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 contact with clinicians Online counseling Pre-visit testing Support groups Personalized medicine
Description of the Online Services Health education contact with clinicians Online counseling Pre-visit testing Support groups Personalized medicine
Description of the Online Services Health education contact with clinicians Online counseling Pre-visit testing Support groups Personalized medicine
Description of the Online Services Health education contact with clinicians Online counseling Pre-visit testing Support groups Personalized medicine
Description of the Online Services Health education contact with clinicians Online counseling Pre-visit testing Support groups Personalized medicine
Description of the Online Services Health education contact with clinicians Online counseling Pre-visit testing Support groups Personalized medicine
Description of the Online Services Health education 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
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