The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.
Does IT Matter: Six Years Later
In a 2003 opinion piece for the Harvard Business Review, Nicholas Carr threw a grenade on the IT dinner table. Carr argued vehemently that IT no longer mattered. He leveraged this high-profile editorial into a best-selling, thought-provoking book in 2004, Does IT Matter?
Carr’s central argument states that the strategic importance of IT has diminished over time; that IT has become nothing more than a commodity providing little competitive advantage. Consequently, according to Carr, companies should rethink their investment in IT. He also laid out his agenda for IT management, examining implications for business strategy and organization. Carr’s thesis was both embraced and vilified.
Written in the IT boom years, post-Internet “bubble,” does the economic downturn change the game? What about healthcare reform implications? Are we any different?
As I observe and research, I see fatalists and opportunists at odds.
The fatalist has accepted Carr’s pronouncement as fact and has become complacent, allowing the administration to marginalize IT. Opportunists, on the other hand, see the circumstances as the tipping point to reinforce, or for the first time, to position IT as strategic.
I interpret Carr’s compelling arguments as a call to action.
During these dour economic times and the uncertainty of healthcare reform, IT has a heroic opportunity to be a catalyst for prosperity, a key differentiator. This means I cannot sit back and accept current fate, allowing IT to dissolve into a simplistic commodity or back-office function.
To advance my organization, I hunt for and seize strategic opportunities. The economy will not determine my destiny if I choose to leverage it as a clarion call and make every effort to expand our services while lowering costs.
Our department reaches out to select vendors, changing our value proposition from transactional to transformational relationships. I shared this in-depth in Maximizing Vendor Relationships. It’s not about broad generalizations. Success is about the individual organization; its circumstances; and ultimately you, the IT leader.
As organizations look to cut spending, IT is not immune. Continual across-the-board expense reductions will underscore IT as a commodity and a cost center to be managed — Exhibit #1 for Carr.
Call me competitive, but I believe that companies that lay low and marginalize their IT will have a much lengthier recovery period. Especially when it comes to seizing the initiative on healthcare reform dynamics that are fundamentally changing the value equation of cost, quality, and revenue.
In contrast, those companies that seize the opportunity and invest in IT strategically will not only perform better, but will do so at the expense of their competitors. Some of our current work is going to change the competitive dynamic.
Think. Brainstorm. Mashup. Research and develop strategies that will propel your organization forward. Even if your company is panicking and relying solely on expense reduction tactics, present ideas that demonstrate bottom-line reduction, improve clinical outcomes, and support top-line growth. Innovation that will set your organization apart in dealing with the nuances of future payment and care delivery models. Insist on having your voice heard. Demonstrate ROI through IT’s transformative and innovative power.
For competitive reasons, I cannot share details, but we are doing these things. A risk-free example from my past happened at a community hospital. Our historic 45% market share in this two-hospital town was starting to plunge. Our cross-town rival was replete with cash, given their enviable position as part of a regional health system. Our board decided that the best antidote was not to reduce expenses, but rather to make strategic investments in IT.
One year after the implementation of affiliated practice-based EMRs, clinical inquiry application, and software to link referring physicians, our market position flipped. We saw a 20% swing, especially in our target areas of hearts, births, orthopedics, and neurosurgery. We were featured nationally.
I have additional career examples, but I believe the point is made. Yes, the economy is tough. Healthcare reform is a bit fuzzy still. Fatalists seek to marginalize IT. But the time is right to forcefully lay hold of this opportunity and (re)establish IT as strategic and foundational for your organization’s long-term success. IT is not back office!
Demonstrate the strategic power of IT.
Good debate on IT value. My leadership team just started on our next book, also by Carr, entitled The Big Switch…Rewiring the world from Edison to Google. Whether you agree or not with Carr, it is healthy to debate his ideas and come to grips with his messages. Is IT strategic? Will cheap utility-supplied computing change the game? Does the Internet take away our ability to think deeply? Are we losing our capability for concentration and reflection?
I still maintain that we can leverage even the most common of tools in a strategic fashion. It comes down to culture, risk, vision, innovation and leadership. Give me two organizations that each implement the identical EHR and I can show you two radically different approaches…and executed well, one can be a strategic differentiator over the other.
I do not agree that IT is purely a support function. Sounds good on the surface but, short sells the innovation and passion we have been endowed with. I have been fortunate to work with incredibly talented individuals who have taken common tools and developed these to improve patient safety and increase the quality of care. I have also witnessed similar gains on the business side. As a by-product, these have helped grow IT and proven to help us differentiate ourselves from competitors.
Not everyone will adopt or deploy it as strategic, nor should they. But it can be done.
Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook, and you can follow him via Twitter – User Name “marxists.