Centralized leadership model isn't connected with local teams
Pros
Competitive pay for healthcare IT. AHIS gets this right. Promotes from within, however that's based primarily on personal relationships rather than quality of work and potential. Mostly one has the tools they require to do their best possible work. Project management processes are solidly put together.
Cons
There are too many layers of management, particularly from the director level and up. Mid-level and senior leaders who are located away from their core teams and the hospitals' IT staffs are utterly disconnected from what really happens where the boots are on the ground. Inane decisions are made on a regular basis which creates days and weeks of unnecessary work. Non-sensical IT projects are routinely created simply to justify leadership and system office jobs; meanwhile the negative impact of the same falls upon the front line employees at the local health systems. System-wide solutions often do not meet local hospital customer needs, and again the explanation for that falls upon the front line employees. Poor results from senior level staff/teams are often praised by senior level leaders due to all the hard work put in (ignoring the poor results).