my work email on that device, but seeing what else is on the IT priority list I recognize why other choices were made.