Lessons Learned from Two IT Failures

Lessons Learned from Two IT Failures Farrokh Alemi Ph.D. Lee 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

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 by new business processes? Case of an Online Patient Service Company

Organization's policies on scope of services must change Focus on economies of scale not scope

Organization's policies on scope of services must change Small is Beautiful

Organization's policies on scope of services must change Conflicting Demands

Organization's policies on scope of services must change Examples: Salic Clinic; CABG operations

Organization's policies on scope of services must change Focus

Recruitment and training policies must change

Recruitment and training policies must change Physicians resist remote management

Recruitment and training policies must change Initiating Contact

Recruitment and training policies must change Changes the relationship

Policies on capital purchases must change Shrink the physical overhead

Policies on capital purchases must change Example in banking

Policies on the gatekeeper must change Health educators making triage decisions

Policies on the gatekeeper must change Drop in Value of Primary Care Clinics

Policies on the gatekeeper must change Managed by Specialists

Policies on the gatekeeper must change Example among AIDS patients

Policies on medical records must change Electronic records are needed

Policies on medical records must change Decision aids are needed

Patients' Attitudes Will Change Definition of illness will change

Patients' Attitudes Will Change Informed consumer

Patients' Attitudes Will Change Patients may know more than their clinicians

Patients' Attitudes Will Change “You have been mothering us, how dare you stop?”

Technology Demands Process Change So much needs to change

Technology Demands Process Change You may disagree

Take Home Lesson Management Matters

Lessons Learned from Two IT Failures

Lessons Learned from Two IT Failures

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