Managers at B.C.’s Health Ministry have decided they need better guidance before embarking on major computer projects. A panel of external experts is being hired to offer advice.
The need for a reset is apparent. Several expensive new systems are over budget, behind schedule or both.
The ministry deserves credit for facing reality. It’s never easy to ask for help. But is a panel of outside advisers really the answer?
By some estimates, 40 per cent of IT projects across all industry sectors are either abandoned entirely, or fail to live up to expectations. Some studies put the failure rate at 70 per cent.
The issue is not technology, as such. The ministry has 51 minor system rewrites underway that are, it says, on time and budget.
And staff have done a first-rate job making medical lab-test results available online. Patients can now read their results often within 24 hours, instead of waiting several days to see their GP, or weeks and months to see a specialist.
The problem is human nature — specifically, the reluctance we all feel when asked to do things differently. The ministry project most in trouble involves three major care providers — Vancouver Coastal Health, the Provincial Health Services Authority and Providence Health Care.
Two years ago, IBM was hired to merge the five information systems used by these authorities into one common format. The scheme made perfect sense.
As things stood, if a patient was treated at Vancouver Coastal, then subsequently admitted to a Providence facility, no one at Providence would know about the earlier treatment. The files were incompatible.
But 18 months and $71 million later, the project stalled and IBM was fired. Complexity was certainly a factor. Between them, the three authorities treat more than a million patients a year. Standardizing that many records was always going to be a challenge.
As well, caregivers and IT professionals have a difficult time communicating with each other. They are trained to see the world in different ways and they describe their needs in different languages.
But a bigger difficulty is getting staff buy-in. Merging formats creates enormous upheaval. It affects how diagnostic tests are labelled, how patient outcomes are defined, how illness severities are rated.
These might sound like technicalities, but there are thousands of them. That means staff must cope with completely new computer readouts — different terminology, different presentations, different look.
But physicians, nurses and administrators are harried enough at the best of times. How do you convince them to go along?
Lay down the law and you get everyone’s back up. Rely purely on persuasion and you come up short — old habits die hard.
There are, in effect, two different camps here. Some believe the ministry should retain the final say. Others believe health authorities are best equipped to plan new IT systems.
And unfortunately, the government has a foot in both camps. The ministry does retain the last word, but it tries to work with project teams that include health-authority staff.
There is a bullet here that needs biting. The complexity of major IT projects lies beyond the skill set of most ministry officials or health authority managers.
Hiring external advisers is only a temporary stopgap. They do bring an element of expertise, but they take it with them when they leave.
What’s needed is a high-powered IT shop in a central location — either in government or some form of Crown agency. Its job is to assess the needs of user groups, oversee design work and manage contracts.
The government currently has a Ministry of Technology, but its mandate is too weak. It’s time to beef it up.
Some major projects lie ahead. As things stand, we’re under-gunned to deal with them.
