There is an adage in the military—different spanks for different ranks. It speaks to a double standard; less egregious punishment for similar offenses, similar misjudgments.
We see that every day in business, and we see it a lot in healthcare, especially in hospitals. Physicians are held accountable for medical errors. Hospitals pay millions for malpractice insurance knowing that mistakes will be made and people will be held accountable for those mistakes.
But what about on the business side? Who is held accountable for business mistakes? An acquisition that failed to deliver. An expensive new service offering that bled the company dry. A decline in the number of patients. The failure of a major IT initiative to deliver results.
Take EHR. Some of you are saying, “Yes, please take it.”
- Around sixty percent of the large EHR projects have failed in one respect or another
- Egregious productivity losses
- A large number of hospitals are on their second implementation of EHR
Who is going to be fired for the two hundred million dollar misstep? The board? Never. The CEO—no. The COO or CFO? Unlikely. The CIO? That is the safe bet.
Did the CIO authorize the expenditure? Probably not. Did the CIO get all the dollars needed to be successful, all the user support? Unlikely.
In most cases the CIO has all of the responsibility and only some of the authority. There are a handful of people in each organization tasked with the oversight of the large project. They are the ones who should be asking the right questions, the ones who should be demanding answers.
Even worse, hospitals have accepted the productivity loss as their new steady state.
A failed project, a failed strategy should not come as a surprise. The only people who will be wearing EHR 2.0 T-shirts are those who authorized EHR 1.0.