CIOs Fight Epic Battle for the Right Path

Anthony Guerra, founder/editor,

Anthony Guerra, founder/editor,

In what’s become an epic (excuse me) battle for the heart and soul of sound CIO strategy, I continually hear the emergence of two camps — the enterprise, one-vendor-for-all folks, and the cobble-it-together best-of-breed/suite folks. In interviews with CIOs of each type, I hear different levels of derision directed at the other camp. None of this, mind you, is extremely overt, healthcare CIOs are too deferential for that. Most of it comes in the form of questions, such as, “I’m not sure that’s the most responsible strategy.” The funny thing is that this exact barb has been directed by each side towards the other. Read the rest of this column at Information Week …


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  1. This is truly a tough conundrum for any strategically-oriented CIO. In my career, I have leaned more toward the “best of suite” space, but have been prepared to make a few exceptions where certain components of the “suite” offer sufficiently compromised functionality as to either outright jeopardize patient care or jeopardize the clinician’s enthusiastic adoption of the system (also, a major success factor in any EMR implementation).

    So, I think it is fair to adopt one school of thought or another (both truly do have their “pros”), but leadership needs to be flexible enough to place a toe or two in the other camp when reality dictates. It really is all about the clinician at the end of the day, right?

  2. The best of breed v. single source argument is a red herring. Organizational culture, politics, and pocketbooks sustain this argument and detract from the real issue; adoption. I will do whatever it takes to blend systems with workflow to optimize adoption. If it is one one vendor great. If it is with multiple vendors great. We have to do what is best for our care givers.

  3. jbormel says:

    The root issue, IMHO, is design.

    There are certain functions that can be divided among cooperating systems. There are other functions that cannot. Portal access to isolated systems to acquire one or two pieces of information, no less than six times a day is an example of the former. Medication management is well understood to be in the latter. Systems, whether assembled from BoB (Best of Breed), BoS (suite), or Single-Enterprise-eXperience need to be designed back to the end-users’ tasks and the process goals.

    Access to data at the level of folders and interfaced solutions (even from a single vendor) are always less expensive to assemble. Their adequacy can only be assessed by end users, and not by any of the CXOs.

    At the end of the day, it’s a predicament and not a problem. When there are cleavage planes, i.e. places where systems cleanly detach from each other, it may be better, faster and cheaper to exploit that. Otherwise, it’s best to not get too self-righteous about the opposing point of view. It’s distracting, energy-depleting, and counter to the larger issue of building a culture of teamwork where clean communication about needs and solution strength can occur.

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