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Lessons Learned from Two IT Failures
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  1. Lessons Learned from Two IT Failures Farrokh Alemi Ph.D. Lee Baliton

  2. Case Study • Interpractice Inc. ($15 million and 7 years wasted) • Web-based services to patients of an HMO • Telepractice Inc.($6 million & 3 years wasted) • Computer services via telephone to patients of an HMO

  3. Description of the Online Services • Health education • Email contact with clinicians • Online counseling • Pre-visit testing • Support groups • Personalized medicine

  4. Description of the Online Services • Health education • Email contact with clinicians • Online counseling • Pre-visit testing • Support groups • Personalized medicine

  5. Description of the Online Services • Health education • Email contact with clinicians • Online counseling • Pre-visit testing • Support groups • Personalized medicine

  6. Description of the Online Services • Health education • Email contact with clinicians • Online counseling • Pre-visit testing • Support groups • Personalized medicine

  7. Description of the Online Services • Health education • Email contact with clinicians • Online counseling • Pre-visit testing • Support groups • Personalized medicine

  8. Description of the Online Services • Health education • Email contact with clinicians • Online counseling • Pre-visit testing • Support groups • Personalized medicine

  9. Description of the Online Services • Health education • Email contact with clinicians • Online counseling • Pre-visit testing • Support groups • Personalized medicine

  10. Technology is Seductive • A fix: efficient production

  11. Technology is Seductive • A fix: efficient production • Changes what we do, re-defines us

  12. Technology is Seductive • A fix: efficient production • Changes what we do • InterPractice Inc • TelePractice Inc.

  13. Randomized Clinical Studies • Improve patient outcomes • Reduce cost of care • 28% total health care cost savings • 33% lower cost for AIDS care

  14. Randomized Clinical Studies • Improve patient outcomes • Reduce cost of care • Failed as a business

  15. Business Process Change Needed • New technology is not enough • Process change is needed You cannot take a car for a walk

  16. What do we mean by new business processes? Case of an Online Patient Service Company

  17. Organization's policies on scope of services must change Focus on economies of scale not scope

  18. Organization's policies on scope of services must change Small is Beautiful

  19. Organization's policies on scope of services must change Conflicting Demands

  20. Organization's policies on scope of services must change Examples: Salic Clinic; CABG operations

  21. Organization's policies on scope of services must change Focus

  22. Recruitment and training policies must change

  23. Recruitment and training policies must change Physicians resist remote management

  24. Recruitment and training policies must change Initiating Contact

  25. Recruitment and training policies must change Changes the relationship

  26. Policies on capital purchases must change Shrink the physical overhead

  27. Policies on capital purchases must change Example in banking

  28. Policies on the gatekeeper must change Health educators making triage decisions

  29. Policies on the gatekeeper must change Drop in Value of Primary Care Clinics

  30. Policies on the gatekeeper must change Managed by Specialists

  31. Policies on the gatekeeper must change Example among AIDS patients

  32. Policies on medical records must change Electronic records are needed

  33. Policies on medical records must change Decision aids are needed

  34. Patients' Attitudes Will Change Definition of illness will change

  35. Patients' Attitudes Will Change Informed consumer

  36. Patients' Attitudes Will Change Patients may know more than their clinicians

  37. Patients' Attitudes Will Change “You have been mothering us, how dare you stop?”

  38. Technology Demands Process Change So much needs to change

  39. Technology Demands Process Change You may disagree

  40. Take Home Lesson Management Matters