Having had a connection to at least two early-stage hospital EMR failures, I have always been fascinated by this topic. Such failures are not uncommon (see: EMR Failures and a Recipe for Their Avoidance in the Future; Why Cats (and EMR Consultants) Don't Bark; Implementing an EMR or health IT system is harder than it looks). For this reason, I paid close attention to a recent blog note discussing a very rough estimate of the cost of global IT failures (see: Critique: $6.2 trillion global IT failure stats). Below is an excerpt from it:
Researchers often attempt to quantify the number of failed IT projects, usually reporting statistics that discuss failures as a percentage of the overall number of IT projects. These failure stats are primarily useful to the extent they illustrate that IT failure is a common and serious problem. In a recent white paper, Roger Sessions defined a model (Cost of IT Failure) that quantifies the dollar cost of IT failure worldwide. Roger concludes that global IT failure costs the world economy a staggering $6.2 trillion per year, or $500 billion each month. Given these large numbers, it’s no surprise the white paper has received much attention from this blog and elsewhere. Reactions to the white paper are mixed, with both supporters and detractors lining up with their opinions....We still do not have accurate numbers on the annual world-wide cost of IT failure. Nonetheless, an incorrect guess based on rough and incomplete data is better than nothing at all. Still, I remain most interested in a different model for quantifying failure: understanding the real-world costs of IT failure inside individual organizations. Information derived from that model would help companies better link IT investment choices to outcomes, utility, and waste (or failure). Organizations could use that information to help guide better IT purchase and deployment decisions.
Modeling the global cost of IT failures certainly produces impressive numbers. I, however, would be content with the more modest goal of developing a methodology for estimating the cost of a failed EMR project in a single hospital. My major beef with the ex post facto post-mortems of the failures that I have witnessed has been that there was little effort to take into account the internal personnel costs associated with the project. The focus, instead, was on the external software and vendor labor costs. In fact, there tends to be little public accounting at all for EMR failures for obvious political reasons. In my experience, the C-suite executives were all scrambling to minimize the political fallout from the event and save their own skins, often attempting to deflect blame on the CIO.
This brief discussion raises an interesting topic. What is the value, if any, of assessing the cost of any organizational failure, IT or otherwise? Why not let "bygones be bygones"? For me, the answer to this question is simple. In my opinion, many of the EMRs available in the market today do not provide sufficient value. In order to correct this problem in the future, we need to be able to accurately assess the value of such systems prior to their purchase and also the cost and reasons for any particular system installation or operational failure. These data need to be made public in order to inform all future buyers. This will enable the EMR market to operate effectively like that of other major markets. Any attempts by EMR vendors to squelch such public discussions with contractual gag clauses should be prohibited.