Time Capsule: Is Your Hospital IT Department like the Soviet Union? If So, It’s Time for Glasnost

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 September 2008.

Is Your Hospital IT Department like the Soviet Union? If So, It’s Time for Glasnost
By Mr. HIStalk

I’ve been on both sides of the hospital IT fence. More than once, in fact, and in more than one organization.

I was frustrated by illogical users when I was in IT management. I was frustrated by illogical IT management when I was a user.

I was thinking the other day that IT is like the old Soviet Union, at least in some of the hospitals I’ve worked. It’s no wonder that the proletariat and the ruling party can’t get along.

Stoic bureaucrats in unelected positions of authority lay out an immovable five-year plan that changes every year. That frustrates the average citizen, who only knows what they can see first-hand: IT systems haven’t made their jobs easier or better.

Projects are kicked off with a revisionist review of history: similar projects were successful because IT says they were, user experience notwithstanding (lofty benefit projections for big-ticket IT purchases are never discussed publicly after they invariably fail to materialize).

High-profile project failures require placing personal blame, so somebody gets fired (usually the person least responsible for failure, dismissed by the person most responsible). The “Ministry of Our Projects Are Going Great” cranks out endless propaganda. Any vocal dissenters are deported to Siberia, stripped of IT committee and liaison responsibilities before they can cause an ugly uprising, replaced by more loyal party members.

Well-intentioned IT inefficiency designed to ensure equal treatment for all creates bread lines, i.e. long waits for the help desk line and a bureaucratic approval process for big ticket IT purchases (like $10 keyboards and $20 DVD drives).

That inefficiency in supply and demand leads to black markets, where people go to Office Depot with their department’s procurement card to buy laptops or bring in their own unsecured $30 router because wireless coverage is poor in their area and nobody’s fixing it.

All the cheap Best Buy technology is infinitely cooler than the stripped down, beige box PCs that IT issues. They’re like ugly Russian automobiles of the 1970s, thrown together by tractor makers for purely utilitarian purposes.

State-ordered collectivization forces local technical resources like servers and programmers to be brought under IT’s control in an attempt to boost productivity. It rarely works except on paper.

The creative and intellectual classes may seek a less oppressive environment, preferring a workplace where they can load their own software, use Macs, or buy an unapproved PDA that they’ll have to support themselves anyway.

Leaders, in the mean time, live in a more privileged world. They get sexier IT equipment (that they rarely know how to use) and get VIP treatment when they need IT help. Instead of cruising around Moscow in limousines, they peck publicly on BlackBerries and fancy laptops that the peasants can’t have.

Soviet-inspired IT leaders sometimes end up like Czar Nicholas II, overthrown and executed by the oppressed Bolsheviks (Career Is Over indeed). Hopefully, though, they (or their predecessor) introduce glasnost, making IT more transparent and allowing more individual freedom for the creative class.

What I learned in IT is that technology management is expensive; that getting people to agree on a common course of IT action is nearly impossible; and that the strategic deployment of IT is not something the average user can understand or appreciate.

What I learned as a user is that IT is often steered on wild goose chases by out-of-touch senior management; that my individual skills and capabilities are unimportant when IT enforces restrictive technology rules made for the clueless masses; and that rigid IT tunnel vision stifles the organization in its attempts to mitigate tiny IT-related risk.

What I learned as both is that everybody wins when IT listens to its users and vice versa.