Electronic health records systems and other information technology projects have moved to the top of the agenda at many hospitals and other healthcare facilities. However, the track record of such projects is not encouraging. Technology projects are often subject to high failure rates, extensive cost overruns, and wasteful delays. Even projects deemed "successful" often do not fully realize their promise or meet user expectations.
With an unprecedented number of technology projects planned, underway, or anticipated, the challenge for healthcare executives is not only for projects to be delivered on time and on budget, but also that they meet real user needs and remain relevant even during protracted development cycles that could encompass years.
We faced that challenge at Texas Health Resources when we launched an EHR project in 2005. With 14 hospitals, 18,000 employees, and 3,600 physicians who practice on the medical staffs, Texas Health had an enormous paper database that needed to be converted. At the same time, we needed technology, processes and procedures that could be easily and efficiently used by physicians, nurses, admissions, and other staff.
We benefited from a strong internal project management process that kept the implementation on course. We also found that it was equally important to look beyond the technical execution to how the project's objectives were being met. We repeatedly learned that a critical factor in keeping a project not only on track but also on mission was strong leadership in the form of an executive sponsor.
The EHR project, like others now underway, benefits from a senior management official who "owns" the project and is responsible for making sure that it achieves its value and user expectations. An effective executive sponsor is necessary in complex organizations such as ours, with intersecting organizational charts, overlapping responsibilities, and key stakeholders who are not employees and may have conflicting priorities.
An executive sponsor can improve a project's chances for success by providing leadership, direction, and problem-resolution skills. The ideal sponsor alternates between advocate and arbiter, manages upward and downward, and can clearly communicate the value of the initiative to the business side of the organization.
It is important to recognize that executive sponsors are not meant to replace project managers. Sponsors' focus should be on the bigger picture not on day-to-day implementation and decision-making. The sponsor should complement the project manager and provide the resources and senior management attention the project needs to succeed. Sponsors should also serve as a guide to the project manager, ensuring that the product will continue to be relevant to end users even after the "go-live" date.
But appointing a sponsor is not enough in itself: Organizations must select the right person, with the right skills and authority, and empower him or her to make the necessary decisions to maintain project agility and progress. Here are seven attributes we, at Texas Health, learned were important when selecting an executive sponsor.
Choose a sponsor who will drive the project as a clinical and operational initiative, not as an IT engagement. The temptation when selecting an executive to oversee a multifaceted information technology project is to look for someone capable of understanding the technical aspects of the job. Understanding the intricacies of a project is important. But even more crucial is an ability to recognize how the project fits into the organization's business and its core function of providing care for patients. All too often, technology managers lose sight of the bigger picture and go off track, wasting resources, and ending up with products that do not meet real-world needs. A good executive sponsor, focused on the operational and strategic aspects of a project, can help keep management on track.
Appoint the person, not the position. The choice of executive sponsor should be made on the basis of interest, personality, leadership skills, knowledge, and even availability. A more junior person could be valuable if she or he has the energy, the time, and the commitment to be more than a figurehead. At the same time, the sponsor must be of high enough rank that he or she can command the attention of those higher and the respect of those lower in the hierarchy. Ideally, the sponsor should be someone who understands the project, believes in it, and can champion it effectively.