The Root Cause of Many EHR Implementation Failures is Bad Leadership

We recently learned of another C-level executive resigning over a failed or challenged EHR implementation (CEO of Georgia Hospital Resigns After Rocky EHR Implementation). These stories are beginning to come with increased frequency as most healthcare organizations are deep into their EHR implementation cycle. If you look closely, the reasons are almost always the same, i.e., lack of physician engagement, difficult implementation time frames or lack of the proper resources. When I read these stories, I usually come to one primary reason for the failure – bad leadership in two distinct areas.

Many try to blame the solution as the problem. The hindsight questions are usually, “Why did we (or did we not) purchase xyz solution?” The name of the EHR solution is really irrelevant. The reason the CEO or CIO were terminated or resigned wasn’t because they bought a “good” or “bad” EHR solution. One of the reasons they failed was because they used a faulty software solution selection process. For years I’vetold healthcare organizations to buy the right solution for their organization. There are no one size fits all solutions in the marketplace. Buying a solution that is overkill is just as bad as buying one that is not adequate enough. Too much of a solution will strain your implementation resources. Too little of a solution will not adequately deliver the expected results.

The second reason I believe they were fired or resigned was because of poor planning and/or management of resources. If you don’t have the proper internal project management and/or technical resources to implement the EHR, then either hire the vendor to perform the complete implementation or an experienced third party organization to manage the project. It usually is much cheaper in the long-run. I’ve sat across the table on many occasions discussing how I could help a company with a technology implementation only to be told how they will do it themselves. Months later I find out they’ve spent millions of dollars with very little to show for it and they either still end up hiring me to get them on track or abandon the project altogether.

In my project management and lean six sigma training we are taught that executive support is the most important key to the success of a project. Without the right support, the right resources may not be allocated or acquired when needed to help complete the project. Therefore, the executive has to take an active role in the implementation process and realize that there is a time to lead (speak) and a time to follow (listen). This support has to extend beyond the start of the project as the executive needs to be engaged throughout the project implementation.

In the leadership class I teach at a local university, we study John Maxwell’s “21 Irrefutable Laws of Leadership.” Many of the laws apply, but I believe there are three that are most appropriate for healthcare stakeholders striving to transform to data-enabled organizations.

#4 – The Law of Navigation: Leaders who navigate control the direction in which they and their people travel. Leaders see the entire trip before leaving the dock and have a vision for how to get to their destination. They understand what it will take to get there, who they’ll need to take with them, and they recognize the obstacles long before they appear on the horizon. Good navigators draw on past experiences, listening to what others say and relying on fact and fiction (gut instinct) to make their decisions.

#14 – The Law of Buy-In: People buy into the leader before they buy into the vision. People don’t follow causes (vision), they buy into the person. To accomplish this, leaders must have credibility with their team members. To establish credibility you have to develop good relationships with your team members to acquire their trust. This can be accomplished by setting a good example for your team members by holding yourself to high standards and providing them with the tools they need to succeed.

#15 – The Law of Victory: Leaders find ways to win despite the situation. The best leaders rise to the challenge and do everything in their power to lead their team to victory. To apply this law requires a unified vision among the team members, a diversity of skills and a leader dedicated to victory and raising team members to their potential or greater. You can have the unified vision and a team with diverse skills, but without the proper leader to pull it all together, you just have a diverse team with a vision.

To be successful, executives are going to have to use all of their leadership skills to put their people in a winnable situation and to get them to willingly go over and beyond what they normally would contribute.

One of my favorite analogies is that of a baseball centerfielder running into the wall to make the catch for his team. He realizes that he might hurt himself (and many have), but he believes that helping his team win the game is more important than his personal safety. I will ‘go to the wall’ for my friends and as a leader, your people may have to do the same for you someday. Good leadership will help them feel good about making that choice.