Law Students

We understand that this blog has introduced concepts (e.g. wicked problems and agile methodologies) that may be foreign to healthcare providers. There are several reasons why we have felt compelled to do so: 1) we are bona fide geeks and can't help ourselves; and 2) more importantly, we believe that maybe (just maybe) some of our readers might benefit from our lessons learned (the hard way) in other industries.

In past lives we have had the opportunity to wear many hats. We lived through (and manged to survive) the dot com bubble bursting, the migration from mainframes to PC's, and the rise of the Internet. All of this before changing careers in mid life to law and nursing respectively. During that time we witnessed more failed technology projects than we care to remember. In fact, we wrote a book about our adventures in technology called Silicon-Stories.

The key "take away" is that most technology projects fail because of people and process challenges that have very little to do with the underlying technologies and almost everything to do with the kind of social complexity that we often write about (i.e. which lies at the heart of wicked problems). An EHR implementation includes so much more than technology that to call it a technology project is itself is a misnomer. An EHR implementations is more aptly described as a change project.

This post will first illustrate why change of this magnitude is inherently chaotic. There are simply no cookbooks, no maps, no videos, no books, no webinars, no conferences and certainly no newsletters that are capable of providing a step by step approach applicable to all providers or even most. Each solution will be different than the next because each organization is different.

We understand that an industry whose very foundation rests on the scientific method will have a difficult time accepting the fact that heuristics is the best we can do. In fact, for many within healthcare it is clearly anathema to suggest that sufficient study of the problem will not only lead to poor results, it will lead right off the cliff to certain failure. The "form a committee to form a committee to study the problem" will lead to death by a thousand cuts. We have seen this movie before and it doesn't have a happy ending.

In short, to solve a wicked problem you must fail fast in order to succeed. Why? Because problems this complex can't even be defined, let alone solved, without a better understanding of where we are today as compared to where we need to be. To solve a wicked problem you must act more and study less. That is the point that Lee Iacocca made when he took a chainsaw to the Mustang. Get busy doing! Break some ground!

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