Nietzsche on HIT Strategy

The problem with being a consultant is not everyone wants their responses packaged in the same manner I tend to deliver them.  I communicate best visually, pictorially.

Asked what I want for dinner, I respond with a 3-D bar graph.  Forty-five percent of me wants pasta, thirty percent wants roast beef—a year over year increase of seven percent, but not a statistically significant sample size—and one hundred and twelve percent of me wants whatever she is willing to cook—which means I do not have to cook.

There are two kinds of consultants and, I am the other kind.  ‘Nuff said.  On a side note, as I keep telling the police, I am not the person responsible for holding giraffe fights in the linen section of Neiman Marcus.  Nor am I the guy with the collection of taxidermist-stuffed German World War II soldiers in my basement.

When one reviews the value of a healthcare IT strategy—if your organization does not have one click ( and you will be taken to a site to make more valuable use of your time—in order for it to be worth more than graffiti on an overpass (plebian) the plan must have a plan.  It also helps if the strategy at least pretends to be strategic.

The stigmata of most strategic plans is they are neither strategic nor plans.

If there is one thing a strategy should be able to address it is to be able to answer why, to be able to answer what benefit the execution of said strategy will deliver.

More than fifty percent of hospitals will not have a written IT strategic plan.

More than half that do have strategic plans will not pass the value test.

Let us suppose for a moment a hospital has what they believe to be a real HIT strategic plan.  Does that document contain answers to the following questions?

  • Implement XYZ EHR.  Why?  Why XYZ?  What benefits will the hospital receive?  Few if any will formalize benefits ahead of time because they can be held accountable when those benefits are not delivered.  Is it safer to simply check the box for having “completed” the implementation?
  • Meet Meaningful Use.  Ditto.
  • Accountable Care Organization.  Ditto.
  • ICD-10.  Ditto.
  • Family Experience Management.  Ditto.

Maybe Nietzsche knew more about IT strategy than he has been credited.  “All things are subject to interpretation.  Whichever interpretation prevails at a given time is a function of power, not truth.”


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