Lessons Learned Lessons Learned from Two IT from Two IT Failures Failures Farrokh Alemi Ph.D. Farrokh Alemi Ph.D. Lee Baliton Lee Baliton
Lessons Learned from Two IT Failures Farrokh Alemi Ph.D. Lee Baliton.
Jan 11, 2016
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Lessons Learned from Lessons Learned from Two IT FailuresTwo IT Failures
Lessons Learned from Lessons Learned from Two IT FailuresTwo IT Failures
Farrokh Alemi Ph.D.Farrokh Alemi Ph.D.Lee BalitonLee Baliton
Case Study• Interpractice Inc.
($15 million and 7 years wasted)– Web-based services to patients of an
HMO• Telepractice Inc.
($6 million & 3 years wasted)– Computer services via telephone to
patients of an HMO
Description of the Online Services
• Health education• Email contact with clinicians• Online counseling• Pre-visit testing• Support groups• Personalized medicine
Description of the Online Services
• Health education• Email contact with clinicians• Online counseling• Pre-visit testing• Support groups• Personalized medicine
Description of the Online Services
• Health education• Email contact with clinicians• Online counseling• Pre-visit testing• Support groups• Personalized medicine
Description of the Online Services
• Health education• Email contact with clinicians• Online counseling• Pre-visit testing• Support groups• Personalized medicine
Description of the Online Services
• Health education• Email contact with clinicians• Online counseling• Pre-visit testing• Support groups• Personalized medicine
Description of the Online Services
• Health education• Email contact with clinicians• Online counseling• Pre-visit testing• Support groups• Personalized medicine
Description of the Online Services
• Health education• Email contact with clinicians• Online counseling• Pre-visit testing• Support groups• Personalized medicine
Technology is Seductive
• A fix: efficient production
Technology is Seductive
• A fix: efficient production• Changes what we do, re-defines us
Technology is Seductive
• A fix: efficient production• Changes what we do
– InterPractice Inc– TelePractice Inc.
Randomized Clinical Studies
• Improve patient outcomes• Reduce cost of care
– 28% total health care cost savings– 33% lower cost for AIDS care
Randomized Clinical Studies
• Improve patient outcomes• Reduce cost of care• Failed as a business
Business Process Change Needed
• New technology is not enough• Process change is needed
You cannot take a car for a walk
What do we mean What do we mean by new business by new business
processes?processes?
What do we mean What do we mean by new business by new business
processes?processes?
Case of an Online Patient Case of an Online Patient Service CompanyService Company
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Focus on economies of scale not Focus on economies of scale not scopescope
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Small is BeautifulSmall is Beautiful
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Conflicting DemandsConflicting Demands
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Examples: Salic Clinic; CABG Examples: Salic Clinic; CABG operationsoperations
Organization's Organization's policies on scope policies on scope of services must of services must
change change
Organization's Organization's policies on scope policies on scope of services must of services must
change change
FocusFocus
Recruitment and Recruitment and training policies training policies
must change must change
Recruitment and Recruitment and training policies training policies
must change must change
Recruitment and Recruitment and training policies training policies
must change must change
Recruitment and Recruitment and training policies training policies
must change must change
Physicians resist remote Physicians resist remote managementmanagement
Recruitment and Recruitment and training policies training policies
must change must change
Recruitment and Recruitment and training policies training policies
must change must change
Initiating ContactInitiating Contact
Recruitment and Recruitment and training policies training policies
must change must change
Recruitment and Recruitment and training policies training policies
must change must change
Changes the relationshipChanges the relationship
Policies on capital Policies on capital purchases must purchases must
change change
Policies on capital Policies on capital purchases must purchases must
change change
Shrink the physical overheadShrink the physical overhead
Policies on capital Policies on capital purchases must purchases must
change change
Policies on capital Policies on capital purchases must purchases must
change change
Example in bankingExample in banking
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Health educators making triage Health educators making triage decisionsdecisions
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Drop in Value of Drop in Value of Primary Care ClinicsPrimary Care Clinics
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Managed by SpecialistsManaged by Specialists
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Policies on the Policies on the gatekeeper must gatekeeper must
change change
Example among Example among AIDS patientsAIDS patients
Policies on medical Policies on medical records must records must
change change
Policies on medical Policies on medical records must records must
change change Electronic recordsElectronic records
are neededare needed
Policies on medical Policies on medical records must records must
change change
Policies on medical Policies on medical records must records must
change change
Decision aids Decision aids are neededare needed
Patients' Attitudes Patients' Attitudes Will Change Will Change
Patients' Attitudes Patients' Attitudes Will Change Will Change Definition of illness Definition of illness
will changewill change
Patients' Attitudes Patients' Attitudes Will Change Will Change
Patients' Attitudes Patients' Attitudes Will Change Will Change
Informed Informed consumerconsumer
Patients' Attitudes Patients' Attitudes Will Change Will Change
Patients' Attitudes Patients' Attitudes Will Change Will Change
Patients may know Patients may know more than their cliniciansmore than their clinicians
Patients' Attitudes Patients' Attitudes Will Change Will Change
Patients' Attitudes Patients' Attitudes Will Change Will Change
““You have been mothering us, You have been mothering us, how dare you stop?”how dare you stop?”
Technology Technology Demands Process Demands Process
ChangeChange
Technology Technology Demands Process Demands Process
ChangeChange
So much needs to changeSo much needs to change
Technology Technology Demands Process Demands Process
ChangeChange
Technology Technology Demands Process Demands Process
ChangeChange
You may disagreeYou may disagree
Take Home Lesson Take Home Lesson Take Home Lesson Take Home Lesson
Management MattersManagement Matters
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