Is your IT project set up for success or failure?

Mica Deshaw Practice Leader, Spok

There is no such thing as ‘just another IT project’ anymore, and the reason is simple. Nearly all IT projects that aim to solve business problems require users to modify or completely alter their behavior in order to be successful. For example, during the conversion to computerized provider order entry (CPOE), physicians had to transition their prescribing habits from pen and paper to keyboard and screen. The shift to CPOE necessitated change management planning to ensure that doctors used the new process instead of maintaining their analog ways. Without a change in behavior, the new technology would have failed to achieve any true return on investment. Yet human behavior continues to be a missing element from most IT project plans. In fact, a lack of consideration for the human factors as a part of the change management process is one of the biggest contributors to project failure.^{1, 2}

IT departments are all too familiar with failure. More than 70% of IT projects are deemed unsuccessful because they do not meet three basic criteria: Finishing on time, within budget, and with satisfactory results.³ And these challenges can largely be attributed to poor organizational change management which is evidenced by the following:⁴

Lack of strong executive sponsorship and engagement,
lack of project management framework, and
lack of support and buy-in from middle managers and employees.

Mobile messaging

Let’s look at a current healthcare IT project example: Mobile messaging. When applying mobile messaging technology in the healthcare setting, texting (a commodity that most of us use personally every day) becomes much more than just two-way messaging. It can support test results reporting for faster treatment planning and delivery, EHR integrations to speed up admissions or discharge processes, and emergency communications to improve patient outcomes during code calls and rapid response team notifications. All of these different use cases can contribute to better patient care, but if the healthcare staff does not know how to use them, the technology will fail to deliver on its original goals.

I see many IT teams approach mobile messaging technology from largely a technology deployment focus. There is so much attention on the technical aspects of the installation that teams overlook the need to address change management, especially the human elements, along with the technology install. The lesson here is that building it does not mean they will come.

In order to realize the return on the investment (ROI) and achieve tangible value, the staff has to use the messaging platform. IT teams are learning how to inspire people to use the new technology to message one another. But even then, the ROI often falls short because staff aren’t using the tool in multiple ways to enhance care coordination. Physicians may send consult requests to one another, yet overlook the opportunity to message directly with nurses and cut time from the discharge approval processes or pain medication requests.

I’ve put together a list of the six most important change management elements IT teams should include in their project planning landscape for greater IT project success, especially for mobile messaging.

Start at the beginning: Best practices demonstrate that IT solution configuration and change management planning should begin at the same time and continue in parallel because they are interdependent throughout the process. The plans for how a solution will be applied and used will determine the information and positioning statements that are communicated to end users in preparation for future behavioral changes.
Build a commitment: The most successful IT projects create a solid steering committee at the very beginning. The committee needs to be fully invested in the success of the project to ensure the team will overcome obstacles and see the project through implementation, adoption, and ongoing support post go-live. Just like EHR installations, mobile messaging projects require ongoing optimization efforts for the best ROI.
Secure an executive sponsor: Finding an executive sponsor who is willing to invest time and energy to the project can be difficult, but the rewards are well worth the effort. An executive sponsor, especially a clinical sponsor such as the CMIO or CNIO, is highly respected within the organization and well positioned to act as the clinical champion to elicit the requisite behavioral changes. This person cannot be a figurehead. This individual must show up, participate, and be willing to advocate for the project team.
Require cross-functional participation: Traditionally, communication projects were owned by the telecom department. Mobile messaging is far more expansive and should include representation and expertise from clinical areas, patient safety, digital security, process improvement, and others depending on the intricacies of each hospital environment.
Look at your policies: Be sure to look at your hospital or health system’s policies along the way. Mobile brings a new layer of complexity to security efforts, HR policies and the IT help desk. Including consideration of these policies in the planning phase can prevent problems further down the project path.
See the value: Most IT projects, and especially mobility projects, are an evolution. Don’t underestimate the value of the technology and leave opportunities on the table. Continue to work on the project after initial installation and find more ways to maximize integrations, usage, and impact.

Advancements in planning, processes and tools have helped project teams evolve, yet IT projects are no more successful than they were 20 years ago.5 The biggest barrier to project success is human behavior. To overcome that obstacle, get the right people on the planning team, look beyond technical specifications to see the project from multiple perspectives, and incorporate change management as a key element in your plan. Driving behavioral change once the technology has been installed is the ticket to realize ROI and deliver perceived value to the end users, the project team, and the organization.

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