Short Cuts to Failure

A large number of eHealth initiatives, especially those that are infrastructure oriented, are government sponsored or led. I came across a paper titled Walking Atop the Cliffs: Avoiding Failure and Reducing risk in Large Scale E-Government Projects. The paper identifies six "Short Cuts to Failure". These shortcuts include projects that:

• Will conduct a cursory stakeholder identification process
• Will not seek serious partnerships or ongoing information collection with stakeholders, key or otherwise
• Will curtail the breadth and depth of the feedback collected from stakeholders
• Will follow a pre-determined path for the project and not develop a plan based on stakeholder feedback
• Will revert to traditional analysis methods in response to environmental pressure for an answer
• Will adopt the results of the pre-study of business processes rather than invest in comprehensive investigation and documentation necessary.

The paper includes a review of the literature on project management and illustrates its findings with a case study.

Long gone are the days when IT folks could restrict user involvement to requirements definition and acceptance testing - leaving most of the development process to the engineers and technical analysts. End users must be involved at every stage of the development process and beyond. They're the ones who must live with the system.

I find it interesting that most of these short cuts to failure involve the failure to effectively engage stakeholders or respond to their issues, needs and concerns. I personally am aware of a number of major eHealth projects that fall into this category. Due to time pressure or politics they don't engage stakeholders; especially the end-user health professionals who are supposed to use the systems. On occasion the principals even hold significant stakeholder groups in contempt, hiding ulterior motives for the system such as cost containment or greater control of the health system.

The one conclusion I've come to in my research on eHealth risk is that effective and meaningful stakeholder engagement is MANDATORY for eHealth projects. It will take more effort and time, but its the shortest "Shortcut to Success".