Oct
28
Solving the Problem called HCIT Implementation Failures
Filed Under Clinical Informatics, IT-related, Management, Observations
I recently read a blog at http://hcrenewal.blogspot.com/2009/10/from-down-under-story-of-deployment-of.html
This is yet another example of “those who do not learn from history are condemned to repeat it”, I am afraid. People listen, hardly ever learn.
This is becoming a real problem.
- Firstly, people really do not understand what healthcare IT is all about.
- Secondly, they visit a few conferences, read a few articles, and get taken in by the rhetoric spouted by entities with vested interests – need to make a sale/do the numbers – that are keener on doing the business instead of creating a value. This results in them having faulty ideas and they ask for stuff without thinking through the consequences of having them. E.g., web browser based Java product. Ask them why, and they have no clarity whatsoever.
- Thirdly, they wish to economize in every possible way. Best is not having to pay anything at all for the software. Not much problems with hardware.
- Fourthly, the voice of reason being the most muted, it gets drowned out in the din raised by those of vested interests.
- Fifthly, the entire planning, procurement, implementation, change management and maintenance process is so poorly handled throughout that not even a wild goose is to be found at the end of the chase.
- Sixthly, requirements management is non-existent, even though it is the single-most crucial thing in any IT solution development process. Those who understand it do not practice it. Those who don’t are never even told about it. The end-result is that the one who sanctions and pays for the solution gets any attention paid to; yet, the end-users who actually have to use the system are never even consulted. This situation translates into the creation of a solution that no one uses, which makes it uncomfortable for the sponsors and solution champions to justify the costs, which makes the administration/management/board very unhappy, which creates a particular dislike for the supplier and a general feeling of distrust at healthcare IT as a whole.
- End result? We are where we are.
The solution is not too complicated.
- Firstly, get proper and knowledgeable expertise who will guide the entire process. Best is internal who can be a champion for the entire process. External ones are always next best.
- Secondly, recognize that the solutions pay back through increase in efficiency and productivity with generation of goodwill as a direct result of increased stakeholder satisfaction.
- Thirdly, involve the end-users at all levels. There will be certain hostiles who will not allow the system to run for one reason or the other – loss of power, fear of getting caught, etc. Recognize and deal with these power-plays at work.
- Fourthly, pay maximum attention to requirements management and end-user acceptance testing.
- Fifthly, economize at one’s peril. It will be great to remember, if you pay peanuts you will get monkeys.
- Sixthly, pay equal attention to people, process and technology (the actual solution) and not 80% to technology, 15% to process and 5% to people. Pareto’s rule does not apply.
- End result? We might get there.
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