From Barriers to Boundaries: Learnings from a Healthcare IT Project Failure

Abstract

In this chapter, I present a case study that describes my experiences of introducing a multilingual patient information system in a UK Primary Care Trust (defined in the previous chapter), the first of its kind in its region of the UK. This technology-based project, commissioned as a pilot for the establishment of an information system to cater to the needs of ethnic minority languages failed to make progress despite its great potential and the user acceptance that it offered. I present a number of issues that I encountered in working under the constraints of a large bureaucratic setup and those related to the design and deployment of the project that I believe resulted in its lack of satisfactory closure. The findings from this case analysis suggest the failure as a direct result of the constraints the system posed resulting in the project to find itself in a state of inflexibility and lack of adaptiveness. I argue that sub-systems in the overall system in focus were treated as opaque setups with artificial barriers around them. Barriers restrict interaction and creativity. I build a case for managers to identify with boundaries, rather than with barriers to overcome such limitations. I will talk about the difference between a barrier-mentality as opposed to a boundary-mentality. Whereas barriers are prohibitive, boundaries are protective.

Parts of this chapter have appeared previously in “Healthcare Knowledge Management and Information Technology: A Systems Understanding”, authored by Rajneesh Chowdhury, Steve Clarke and Ruth Butler (2007), “Healthcare IT Project Failure: A systems Perspective”. Journal of Cases of Information Technology, Idea Group; 9(4); pp. 1–15. Reprinted with permission from the publisher.