Anthony Guerra, founder/editor, hsCIO.com
Peter Drucker called it “systematic and purposeful abandonment” — the idea that you can’t do everything at once and still do it well. To be more specific, let’s consider the question of proper resource allocation in the context of massive change, the kind of change Clayton Christensen discussed in The Innovator’s Dilemma. In the book, the author looked at companies that were once king of the hill, but failed to maintain that position. What, he asked, causes the mighty to fall? Read the rest of this column at Information Week …
flpoggio says
Anthony,
Timely and interesting post, but I beg to differ. It is not an either or question.
To my mind there is only one choice and it’s differentiated only by a matter of degrees. Over the course of my thirty plus years in HIT, enterprise (single vendor) versus Best of Breed (multiple vendors) is a moot point.
Every hospital must have a multi-vendor solution. How many is more a function of size and complexity than anything else. The complexity and variability of delivering patient care demands multiple suppliers since no one vendor can, or does it all. Now or in he future.
The often repeated reason that the one vendor ‘enterprise’ approach is simplest and therefore best is a hollow argument. The main attraction to this argument is that it will eliminate the hassles and problems of interfaces and lack of interoperability. I have always referred to it as the ‘less work for mother (CIO)’ approach, but more work for the children!
Several years ago there was an excellent article in CIO magazine that discussed the future role of the CIO (the focus was on commercial business). The piece stated that since most IT departments purchased packaged software the need to build, direct and maintain inhouse systems was disappearing rapidly. So what was to become of the CIO? The answer was that his/her primary role was to get the best systems in each of the key operating departments and make sure they worked together. In effect he/she needed to become a new CIO, the Chief Integration Officer. The price of not taking on this role by looking for the single enterprise vendor solution was that some operating units would have less than adequate software tools and operating performance would suffer.
That’s where I believe we are today with HIT systems. There always will be multiple vendors in every health facility it’s the nature of the beast. The only question is how many. Too many is just as bad as one. The answer is somewhere in the middle and is different for every facility based on size, complexity, organization, future plans, etc. As a CIO you will always have to deal with interface and integration issues so why not accept that and make the best of it? A good alternative is what some call the ‘suite’ approach. Natural groupings of applications based on service delivery models. That’s where I believe we need to be.
Frank Poggio
President
The Kelzon Group
Anthony Guerra says
I agree with you Frank — when I say “enterprise,” I actually mean a best of suite approach that’s about as tight as you can get — where you buy almost everything you can from one vendor, and only go outside that vendor if the users are up in arms about the application you plan to implement.
You are right that no real enterprise solution exists and isn’t even necessary.
Thanks
flpoggio says
Anthony,
Glad we agree…
But then the problem with burning the boat as you put it, is that Hospitals are dymanic organizations and patient programs and medical protocols are changing all the time. Far more than in commercial industry. If you ‘burn your boat’ the next time the tide changes you’ll be left alone on the beach! And therin lies the challenge for the CIO, you do need to make a commitment but for how long?