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Time Capsule: When CIOs Are Under Pressure, “Man of Action Syndrome” Kicks In

July 29, 2011 Time Capsule 4 Comments

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 June 2006.

When CIOs Are Under Pressure, “Man of Action Syndrome” Kicks In
By Mr. HIStalk

Hospitals and vendors don’t brag when their IT projects harm patients. Therefore, I’m not surprised that press releases haven’t announced several recent, disastrous examples where IT leaders overrode worried clinicians and continued with a flawed clinical system go-live to the detriment of patient care.

Being of a clinical background, I’m compelled to give this scenario a name and an acronym, even though I can’t diagnose or cure it. Man of Action Syndrome, or MAS, is the psychological need of someone in IT authority to veto those more knowledgeable clinicians who express well-founded patient safety concerns about clinical IT projects.

The name is not sexist since I’ve not yet seen a female CIO so afflicted. MAS also seems to spare CIOs with a clinical background.

Its victims are generally male, Type A, ego-driven MBAs with a history of programming or consulting. Anxious to add value by showing business savvy and decisiveness in an ill-suited environment of caring and empathy, they won’t allow budgets or dates to slip. It’s a quantitative thing.

A wise old project management saying is, “Good, fast, cheap — you can only pick two.” Unfortunately, those with MAS obsess on ‘fast’ and ‘cheap,’ knowing that it’s far easier to bury (no pun intended) qualitative project shortcomings that fall into the ‘good’ category. You can always blame users or the vendor.

I’ve been on both sides of the fence. IT people add value in formalizing system selection and planning. Those are repeatable processes where past experience may improve the chance of success. Unfortunately, that kind of management-by-control experience doesn’t work with clinical process change.

Ideally, an assembled group of clinicians would drive clinical system projects. However, it’s hard to engage them. That’s when MAS kicks in: “My neck’s on the line, so here’s what we’re going to do.”

From my limited experience, I would say that CIOs overrule the concerns of nurse informatics people nearly 100 percent of the time and IT-based physicians at least 50 percent of the time. Because those people represent a large number of their disenfranchised non-IT counterparts, the CIO has, in effect, dismissed the concerns of an entire discipline, often with reasoning such as, “They don’t see the big picture” or “They don’t know the pressure I’m under to deliver ROI and on-time implementation.”

Maybe practicing clinicians should be the ones making the go/no-go decision without IT people or other hospital management in the room. I’ve seen clinicians leave meetings shaking their heads, worn down from trying to get their message across to an IT team more comfortable hard-selling their own agenda instead of listening to what’s best for patients.

Perhaps the evolving role of the chief medical information officer will eventually balance the MBA approach. Maybe we’ll see more CIOs who have cared for patients instead of thriving in a Dilbert-esque world. Possibly the new wave of clinicians formally trained in informatics will provide credibility to concerns that the software doesn’t work, the users aren’t ready, or the communication has been poor. Non-IT hospital leadership may eventually understand that that silver bullet they paid for is just lead under the paint. Until then, if you’re a CIO with symptoms of Man of Action Syndrome, please contact your health care professional at once.

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Currently there are "4 comments" on this Article:

  1. How do you know when you have this syndrome? so many clinicians have the “I don’t want to change syndrome”.

  2. Can I get another Amen Halleluja!!

    The CIO of a hospital I worked for in Los Angeles frequented by many in Hollywood, asked the question when planning a data center move of the whole hospital, “I really don’t understand why we can’t just load all the boxes up in a couple of semi’s and do it over a long weekend?”

    Yes, he was very serious and needed it spelled out for him.

    And MountainMan, if you are a CIO making unilateral decisions when most of the clinicians in the hospital are screaming at you? Newsflash, the Emperor is as nekkid as a jaybird and the CIO needs a cephalo-rectal removal procedure more than the clinicians need an attitude adjustment 🙂

  3. The Man of Action article is funny and well written, but in the end, it’s no different than a Survivor type alliance, a political fight, or Snooki cutting up The Situation.

    When I started selling HC software I laughed after my first hospital call – the doctors hate IT, IT hates docs, and the Executives are disrespected by all. I realized my product had nothing to do with my success, but rather my job was to find a way for all 3 groups to get along.

    I found that nursing was the key. They know more about workflows, IT and patients safety than anyone else in the equation. They are high on getting in done and low on the ego wars.

    My suggestion is to take the time to build a relationship and work together. If that is hard to do try reading Dale Carnegie.

    In Europe, where the Survivor series started, the winner was the person that most helped the group survive. In America the winner is the one who can trick people to fight againts each other.

    Doctors and CIOs are much smarter people, but they are not immune to this “I would rather fight than work together” Syndrome.

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