Just the other day I met with the global head of a Big 4 consulting firm at breakfast. He likes meeting heads of organizations that are interested in changing the game and has views on a range of management of issues that draw on his experience. One of the thoughts he shared, and that intrigued me, was that most hospital systems with a revenue of less than a couple billion dollars have a tough time taking good technology management decisions.. ranging from technology choice to implementation to getting business value out of it.
In several ways it resonated with my experience as well. The reasons may be numerous. But in the main revolve around a critical threshold level of investment that may be necessary to have the management team, both for business and technology, to deal with hugely complex technology issues facing health care providers. The organizations with scale may also make sub-optimal decisions. However, they may be better able to get around it relatively quickly. Those who do not make the cut on scale, may nurse the wounds of a sub-optimal decision longer.
Then I saw the news of a small community hospital outsourcing its services.. I had not seen hospital level outsourcing in a while and thought of seeking your thoughts as to what is triggering such thoughts and action. Do you think outsourcing to an organization that can leverage scale works? Does it bring in efficiency? Does it help hospital management make better technology decisions? What do you think? What should the CIO do?