Time Capsule: Enterprise IT Projects Are Like Corvettes: Keep Hotheaded and Unskilled Drivers from Behind the Wheel

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 December 2007.

Enterprise IT Projects Are Like Corvettes: Keep Hotheaded and Unskilled Drivers from Behind the Wheel
By Mr. HIStalk

Big IT projects are a lot more fun to talk about than little ones, aren’t they? Transformational! Visionary! Strategic!

Hospital executives love those adjectives. Big projects make them look like decisive leaders and doers, bold swashbucklers in gray pinstripe who will throw well-placed caution to the wind to get an exhilarating ride to the IT stars.

That those projects nearly always fail doesn’t deter them. CPOE, ERP, and RHIO projects are launched with great fanfare and unrestrained executive enthusiasm. They almost always die an ugly, quiet, and protracted death, sad little pockets of unrealized objectives and defeated naiveté. The executives find other pressing obligations at the first smell of death, leaving the CIO and team to ride the flaming plane into the ground.

Tactical IT projects, on the other hand, nearly always succeed. You want to put in a lab system, HR suite, medication automation, PACS, or portal? They’ll work as planned, delivering pretty much exactly those reasonable benefits projected by the less-lofty suits who are usually involved. Sexy or not, most hospitals have the aptitude to make these projects work.

Unfortunately, enterprise-wide failures suck up a lot of the available capital, organizational energy, and IT resources of hospitals whose reach has exceeded their grasp. Failure is hard work.

The bigger the project, the more likely it will flop. It’s more than a linear relationship. Projects twice the size have four times the chance of failing. (Note: I just made that number up, which is shameful for an objective publication, but then again, I’m just an obnoxious guest here).

Where that failure point lies depends on an organization’s readiness. An assessment tool for warning signs might be useful. Score low enough and your project is doomed before the Rolex-wearing salesperson has headed off for the Caribbean.

Your organization should steer clear of big-vision projects and stick with the tactical stuff if:

• Organizational politics are ugly and widespread.
• Everybody in the trenches likes things the way they are and management doesn’t have the skill to convince them otherwise.
• Strategies always seem to involve copycatting the ideas of smarter or better-known organizations.
• Conditions are never stable enough for long-range planning and consistent execution.
• Stakeholders are too busy to attend project meetings.
• Everybody secretly hopes software will start enforcing all the rules that nobody follows now.
• Managers rely on intuition instead of objective tools like productivity management, process redesign, and a consistent reward system.
• Non-IT projects that cross disputed organizational territories (physicians vs. administration, pharmacists vs. nurses, finance vs. everybody else) fail every time they are attempted.
• Funding never seems to be available for post-project assessment and improvement.

Hospitals don’t see themselves in the flattering mirror held in front of them. Vendors and consultants don’t say a word. The healthcare IT industry would shrink to half its size if somebody created a tool that could unerringly conclude, “Don’t waste your money – you can’t handle this project.”

Rich parents have no business giving their 16-year-old a new Corvette, even though the salesperson is deliriously reassuring. That car is for people with years of experience and cooler heads.

If only the healthcare IT industry could figure out how to keep its overconfident and unskilled drivers from behind the wheel, maybe fewer of them would wrap themselves around trees at 100 miles per hour.