Curbside Consult with Dr. Jayne 4/18/22

A client I haven’t worked with in a couple of years reached out to me over the weekend, asking if I had copies of some materials that I had created for them. The project I originally worked on had been shelved because the company decided to take its solution in a different direction.

I wasn’t surprised when the work was mothballed. When you’re working on the vendor side, priorities can change drastically. Sometimes it’s a new regulatory requirement or the need to keep up with a third-party certification. Other times it’s a high-profile client with a contractual request. I’ve also seen projects get shelved when a competing solution turns out to be more work than originally scoped.

As a clinical content creator, you can’t get your feelings hurt when things change and your work winds up on the chopping block. Sure, as a physician you can be offended that your peers aren’t the priority, but it’s the nature of the beast when you’re working in the vendor space.

Fast forward and the company is trying to land a big client who needs content along the lines of what I created. There’s been a fair amount of turnover among the product and development teams, and although they remembered having content, no one could find it on any of their shared drives, SharePoint sites, email archives, or anywhere else. Despite corporate IT policies that discourage it, unless it is expressly prohibited, I keep copies of all my work product, so I was able to find it easily.

A quick glance reminded me that some clinical guidelines have changed over time and it probably needs a good going-over. I asked the representative from the vendor whether they had done any requirements gathering sessions with the prospective client or how they planned to approach the project. Although I don’t have capacity to work on it personally, I’ve got some informatics colleagues who could step in and get them moving.

I was surprised to hear that despite the fact that the client wasn’t able to find my content and therefore really didn’t have a good handle on what it contained, that they were planning to put it in front of the prospect and hope for the best. Apparently the buzzwords used by the prospect seemed in harmony with what was in the project charter (which they were able to find), so they assumed it was appropriate.

Since the product owner who reached out to me knows me pretty well, I shared a couple of thoughts on the idea of putting half-baked content in front of a high-value prospect without doing any requirements gathering. Without really understanding what the customer needs, how can you hope to hit the mark?

Unfortunately, I see this all too often in the healthcare IT industry these days. There’s a lot of tail wagging the dog between sales and product organizations, and ultimately the customer suffers when they have been promised something that doesn’t exist or that is quite a bit farther down the roadmap than they are led to believe. Having been in the CMIO trenches for longer than I sometimes care to admit, I’d much rather have honesty about what might or might not be available than to be the victim of a bait and switch. I know what my priorities are and what things I can bend on if it comes to that, but if the vendor isn’t interested in documenting my needs, I’m not sure why I’d want to be working with them in the first place.

The product owner was sympathetic to my recommendations, but mentioned that she’s under a lot of pressure from her leadership to make it look like they already had this content (even though they couldn’t even locate it). She knows she’s in a bind and is unhappy with the approach, but as we all know, the mess rolls downhill and sometimes you just have to do things you don’t want or like to do if you want to make those above you happy. Particularly if you’re in an organization that’s strongly top-down and feedback isn’t seen as something positive, you can feel pretty stuck.

I’ve spent plenty of time in organizations like that over the years, so I don’t envy her position. I sent her the files and the contact information of a couple of informaticists that used to work for me. Although I hope they’ll do the right thing (not only for the prospective client, but for the vendor’s own future success) but I’m not optimistic. I know my colleagues will let me know if they hear from the vendor, and it should be good for some stories over cocktails if they do start an engagement together.

While I was digging through my file archive, it was kind of fun to have a blast from the past and remember some of the projects I’ve worked on during my wild ride through the clinical informatics world. I think I’ve worked for clients that use just about every major EHR vendor as well as dozens of bolt-on solutions and even quite a few homegrown ones. I’ve worked with some amazing people who would bend over backwards to make sure that their projects delivered maximum benefit for patients and clinicians, and they’ve made even the most difficult projects rewarding. I’ve also worked with people who were only focused on how to make themselves look good and often did so at the expense of their teams and their colleagues. Those are the most difficult projects because even if you’re a consultant, no amount of experience or advice can make a difference unless there’s higher executive stakeholders who are willing to accept the fact that there’s ego-driven nonsense going on.

I also found some hilarious pictures of go-lives, some of which involved themes and costumes. One involved camouflage and a “M*A*S*H” theme and I think that was probably one of my favorites. I had forgotten coming up with IT-themed nicknames for everyone on the project, including General Release, General Ledger, Colonel Memory, Major Cluster, Major Milestone, Major Conversion, Major Problem, Captain Cloverleaf, Captain CCOW, Lieutenant Login, Sergeant Surescripts, Sergeant SAN, Private Practice, and of course Commodore Sixty-Four. One of the project team fired up her Cricut and made frames to go around our ID badges with our new credentials. That client produces stories that become legends, and I’m glad I got to have that experience.

What’s the most fun healthcare IT project you’ve worked on? What kind of things have you taken from it to enhance your current work? Leave a comment or email me.

Email Dr. Jayne.