When IT Fails, IT Leaders May Fall

June 3, 2014
How does the recent electronic waiting list scandal that rocked the VA healthcare system compare to one of Shakespeare’s greatest plays? Both are a tale of the tribulations of being in power.

Here’s a nice little fact about yours truly: I own the complete works of Shakespeare.

Now before you go praising my intellect, realize that I’ve also probably only read about one-third of his works, not including the sonnets. I took a class in college and thought I’d become some kind of Shakespeare nerd following academia, so I kept the book. Obviously that didn’t happen and right now it’s mostly collecting dust.

Still, I do have a fondness for certain works of his, and having that giant book in my house reminds me of them. I’m talking about A Midsummer’s Night’s Dream, Taming of the Shrew, Hamlet, Othello, and my absolute favorite, Julius Caesar. I love Caesar because it’s about deception, manipulation, and the tribulation of being in power.

Caesar is an examination of what happens when the order of power is thrown into disarray. Caesar is assassinated and those who are left undergo in a power grab that divides the republic.

Can those in power act selflessly for the good of the whole?  Being this is a tragedy; the answer Shakespeare gives in Caesar is an unequivocal no. The end result is chaos, fragmentation, and instability. Ultimately, those who rose after Caesar fell, fall themselves (although Mark Antony doesn’t fall until the next play, Antony and Cleopatra).

In America, there are men and women in leadership roles who can probably relate to the tale of Julius Caesar.  Quite simply: It’s lonely at the top. You have to be wary, something Caesar himself foreshadows in the early stages of the play, saying that Cassius (the man behind his assassination) thinks too much. And once you’re at the top, there is nowhere to go but down.

I couldn’t help but think of Caesar last week when I was reading about the whole Veterans Affairs (VA) healthcare system electronic waiting list scandal that left many veterans without scheduled appointments. If you need the Reader’s Digest version of the story, here is my news item.

Of course, former VA Secretary, Eric Shinseki is certainly no Marcus Brutus, but in many ways, he is similarly a tragic figure. Both fell on their sword for the good of the whole, although one did it literally and the other did it metaphorically.

The modern day Roman healthcare comparisons don’t end with the VA. In Athens, Ga., there was more “falling on the sword.” Athens (Ga.) Regional Health Systems’s CEO, James “Jamey” Thaw and senior vice president and CIO, Gretchen Tegethoff both resigned after they underwent a troubled electronic medical record (EMR) implementation.

 Brutus lost the Romans, the Athens Health System leaders lost their doctors, who unanimously voted no confidence in the administration, and Shinseki lost the American public and Congress. In all cases, they were all removed from power.

For leaders of healthcare organizations, it has to be harrowing. One false move—often something that you didn’t even do, but happened under your watch—and everything can go in disarray.  As Caesar proves, once things are in disarray, there is usually no turning back.

This lesson is especially noteworthy when it comes to money.  If you’re spending millions upon millions on an expensive IT installation, you better deliver. If not, watch out! The CIO and CEO in Georgia weren’t the only ones who learned that lesson. In Maine, one CIO was dismissed over an expensive, failed Epic implementation.

So Friends, Romans, Countrymen, Healthcare Leaders, lend me your ears. I am not here to bury anyone, but to deliver a warning about the inevitability of life: What goes up must come down.

Please feel free to respond in the comment section below or on Twitter by following me at @GabrielSPerna

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