I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).
I wrote this piece in March 2008.
Everybody Hates Their IT Department: Where Alignment, Control, and Honesty Collide
By Mr. HIStalk
I was talking to a colleague at HIMSS about IT departments. “Our users hate us,” he lamented. “We’re nice people trying to do the right thing, but they hate us. You wouldn’t believe some of the jokes and nasty comments we hear.”
The easy answer is that nobody likes being told they can’t do something. That’s a core competency of many IT departments: telling users they can’t install software on PCs, can’t buy systems without IT approval, and can’t blow the entire organization’s IT budget buying big-screen monitors and stylish laptops. Doing their job as laid out by leadership, in other words, as unpopular as that may be.
Implementation projects, however, probably encourage even more unlikable behavior. The marching orders are to get the system live, on time, and on budget. If that means steamrolling user objections for the good of the order, even valid ones, so be it.
In that respect, the interests of the IT department and its vendor are aligned. So, it’s not surprising that users regard them both with the same distrust and sometimes disgust, writing them off as fast-talking flimflammers trying to put something over on the people who have to live with their systems long after they’ve moved on to the next project.
IT is just another vendor. Vendors are unresponsive, clueless, and untrustworthy, users reason. Ergo, we hate them all. They get no credit for trying to do the right thing in moving the big-picture dial.
IT lives in the world of conference rooms, PowerPoints, and big teams. Clinicians thrive on making quick solo decisions with whatever information is available, changing the plan after seeing the result. It’s an honest world, though, and when IT people try to hard-sell the benefits of going live, changing processes, and accepting software inadequacies, the “us vs. them” atmosphere sets in quickly.
Clinicians are also quick to spot even well-intentioned dishonesty or heavy-handed enlightenment campaigns since they deal with human frailties all day long. When project people conspire offline to minimize or even hide major software problems, enlist secret allies to manipulate group thinking, or strategize with leadership to marginalize whiners, finely-tuned clinician noses immediately catch the unmistakable whiff of manure.
Sometimes those noses pick up the scent of condescension as well. IT folks fancy themselves as process experts and unbiased observer, which they very well may be. Users can’t make decisions, aren’t consistent in processes, and don’t understand the big picture, the logic goes. Using that knowledge to influence behavioral change, however, requires an incredible amount of finesse and ongoing respect. Those qualities don’t always run deep in IT-land.
It’s nearly impossible, in other words, for IT to be the much-loved middleman for policies made at the top but despised at the bottom: technology control, process change, and application imperatives. The IT department is often smack in the middle of clashes between what executive management wants and what the rank-and-file is willing to do with the resources they have.
It may be oversimplification to say that every IT department that’s doing its job will be scorned by users. In hospitals, however, the current state of leadership and IT alignment nearly assures it.