Home » Time Capsule » Currently Reading:

Time Capsule: US Hospitals Can Learn a Lot From Richard Granger’s Approach

August 12, 2011 Time Capsule No 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.

U.S. Hospitals Can Learn a Lot From Richard Granger’s Approach
By Mr. HIStalk

The British government’s audit report of its Connecting for Health project, released a few days ago, confirms the obvious. Richard Granger and company have put together a remarkable program for aggressively managing their software vendors.

Granger was tough from the beginning. He threatened, for example, to write his own PACS if high vendor pricing made that an attractive option. Complex contracting was wrapped up in less than a year. Vendors had to prove their ability to deliver through real-life simulations. Most importantly, contracts clearly state that no one gets paid until their stuff is working. All of this, unfortunately, is highly innovative in the back-scratching world of public sector IT.

The Achilles heel of Connecting for Health’s vendors has been the contractor-subcontractor relationship. Big consulting companies won the business, then promptly subbed out to application vendors. That was covered in the contracts, too: the bidder is liable if its subcontractors under-perform, which they largely have. Smart contracting protected the National Health Service against the failings of iSoft and IDX, hitting the consulting companies who chose them squarely in the wallet. That’s how it ought to work.

Granger holds firm and goes public when he has to, unafraid to rip recalcitrant vendors by name. I like to picture him as a Gordon Ramsay-type scrapper, happy to take someone down a notch when they need it.

Providers in the US can learn a lot from the auditor’s report. Vendors throw the ‘partnership’ buzzword around a lot to impress rubes, but it’s usually a marketing term instead of a true risk-sharing contract like Granger demands. Hospitals usually just moan about poor vendors instead of using their intelligently crafted contract to withhold payment or send them packing. The auditors lauded NHS for protecting the taxpayers’ money through smart IT management, and rightly so.

I compare it to road work, which most states do poorly. How many times do you drive by miles of orange barrels with no workers in sight, unless they’re standing around aimlessly, and even then only on weekdays from 8:00 until 4:00 when they’re not on break? Traffic is snarled around the clock for months as grass grows from piles of unmoved dirt amidst infrequent activity consisting mostly of sociable shovel-leaning. That’s how hospital IT projects and vendors sometimes work.

On the other hand, I lived in a state that ran roadwork like a private business. Contractors were given incentives to finish projects early while meeting quality standards, which unsurprisingly, they almost always did. Work could be done only at night, worker inconvenience notwithstanding. The difference to motorists was striking, the state saved money, and incompetent contractors were driven out. The only mystery is why other states aren’t smart enough to copy their success instead of having single-lane rush hour traffic cursing at orange barrels.

I admire Richard Granger. What’s wrong with being tough when so much public expectation and money is at stake? Hospital IT departments may be smaller, but they can learn a lot from Connecting for Health’s experience in managing their vendors and their projects. Of all the blowhards on the health care IT speaking circuit, he’s one of few who I’d look forward to hearing.

View/Print Text Only View/Print Text Only


HIStalk Featured Sponsors

     







Subscribe to Updates

Search


Loading

Text Ads


Report News and Rumors

No title

Anonymous online form
E-mail
Rumor line: 801.HIT.NEWS

Tweets

Archives

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reader Comments

  • Vaporware?: That first KLAS chart really crystallizes Cerner's business strategy for all to see: Above all else, sell. If you los...
  • AC: "Michael Abramoff, MD, PhD is president, founder, and director of IDx of Coralville, IA and professor of ophthalmology, ...
  • Lazlo Hollyfeld: Yet another win for employers over employees which is no surprise given this SCOTUS and previous Roberts' opinions. ...
  • Vaporware?: It's tough to get my head around why Congress would take the time and effort to pass an oversight bill, when the oversig...
  • Mr. HIStalk: I'm going to guess that it was not the real Pharma Bro, who I believe is housed at Fort Dix Federal Prison, which despit...
  • AndyWiesenthal: Is Martin Shkreli really the one who contributed the link to the blockchain article? I liked the article (always like a...
  • Bobs your uncle: Is there just no good news? It's like you don't want to open anything and read it FYI: the Cato institutes' response ...
  • Mr. HIStalk: Thanks, fixed. I've told Cerner before that it drives me crazy that their website omits the dateline of the announcement...
  • IKnowPlenty: Columbus Regional Health System (CRHS) in Georgia is implementing Epic as part of their acquisition by Piedmont Health i...
  • Not Merrick Garland: "unless you’re advocating for judicial activism, which I would hope no one is." is a pretty clear indicator that you'r...

RSS Industry Events

  • An error has occurred, which probably means the feed is down. Try again later.

Sponsor Quick Links