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Button, Button, Who Has the Button?

August 15, 2010
by Bobbie Byrne
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“Careworks: Just a Click Away Nov 2010”: That is what the buttons say for our large HIT project. Our marketing department designed them with a pleasing design and the Edward colors. Our core team and our senior staff have been wearing them on their badges for a few months. We wanted to highlight both the movement from our old DOS looking system as well as the date for conversion. I personally wanted the date on the button. I wanted to use every mechanism to rally the organization around this project being on time. I was not part of setting these dates, but I darn sure wanted to be part of making them on time.

We are ripping and replacing all clinical and financial systems—forging ahead with the assurance that this kind of major surgery is the way to get to the promised land: Meaningful Use, Quality Care, Pay for Performance, Accountable Care and beyond.

Of course, in our “rip and replace,” our users want “like for like.” We need to balance the current automated workflow with the new processes. Our ED, almost paperless, will be the hardest hit. In a single day, when we flip the switch on the new system, we need to meet the exact same workflow that they have been tweaking for years. I actually believe that task is not humanly or technically possible. On a good day, they understand this as well. On a bad day, they just want what they want.

I heard once that fewer than one-third of HIT projects are on time and on budget. It sounds a bit like urban myth, but I don’t doubt that it is accurate. I thought that our project would be part of that magical, on-time minority, mostly because of the incredible team involved—a compulsive PM supported by top-notch analysts, engineers and super-users.

But despite the impressive team and all the hard work, we are in the oh-too-common position of needing to push our go-live date down the road. Our vendor has committed to delivering fixes to our issues—just not in time for our date. We need to find a new date several months later. We need to look at budget, training, retesting, etc., etc., etc.

I informed my boss, the CEO, of this delay. (Unfortunately, this is the very same week that we are determining raises—but, trying not to think about that!) As we are having a very serious discussion of the issues, I just can’t stop thinking about the buttons. Those darn buttons with the date on them. The ones that everyone is wearing to show support for the go-live date. The date that now will be missed. What to do about the buttons?

I need to work on way bigger problems, but in the meantime, does anyone have an inside track on stickers that say, “Careworks: Just a Click Away at an undetermined date sometime in the future” ?

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Bobbie Byrne

Vice President for Health Information Technology at Edward Hospital in Naperville, Ill

Bobbie Byrne M.D. writes about being a community hospital CIO all the while trying to figure out...