Crossing the implementation chasm: a proposal for bold action.

Lorenzi NM, Novak LL, Weiss JB, Gadd CS, Unertl KM
J Am Med Inform Assoc. 2008 15 (3): 290-6

PMID: 18308985 · PMCID: PMC2410010 · DOI:10.1197/jamia.M2583

As health care organizations dramatically increase investment in information technology (IT) and the scope of their IT projects, implementation failures become critical events. Implementation failures cause stress on clinical units, increase risk to patients, and result in massive costs that are often not recoverable. At an estimated 28% success rate, the current level of investment defies management logic. This paper asserts that there are "chasms" in IT implementations that represent risky stages in the process. Contributors to the chasms are classified into four categories: design, management, organization, and assessment. The American College of Medical Informatics symposium participants recommend bold action to better understand problems and challenges in implementation and to improve the ability of organizations to bridge these implementation chasms. The bold action includes the creation of a Team Science for Implementation strategy that allows for participation from multiple institutions to address the long standing and costly implementation issues. The outcomes of this endeavor will include a new focus on interdisciplinary research and an inter-organizational knowledge base of strategies and methods to optimize implementations and subsequent achievement of organizational objectives.

MeSH Terms (9)

Attitude to Computers Delivery of Health Care Diffusion of Innovation Health Facility Administration Health Plan Implementation Information Systems Organizational Culture Organizational Innovation Systems Integration

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