IT Disasters ： The Worst Debacles and Lessons Learned From Them

1. IT Disasters：The Worst Debacles and Lessons Learned From Them Course Name：Health Care Management Professor：Chen-Chung Ma Student：Yu-Chia Li Studentnumber：9651002M Date：2008/03/19

2. Summary • Most articles discuss successes about IT —lower costs and improve outcomes • IT Disasters？ — frustrating、costly and can paralyze an organization

3. How to avoid getting caught in IT debacle? • Lesson 1：Manage Vendors and Understand Their Motives • Lesson 2：Never Outsource the CIO • Lesson 3：Don’t Let Vendors and Consultants Drag Out Implementations • Lesson 4：Never Disenfranchise IT Staff From End Users • Lesson 5：Buy，Don’t Build • Lesson 6：Involve Users Heavily in the Decision Process • Lesson 7：Avoid 〝 Visionware 〞

4. Lesson 1：Manage Vendors and Understand Their Motives (1/4) • The images of an organization and a vendor working hand in hand for the good of the organization. －Partnership － would work closely to develop a shared vision of project goals and outcomes. • Vendors must satisfy their shareholders , so maximizing earnings is a priority.

5. Lesson 1：Manage Vendors and Understand Their Motives (2/4) • Sometimes , partner vendors can become too much a part of the organization. • Consulting engagements should last for months , not years , and vendors/consultants should have a clear-cut project plan. － a fixed endpoint and costs • Cause IT costs were high , so don’t let them talk you into paying more people and even more cost.

6. Lesson 1：Manage Vendors and Understand Their Motives (3/4) • Large , multi-integrated delivery network (IDN) • Conversion and consolidation of the Y2K . － vendors used as an excuse to garner a large project , increasing its revenue and earnings from the expense of the hospital. Y2K 就是 year 2 kilo，也就是西元2000年的意思。Y2K是由電腦年序問題所引起。因為早年的電腦軟硬體設計都是由末兩位數來代表西元的年份，於是電腦便以兩位數來做為運算的基礎。當面臨2000年，避免年序變成00以造成系統產生辨識錯誤，以致發生不可預期的連鎖效應。

7. Lesson 1：Manage Vendors and Understand Their Motives (4/4) • Manage vendors and negotiate clauses in vendor contracts is a responsibility for organizations. －to protect against cost overruns and open-ended projects. • The new vendor relationship included remedies , penalties and risk sharing.

8. Lesson 2：Never Outsource the CIO (1/3) • Outsourcing is not always a panacea. • Once outsourced , it is very difficult to get your IT employees back and costs tend to rise with every new project . • Why outsourcing the IT department was a mistake? (1) while saved money on the surface , it brought many problems in communicating specifications and customers support.

9. Lesson 2：Never Outsource the CIO (2/3) • Why outsourcing the IT department was a mistake? (2) the contract was signed in a rush , leaving service level agreements (SLAs) “to be determined” and “ambiguous.” • The organization’s biggest mistake was outsourcing the CIO position. － who was an employee of the contracted vendor , also was responsible for approving his own firm’s invoices and purchase orders.

10. Lesson 2：Never Outsource the CIO (3/3) • It is critical to be employed the CIO by the organization. － the core mission of ensuring patient safety , providing high-quality services and maintaining efficient operations.

11. Lesson 3：Don’t Let Vendors and Consultants Drag Out Implementations • The CIO was inexperienced in hospital IT and implementation had become a “feeding frenzy.” － with vendors and consultants charging many millions of dollars in time and materials. • A more effective approach － hiring an experienced CIO who knew reasonable implementation time frames and negotiated a fixed fee or not-to-exceed cap on implementation fees.

12. Lesson 4：Never Disenfranchise IT Staff From End Users • The centralized IT analysts tried to learn each system , but users were dissatisfied with their lack of knowledge. • The staffs to specialize in various systems and learn the applications in depth. － users satisfaction increased • Originally , IT staff reported to managers at a corporate office；After reorganizing the IT department , staffs report directly to IT director. － satisfactions scores on customer surveys rose

13. Lesson 5：Buy，Don’t Build • Generally , buying IT systems garners more benefits than building them. • Building IT systems － the high costs of the large in-house programming and support staff who built and supported the system. • When the system crashed , the CIO had no one to turn to for technical support. • There is a supplement to this rule： Do not be the first organization to use a new system !

14. Lesson 6：Involve Users Heavily in the Decision Process • It is important to have input from the end users who are prior to choosing a vendor. • Executives involve the end users enough in the selection process ? • Need to know whether the staff is ready and able to use any particular system. • But end user involvement also needs to be managed.

15. Lesson 7：Avoid 〝 Visionware 〞 • It is far easier to build a PowerPoint presentation with program prototype screen images of a new system than to finish a code and debug it. • Windows 95 , Microsoft’s first graphical user interface , but its predecessors , Windows 1.0 , 2.0 , 3.0 and 3.1 , which were full with bugs and caused system crashes. • The programmers are struggling with the same issues you are － budget cuts , cost overruns , insufficient staffing , changing requirements.

16. Conclusion (1/2) • Technology：Not the only Answer － can’t take the place of person-to-person teamwork and communication. － the use of EMRs and CPOE still can cause patient care problems. • Complications will always accompany every IT conversion. － the responsibility of the healthcare executive to guide the institution through these land mines and minimize any damage that occurs.

17. Conclusion (2/2) • Successful organizations will recognize these problems as they occur and adjust to avoid the pitfalls.

18. Thanks for your listening！

19. Slangs • You’re way too far ! 你太過份了! A：That’s your younger brother . How could you beat him for no reasons? B：Yeah , you’re way too far. • We’re through. 我們完了。 A：Johnson often quarreled with me over trivial matters . I can’t bear anymore . B：So , you’re through?

20. 何謂SLA？ • Service Level Agreement • 一種雙方(客戶-業者或業者-業者)所協商出的一種契 • 約服務提供者及顧客之間雙方同意的約定，裡面定義 • 了服務目標及雙方的預期及責任。 • SLA objective • Develop SLAs that ensure sellers are aligned with • buyers in providing service at the contracted • level. 國立中央大學資訊工程學系周立德副教授