This document discusses 5 key considerations for improving healthcare IT performance and security: 1) Get a handle on assets to improve scalability, 2) Break out of technology silos to improve reliability, 3) Target specific areas for performance improvement, 4) Predict future performance issues related to scalability and performance, and 5) Implement a methodology for continuous improvement rather than reactive changes. It emphasizes focusing on "lead metrics" like packet loss that predict issues rather than "lag metrics" that measure after problems occur.