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Time Capsule: Why IT-Led Change Projects are a Bad Idea: We Aren’t Charming Enough to Convince or Scary Enough to Threaten

March 22, 2013 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 July 2008.

Why IT-Led Change Projects are a Bad Idea: We Aren’t Charming Enough to Convince or Scary Enough to Threaten
By Mr. HIStalk

I was e-mailing a colleague the other day and spouted off an off-the-cuff remark that I kind of like in retrospect (that’s not just vanity talking because sometimes I say something really stupid and I realize it right away.) It was this:

“Executives buy IT because they want to crack the whip but aren’t willing to, so they use IT to force conformance without confrontation.”

I’ve been the poor IT guy who became the lightning rod for some executive’s grand plan for change. The IT project was where the rubber met the road, so we became the bearer of bad news for the masses: “You have to change your ways — your boss told me to tell you.”

(Please excuse those arrows sticking out of my back. We IT messengers get a lot of those, so they don’t really bother us all that much.)

For that and other reasons, I don’t even like the idea of calling anything an “IT project” unless it involves user-invisible infrastructure. “Buying IT” really means “demanding change,” so the expected result isn’t a “go-live” — it’s a “be-different.” Only a little of that involves computer stuff.

Anointing IT people as change agents is like enlisting the CFO to redesign care (i.e., asking for trouble). Computer-loving pessimistic perfectionists don’t make good charismatic visionaries who can get people to fall in line behind a radical change like a Pied Piper. Three seconds after the wary masses start complaining and rolling their eyes, we’re commiserating with them and casting conspiratorial glances as we say quietly, “I don’t think it will work either, but that’s what I was told to do.” That’s realistic, but not so inspirational (it’s not surprising that CIOs rarely seek political office).

The IT department doesn’t carry a lot of weight. We’re always overloaded with somebody’s great ideas from last year that still aren’t finished. We zeroes-and-ones types have minimal user credibility (insert obligatory user help desk scorn here). Most importantly, we carry no explicit or implicit authority outside of our own little domain, so we can’t impose our will on mutineers. We aren’t charming enough to convince or scary enough to threaten.

I think of IT as a subspecialty of change, right up there with communications, metrics, and process design. There’s no shame in doing any of those subspecialties well without actually running the show, even when the most visible part of a project is a computer.

This is so obvious that I’m hesitant to risk my shaky reputation by even saying it out loud, but here we go. Projects with user visibility are change projects, not IT projects. Change projects should have real objectives, not just IT objectives. Attaining real objectives requires the leadership of people who have influence and skin in the game, not IT people whose expertise involves the tools. Ergo, IT should always be supporting cast, not limelight-hogging stars.

When it comes to big change projects that happen to involve the computer, the worst idea in the world is letting the IT department run the show. It’s no accident that big projects at Kaiser and Allina were run by project teams that were completely separate from IT and staffed by people with operational expertise and credibility instead of IT managers and technicians. They recognized that their project wasn’t CPOE, it was changing the behavior of clinicians. Not coincidentally, those projects succeeded where IT-led ones elsewhere went down in flames.

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Currently there are "4 comments" on this Article:

  1. And this is, of course, what’s wrong with the idea of a PMO within IT. And IT promulgating “methodologies” for completing projects. And owning “business transformation.”

  2. I cannot agree more on having IT drive change projects. Over my 30+ years in IT I have seen few successful IT lead change projects. On many occasions I have seen executive leadership appoint the IT folks to drive the change thru implementation on new systems rather than accepting a leadership role. One CEO told me that more CEO’s lose their jobs over bad IT decisions. Looks like a perfect reason to blame the other guy. You bet this type of change drives change but in the wrong direction creating “The I Hate IT Syndrome”. The executive leadership leaves and the next thing you know the users gang up on IT, the CIO is fired, a new IT selection committee is formed driven by end users, and the hospital spends millions of our tax dollars replacing a system that was improperly installed.

  3. Having setup and run several IT PMO’s inside of healthcare I can use that experience that a PMO must support and enable the business. In my case it was healthcare providers and I always made sure we took direction from that business. IT is an enabler not an inhibiter so let’s make sure we focus on the business and we let those folks make the decisions and we implement what they define as best. Who would we think we are if we try as IT to tell the business what to do as that would be a fatality.

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