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September 4, 2013 Readers Write 1 Comment

Be the One
By Daniel Coate

9-4-2013 6-01-52 PM

Amidst all the paperless aspects of our world, last year I subscribed to the New York Times Sunday edition on paper. I really enjoy the old-school nature of waking up Sunday morning, walking down my driveway to pick up the paper, and spending a couple of hours with a cup of tea or coffee reading the in-depth analysis of the week’s news.

I was taken by an article in the December 8, 2012 edition of the paper entitled, “Billion-Dollar Flop: Air Force Stumbles on Software Plan.” I’ve had it on the corner of my desk since and am just now thinking I should write about it.

The bottom line is that the Air Force is canceling a six-year modernization effort of its logistics systems and processes. On the technology front, they were attempting to convert from custom legacy logistics systems developed in the 1970s to an Oracle ERP system. The six-year track of the project cost “them” $1 billion (oh, and when I say “them”, I really mean “us”). By the time the Air Force canceled the project, it had realized it would cost an additional $1 billion just to achieve one-quarter of the capabilities originally planned. As a reminder, one billion is a big number – if you were to start counting right now at a rate of one number per second, you’d get to 1 billion in 2045 (32 years).

In analyzing the reasons for this colossal failure, many contributing factors were identified, such as starting with a big bang approach that tried to put every possible requirement into the program, making it very large and very complex.

However, the main reason identified was, “…a failure to meet a basic requirement for successful implementation: having ‘a single accountable leader’ who ‘has the authority and willingness to exercise the authority to enforce all necessary changes to the business required for successful fielding of the software.’”

As we all know, there are a number of exciting developments and converging forces changing the healthcare industry right now. With these converging forces, healthcare organizations are under tremendous pressure to address a number of priorities simultaneously:

  • Reduce operating costs while driving value
  • Implement and realize the full benefit of electronic health records
  • Transition from volume to value and plan for the accountable future
  • Harness the power of data and analytics to drive a data driven culture
  • Enable the connected community across the care continuum
  • Achieve Meaningful Use and complete ICD-10

While it seems like a tidal wave, these initiatives are aimed at paramount goals: better care, better health, and lower per capita costs. It’s essential that we as an industry heed lessons learned like this example from the Air Force to avoid similar stumbles or flops. While it’s never a comfortable position to be that single accountable leader, I think it’s important that as we all do our day-to-day work, we look for ways where we can either assume that leadership or recommend that a specific person assume that position. It is a key way to drive value from investments in information technology, operations and process improvement, and change leadership.


Daniel Coate is principal and co-founder of
Aspen Advisors of Pittsburgh, PA.

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Currently there is "1 comment" on this Article:

  1. The USAF still has the original problem. How are they working toward the solution now that the first effort was declared a failure? Is naming a single point of accountable leadership enough of a solution?

    So who can stand up and say ‘enough already’ for the tangled, expensive initiative created by funding from HITECH in 2009? My clinical colleagues and myself are computer literate, yet very disappointed in what industry has delivered to date. The financial impact of IT ‘investment’ has devastated many hospitals and clinics, without a clear ROI. It seems decisions are made without consideration of the value to patients and clinicians, only to harness their work to drive data collection.

    I for one agree a serious study of IT failure such as the USAF would be enlightening to health IT leaders, for those willing to actually consider the current situation is ‘not leading to success’.







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