The Leapfrog Conundrum

Tech leaders, especially those in healthcare (having historically lagged behind other industries in technology), are faced with this conundrum when asked to oversee a large IT transformation.

Provided capital is available and there is a coalition of the willing to make technological (hence human and cultural) changes, it becomes easier and easier to wonder, as the CIO or CTO: “If we’re doing all these painful technological overhauls, why not just take it a step beyond and overtake all our competitors? Why go through all this for the metaphorical bike or car, when we can go straight to a jet and be set for the next decade?!”

At face value, this leapfrog approach does make sense. There are many organizations that have done exactly this in other areas and succeeded. In fact, my new home, the United Arab Emirates, has experienced this in both public and private sectors; from creating Customer Happiness Centers to bring all government services together for their residents, to the amazing passenger services offered for customers when they choose to fly on Emirates Airlines.

However, as is the case with anything in life, without first understanding the intricacies of each use-case, it can become rather dangerous to apply the leapfrog approach to everything that requires a technological overhaul. And therein lies the conundrum.

Why go through all this for the metaphorical bike or car, when we can go straight to a jet and be set for the next decade?

This question, working in the form of an analogy for our dilemma, therefore, has the potential to become at once the most wonderful dream or the darkest nightmare for any CIO/CTO out there. More so in healthcare, where the price of failure is measured in human lives and operating margins are getting thinner and thinner.

In my current part of the world, there was never a Meaningful Use program that spurred the foundational Electronic Health Record system adoption in the U.S., hence an IT infrastructure base to go along with it (whether it was truly “meaningful” or not is another debate). And so, this aforementioned conundrum is today’s reality for healthcare leadership here in the MENA (Middle East and North Africa) region. I myself have faced it many times in just this short period that I have been a CIO in the U.A.E.

When approached with the Leapfrog Conundrum, what should a CIO or CTO do? How does one get some perspective, while availing of the opportunity to advance their tech rapidly (and appropriately)? Here are some of my thoughts:

1. How did you get to where you are today and where do you want to be tomorrow? This is an important question to ask yourself, because if you got here due to lack of attention/investment in IT over the past several years after an initially-lauded implementation, then the approach of “go big in tech today and be set for a decade” will land you back in this very same spot in half the time. As for the second part of the question, while most organizations do spend time on thinking about it, many fail to frame it with other factors (effort, cost, time). Know that the answer to this second part of the question will most probably require continued investment in whatever you decide to implement.
2. Do you have the foundation to support the highest tech you’re aiming to leapfrog to, within your preferred timeline? It’s easy to say that you’d like to implement the latest technology in the shortest time frame, especially if you’re willing to mobilize capital up front. However, it would all be for naught if the very operational foundation for such a jump does not exist in your organization. As our analogy for this article would state: if you want to skip directly to the jet plane, do you have an airport ready to go, with operational runways, hangars, maintenance/refueling personnel, and equipment, etc.? If not, that jet will probably look pretty sitting on the tarmac, but will never really be of much use beyond that. And if you’re willing to build that airport for a jet plane, are you willing and able to give it the time it needs to be constructed, staffed, and fully operational to start launching aircraft? If not, a plane might not even be an option for you. The leapfrog spectrum can be a wide one; knowing which point to jump to, under real-world conditions, to maximize your chances of success is extremely important.
3. Do you fully understand your organization’s current and future needs that need to be satisfied? Again, this is one of those basic questions that actually takes a fair amount of effort and introspection to answer. Especially if yours is a large healthcare organization, spread out across many national boundaries. Do you understand the pain points in the nooks and crannies of your organization that need to be addressed by the overarching tech you’ll be implementing? Keeping with the analogical theme of this article: if you want to jump straight to the jet because you believe your organization actually will someday need that plane, what are your actual requirements for that mode of transport? Do you foresee the need to have combat capabilities or do you just want to ferry passengers quickly across great distances? Because that would be the difference between a fighter jet and a passenger plane and would, therefore, require different types of airport facilities to be created, not to mention price tags. The highest-end of the leapfrog spectrum may not automatically solve all your underlying problems.
4. Is your organization able and willing to support the non-tech changes that will go along with this IT transformation kick-off? Do you have an IT org structure ready for the evolution that is sure to occur? Are all your folks aware of the changes occurring and what it means for them and their roles? Is HR ready to start assessing Job Descriptions and hiring/managing as needed? Are other departments like Finance and Contracting ready to start reviewing/signing contracts and paying invoices from vendors? Do you have training resources in place where needed? Will there be any additional physical office space needed and do you have it ready to go? From our analogy: running an airport is an extremely complex task that requires people and resources well beyond just buying a plane and hiring a pilot. So, you might want to be ready to deal with airport operations up front if you plan on buying and operating planes.
5. Are you willing to give up control to achieve the leap you’d like? This is a fair question to ask yourself if you’re struggling with any of the main 3 factors inherent in all large initiatives; money, staff, and time. In other words, if you’re lacking in any of these 3 variables, are you willing to partner with external entities to achieve the goals you’re setting? Do you need to own all the tech you want to implement or are you willing to license it from someone else? Do you need the staff to all be your own FTEs or are you willing to get a large number of contractors in quickly? Leaning on our analogy again: if you still want planes and want them ASAP, hence do not have the time to build an airport, are you willing to pay someone else to use their facilities, knowing that you’re giving up some amount of control?

Now, don’t get me wrong; I’m not saying it’s a bad idea to leapfrog tech, especially if you’re in a place where that is a viable option from a capital investment standpoint. You cannot expect to innovate and build things unless you’re willing to take that leap; we’ve all heard the famous Henry Ford quote: “If I’d asked people what they wanted, they’d have asked for faster horses.”

I’m just saying that the jump still has to be planned and some level of introspection carried out; you can’t leapfrog the What/Where/How/When stage. Simply aiming for the absolute latest/fastest/flashiest thing out there on the quickest implementation timeline won’t get you where you need to be.

The leapfrog spectrum can be a wide one; knowing which point to jump to, under real-world conditions, to maximize your chances of success is extremely important.

Oh, and in case you’re wondering, the bike won the race. The parameters (400m track + stationary start) were such that the bike was the fastest vehicle under the circumstances, even when racing against a Formula-One car and a fighter jet. An apt ending to the analogy, in my opinion.

This piece was written by Saad Chaudry, who recently moved his family across the world to take on the role of CIO at Saudi German Hospitals, one of the largest healthcare organizations in the Middle East. Previously, he served as associate CIO at Anne Arundel Medical Center, having also spend time at Johns Hopkins Medicine and UPMC.