Technology Is Not Transformative

I recently had the opportunity to speak at the AEHIT/CHIME event in San Diego for healthcare IT executives.  My topic was on the technologies of hype in healthcare IT.

In preparation, I ran across the following quote from the Gartner 2018 Hype Cycle for Healthcare Delivery Organizations.  In it, I read the following quote:

This matrix reminds CIO’s that their recent priorities — EHR’s, enterprise data warehouses and patient portals — have become foundational/commodity (not transformational, as we would have hoped, but surely not passé).” – Gartner

I shouted when I read this.  I jumped up and wrote on my whiteboard:

“Technology is not transformative, people and leaders are transformative.”

It seems so obvious.  It seems so simple.  I’ve heard it before.  But I continue to see companies act as if there is a technology magic wand that will somehow, with the right flick of the wrist and words of enchantment, will transform an organization.

But when you look at the technology implemented in a Proof of Concept (POC), the first organizational unit, the multiple silos, or consolidated in the Center of Excellence (COE); oftentimes the technology has not changed, rather, our skills in using it and our understanding of it has grown.

The real challenge is in taking the technology of the pilot and creating true enterprise impact.  In healthcare we speak of the Quadruple Aim: patient experience, clinician experience, value/cost and quality/outcomes. For a technology to make a difference at enterprise scale, one of these four attributes must be present at a level that’s materially significant to the enterprise.

And going beyond enterprise impact to true transformation, well, very few technologies ever get there.

If an organization is truly transformed by a technology, it’s because leaders in the organization have chosen to reframe the enterprise in context of the new thing, whatever that thing is.  This is Apple becoming a phone company.  Amazon changing the landscape of commerce while also taking their internal IT platform and bringing it to market as AWS.  NYU Presbyterian putting telemedicine in the middle of the Emergency Department to change the patient experience.  These companies re-wove the fabric of their company to align with a new technology.  They transformed.

This was not a product of the technology.  It was a product of the people.  It was leaders.

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In last year’s class on Systems Thinking for Digital Transformation, Rob Siegel of Stanford’s Graduate School of Business, a good friend and collaborator with OST, used the below graphic to depict how the systems thinker sits in the middle of the customer framing, value, and partner network. In this way, they are able to transform an organization in the face of a new digital capability.

System leadership is especially necessary when moving technology from a center of excellence (CoE) to a level of enterprise impact. It moves the focus off the technology and shifts to how this new digital capability changes the enterprise and brings value at scale.

Leadership is required at each stage of the journey:

• Leadership of ideas.
• Leadership of technical execution.
• Leadership of expansion and advocacy.
• Leadership of standards and control.
• Leadership of scale to achieve solid business outcomes.
• Leadership of strategy and vision to transform the organization.

The most dangerous stage for a technology, and the one I see most often, is getting trapped in one of these phases – often the POC (failure to scale to the second example) or in the COE. This is often a leadership problem.

You might need to change leaders to move from one stage to another. If the leader cannot change, they may have been great at one phase, but have behavior or skill gaps between the actualized and aspirational.

Technology is not transformational.  People and Leaders are.