Thursday, August 16, 2007

A Program View of eHealth

I am a big fan of the book by John Thorp titled The Information Paradox: Realizing the Business Benefits of Information Technology (unfortunately it is out of print, though used copies can be ordered through One of the main points in his book is the need to take a program view of IT initiatives.

Far too many eHealth initiatives start and end with the development and implementation project. Many project sponsors and managers have a "build it and they will come" attitude. They're convinced of the benefits of eHealth. Surely health care workers will see the light and happily adapt their day-to-day routines to accommodate the new system. Unfortunately, taking a narrow IT project view will more likely end up with interruptions in business and clinical processes, user rejection, and ultimate failure.

Programs are structured groupings of projects designed to produce clearly identified business results or other end benefits. Rarely does an eHealth system stand on its own as a single project. eHealth is invariably implemented into a complex environment requiring a range of interventions to ensure a successful outcome.

For example, eHealth systems often form part of larger business transformation initiatives such as those supporting primary care reform or wait-times management. Even on their own, eHealth systems require re-engineering of business and clinical processes, changes in job function, end-user training, transformation of organizational culture and ongoing management and maintenance in the operational environment in order to be successful.

One cannot realize benefits or manage risk with a narrow project view of an eHealth initiative. The implementation project represents only the first phase in a long term eHealth program designed to benefit patients, health care providers and health care organizations.

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