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 November 2006.
The Bandwagon Effect and Healthcare IT Purchases
By Mr. HIStalk
TV networks don’t announce election winners until the polls close. Why? Because those people who haven’t yet voted will be more likely to vote for the projected winner instead of whomever they really want to see in office.
It’s the same phenomenon that makes the Super Bowl or World Series winner everyone’s sudden favorite team. Everyone likes to be associated with a winner. Or, more precisely, no one wants to be associated with a loser.
Big healthcare IT vendors and consultants use that tendency to their advantage. Big Vendor A pretends to be genuinely puzzled as to why you’d risk your reputation and your career on smaller Vendor B. After all, everyone whose organization is as good and well-known as yours is buying Vendor A’s products, they say. Those customers are not only deliriously happy, they’ve formed a high school-like clique that makes fun of Vendor B losers and dates cheerleaders after football practice instead of attending chess club meetings. So you’re told, anyway.
Hospital IT people ought to know better. Unhappy Vendor A customers aren’t hard to find, although in some cases you must evade their marketing people and their cease-and-desisting attorneys threatening unhappy users to keep their gripes to themselves.
Healthcare IT also tends to follow polls run by HIMSS and vendors. What technologies are hot? What are other CIOs planning to implement? What IT projects do hospital CEOs see as strategic? Never mind the methodology of the survey or its applicability to an individual hospital. If everyone else is buying CPOE, single sign-on, or business intelligence applications, then who wants to be a contrarian loser?
Those in charge of technology decisions could make a brave stand for a product or vendor that their gut tells them is right. Or, more importantly, to provide the voice of reason for a purchase that makes little sense. They usually don’t. The fear of being fired if it doesn’t work out usually wins. Even if you’re right, you won’t get much reward for it, so why take the risk? Surely the popular product is at least “good enough.”
It’s ironic, though, that by making the “safe” decision, executives are often rewarding the behaviors opposite those they supposedly admire: innovation, entrepreneurship, customer support, and honest sales and marketing. If the market votes one way with its mouth but another with its dollars, those unrewarded traits everyone admires will become extinct.
CIOs gripe endlessly about Microsoft, but Linux on the desktop or even using open source office suites is too much trouble. They fuss about consulting fees, but don’t bother to make the case for bringing expertise in-house instead of contracting for it. They want the best PACS system, but not if it involves a low-profile company unwilling to fund travel junkets or make donations to the hospital’s foundation.
Bigger is not necessarily better. Best marketed, most widely sold, most written about, highest stock market capitalization, most money spent sponsoring industry events and organizations: none are necessarily better.
When all the lemmings are heading in one direction, the path of least resistance is to follow them. On the other hand, once you’ve seen where they’re going, that extra effort to break rank seems worth it.