Maybe healthcare IT leaders spend a lot of time reading Socrates or Marx or Locke on the philosophy of human nature and whether we are doomed to repeat mistakes made throughout history, or whether we are free-willed creatures capable of charting our own course through existence.
Maybe these leaders are too busy putting a crank to recalcitrant vendors to pay much attention to the ethereal questions of change and inevitability. But it seems some healthcare information technology leaders are doomed by Sisyphean forces to make the same mistakes over and over again.
In more than a decade of covering this industry, HealthLeaders Media has talked to or surveyed hundreds of healthcare CIOs, CMIOs, physician leaders, nurse leaders and executives of all stripes on what makes HIT projects work and what makes them fail.
Some trends emerged to the point of boredom. In fact, I got so tired of reading case studies that praised the virtues of "getting physician buy-in" that I banned one earnest tech editor from using the term.
Years later, I'm amazed to hear that despite our constant work to bring common mistakes to light, the same gremlins are still with us. This is not to say all or even most healthcare HIT leaders make them, but too many are still…
1. Thinking they own the stuff
It's human nature to make a soulful attachment to our work, especially on a project of as grand a scale and effort as your typical electronic medical records system implementation. An EMR implementation project is often described as a "journey" and can take a decade or more.
The mistake is that IT leaders may forget they are creating a tool to be used by clinicians, not a piece of software design to be admired for its technical beauty. Compromises must be made. Avoiding the dangers of "not getting physician buy-in" is one thing, but truly turning over ownership of the technology to those who use it is a leap of trust that some in healthcare IT are still wrestling with.
2. Putting HIT first
In an industry so woefully behind on automation and information technology, it's a forgivable mistake perhaps that HIT leaders are content at this point to "wire" hospitals and physicians offices for the first-generation benefits of such.
One of the inevitable byproducts of the rush to automate under HITECH meaningful use provisions is that some providers will simply look to "wire up" without taking the time to re-engineer the underlying clinical processes.
The very real fear is that the result will be "really bad healthcare done really fast." The solution is thankfully within reach for hospitals that begin with carefully mapping care processes that need to take place. That process itself has benefits of finding waste and areas for clinical improvement.
3. Not thinking like an executive
At a user's conference where I spoke last spring, one of the speakers before me was Sheila Currans, CEO of the 61-bed Harrison Memorial Hospital in East Cynthiana, KY. Her topic was on how CIOs can become part of the leadership team, including such simple advice as keeping the tech jargon to a minimum when working with executive and clinical leaders on a key project or decision.
In larger health systems, the CIO has moved into a strategic role of running the clinical data enterprise and is looking for ways to grow the business using technology.
4. Always thinking like a customer
True, only a miniscule number of hospitals have the resources, expertise, or mission to develop their own technology solutions and must go to the market to purchase tools. The mistake is in accepting that in every case.
Are there opportunities to work with vendors on site testing or other pilots in exchange for price concessions? Are there applications or workarounds developed by your team that have the potential to be "entrepreneurialized"?
Denver Health, a public, safety-net health system, might not seem an obvious choice for HIT development, but its team discusses ways it has saved money and tailored tools by taking a more active approach to HIT development.
Serial offenders guilty of these four mistakes would not be running a technology program anyway. But every time I think these blunders are ghosts of a bygone era, some leader shares a story of a project gone wrong because one or more has been committed.
Healthcare IT leaders are smart people. I have faith that smart people can change. Or at least avoid a wreck when it's a mile down the road.
Jim Molpus is the director of the HealthLeaders Exchange.