Sorting Through HIT’s Cultural Revolutions

Posted on June 15, 2017 I Written By

When Carl Bergman isn’t rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of EHRSelector.com, a free service for matching users and EHRs. For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manger doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst.

HIT is a small ship in the large IT sea. Whether we like it or not whatever stirs IT will rock HIT’s boat – to stretch an analogy. Sometimes it’s a tidal change in how we do business. Dial up modems, for example, gave way to high speed lines revolutionizing all that they touched.

Sometimes these revolutions – to switch analogies are much welcome and undeniable. No one is going back to MS-DOS or parallel interfaced printers. Sometimes, though, IT gets caught up in cultural revolutions (CRs) that eventually fade and disappear, but take a toll before their done and gone.

Chinese Cultural Revolution Poster

Chinese Cultural Revolution Poster. Source: chineseposters.net

By cultural revolutions I don’t mean the extremes of Chairman Mao’s creation, with Red Guards who destroyed everything and everyone in their path. We’re far more kinder and gentler than that. The CRs I’m talking about are organizational or technical fads noted for their promoters’ evangelical zeal. Heavily promoted they soak up organizational time and effort often with little to show.

To be sure IT’s not the only organizational sphere with fads. DOD’s Program, Performance Budgeting System (PPBS) is a famous 1960s example. It promised an almost mechanical solution to DOD’s major logistical, operational and performance review problems. It didn’t. Little changed. That doesn’t mean PPBS didn’t have some practical aspects, or that it didn’t leave behind some improvements. However, little justified its over blown hype and massive organizational disruption.

IT and HIT have had their share. Six Sigma, CMMI, and ISO 9000 quickly come to mind. I would add XML and Big Data. Advocates pushed these in the name of curing many woes or reaching new heights by adopting a new way of thinking or doing. However, CRs almost always just put old beer in new bottles.

Spotting a Cultural Revolution

Each day brings something new in IT/HIT. Here some ways to determine if what you’re facing is a fad or not:

  • Advocates. Who’s promoting it? Who certified them and what did that entail?
  • Analogues. Who’s implemented the CR and can you speak to them freely?
  • Client Demand. What do your clients think? Do they want you to adopt the new ways?
  • Effort. What effort will it take to adopt the CR? What are the opportunity costs?
  • Focus. Does the CR require your staff to stop what it’s doing and attend lengthy, expensive seminars?
  • Jargon. Do the advocates speak terms you know, or do they promote a whole new language you’ll have to master?
  • Organizational Fit. How well does the CR fit into your current way of doing things?
  • Payoff. What are the CR’s specific, definable advantages?
  • Segments. Does the CR give you a menu of choices or is it an all or nothing approach?
  • Sponsors. Who’s the CR author? Is it a standards organization, a movement by knowledgeable users or a self referencing group?

CRs aren’t a simple matter of useful or not. Sometimes even fads can bring a useful approach wrapped up in hyperbole.  For example, XML advocates claimed it would change everything. After that promotional tide receded, XML became another tool. The challenge, then, is being able to see if the current CR really offers anything new and what it really is.