Government // Leadership
10:43 AM
Anthony Guerra
Anthony Guerra

Guerra On Healthcare: When Clinician, IT Priorities Collide

In selecting doctor-friendly electronic medical record systems vs. more IT-friendly options, corporate philosophy should guide your decision.

It's almost impossible to develop a successful business unless that business is built on a core foundation of sensible and complementary philosophies. Among other areas, those philosophies should set the stage for more concrete policies that govern everything from the company's view of its customers to its employees.

For example, I recently interviewed John Glaser, CEO of Siemens Health Services and former CIO of Partners HealthCare in Boston. When a new CEO takes the helm, sometimes they bring in new philosophies that click, or don't, with the policies already in place. So I asked Glaser about his view of customers, a view that would then allow him to make specific calls in particular cases that reflected those views.

"If what a customer needs is X, and we can do X, then we should do X," he said. "And at times X may not be the best business decision we could possibly make but, if it helps them, I'm inclined to take a really hard look at doing it. Part of it is because they will remain customers and word like that spreads, and people will say, 'You know, those guys are flexible and, while they might not be able to do everything we want, they work hard to do it.'"

Philosophies are also important in developing an application environment. Most CIOs I know talk about either having a philosophy that leans toward a best-of-suite world, where they really, really try to buy everything possible from a core vendor, or a best-of-breed world, where they buy the most clinician-friendly product, regardless of how much duct tape is necessary to keep the pipes together on the back end.

I've had a number of CIOs tell me they absolutely, bar none, will go with the clinicians' choice, but when I press them, their natural CIO desire to at least get a few applications working off the same database comes to the fore. What's important is that behind it all is a philosophy, which must be firm (and agreed to by other C-suiters) before it can be turned into policy.

Now, both of the above trends in application environments can be called pro-patient. In the best-of-suite case, CIOs see the more simplified architecture as being easier to manage, producing fewer data errors, and, thus, resulting in greater patient safety dividends. In the best-of-breed case, greater physician satisfaction with the application interface is seen to result in deeper (and more meaningful) use, and thus fewer errors. Neither is wrong, and much depends on existing IT environment and funding.

Whether it's related to customers, clinicians, or patients, clear organizational philosophies, and the policies they bring forth, are critical to success. I've often thought of this as the organization's soul. I used to feel it was trite for people to walk around with company-issued plastic cards in their wallets, emblazoned with the organization's principles, but I've worked for places that had no such cards because they had no such principles, and the latter is far, far worse.


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Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at

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