I once gave a talk called “How to manage your CIO” for CFOs and CEOs from the region in an event in Bangkok. My main premise was that the single biggest factor to consider when buying a system or systems for your hospital/hospitals is understanding your organisation and its IT / Informatics maturity and the vision of where you need to be in the next few years. Nothing revolutionary I know, it would even seem like it should be obvious – but you would be surprised how often healthcare providers don’t get this. So much effort and focus is spent on understanding technology, features and vendors before sufficient soul searching has been done to answer preliminary questions such as;

1. what is going to be our business focus and differentiation over the next few years, ambulatory care?  wellness?
2. can we ever picture ourselves as leveraging IT to unlock new capabilities and markets or is that too far fetched for now?
3. are we looking to build a community? branches? regionally?
4. will we build up internal IT capability or will we always be dependent on partners?
5. do we know where we are in terms of IT maturity now? do we have a way to measure it and chart a course?
6. will we be able to secure executive sponsorship and a competitive budget? how will we manage the BOD?

The answer to these questions have serious impact to the vendors and solutions a hospital should be choosing. The economics of Malaysia usually mean that we do not have sufficient buying power as a nation to demand customisation from mature technologies. So often buyers in Malaysia have to choose between reengineering their processes and informatics to conform to mature technology and workflows from proven overseas systems or to have something bespoked to their needs locally and risking the quality issues inherent to this option. Some vendors have strong systems but others have strong implementation skills – which is more important for your situation? Some hospitals lack the IT maturity and need a vendor who will come and tell them what to do and conform them to their image – others have such strong preferences and needs, they will be better suited to a vendor who listens and conforms. In my experience many customers do not understand themselves, thinking they are the latter when they are really the former – resulting in implementation deadlocks where they feel the vendor is not helping them to complete a task or make meaningful choices. The analogy I like to use is a golfer putting. A successful putter is one who is not only sufficiently practised but able to read the greens and choose the right stroke and approach to sink that ball.