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. 2008 May-Jun;15(3):290-6.
doi: 10.1197/jamia.M2583. Epub 2008 Feb 28.

Crossing the implementation chasm: a proposal for bold action

Nancy M Lorenzi  1 , Laurie L Novak, Jacob B Weiss, Cynthia S Gadd, Kim M Unertl
Affiliations

Crossing the implementation chasm: a proposal for bold action

Nancy M Lorenzi et al. J Am Med Inform Assoc. 2008 May-Jun.

Abstract

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.

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Figures

Figure 1
Figure 1
BHAG for implementation research.
Figure 2
Figure 2
A Modified view of Diffusion of Innovation depicting major implementation chasms.
Figure 3
Figure 3
A depiction of the major problem blocks creating the chasms.
Figure 4
Figure 4
Implementation scenario.
Figure 5
Figure 5
Implementation scenario continued.
Figure 6
Figure 6
Focusing on interactions among domains can result in synergistic benefits.
See this image and copyright information in PMC

References

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