Daniel J Panyard1, Edmond Ramly2, Shannon M Dean3, Christie M Bartels4. 1. Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 2. Center for Health Systems Research and Analysis, College of Engineering, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 3. UW Health, Madison, WI, USA; Department of Pediatrics, Hospitalist Division, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 4. Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; UW Health, Madison, WI, USA. Electronic address: cb4@medicine.wisc.edu.
Abstract
PURPOSE: We present a case report detailing a challenge in health information technology (HIT) project implementations we term "stakeholder creep": not thoroughly identifying which stakeholders need to be involved and why before starting a project, consequently not understanding the true effort, skill sets, social capital, and time required to complete the project. METHODS: A root cause analysis was performed post-implementation to understand what led to stakeholder creep. HIT project stakeholders were given a questionnaire to comment on these misconceptions and a proposed implementation tool to help mitigate stakeholder creep. FINDINGS: Stakeholder creep contributed to an unexpected increase in time (3-month delayed go-live) and effort (68% over expected HIT work hours). Four main clinician/researcher misconceptions were identified that contributed to the development of stakeholder creep: 1) that EHR IT is a single group; 2) that all EHR IT members know the entire EHR functionality; 3) that changes to an EHR need the input of just a single EHR IT member; and 4) that the technological complexity of a project mirrors the clinical complexity. HIT project stakeholders similarly perceived clinicians/researchers to hold these misconceptions. The proposed stakeholder planning tool was perceived to be feasible and helpful. CONCLUSIONS: Stakeholder creep can negatively affect HIT project implementations. Projects may be susceptible to stakeholder creep when clinicians/researchers hold misconceptions related to HIT organization and processes. Implementation tools, such as the proposed stakeholder checklist, could be helpful in preempting and mitigating the effect of stakeholder creep.
PURPOSE: We present a case report detailing a challenge in health information technology (HIT) project implementations we term "stakeholder creep": not thoroughly identifying which stakeholders need to be involved and why before starting a project, consequently not understanding the true effort, skill sets, social capital, and time required to complete the project. METHODS: A root cause analysis was performed post-implementation to understand what led to stakeholder creep. HIT project stakeholders were given a questionnaire to comment on these misconceptions and a proposed implementation tool to help mitigate stakeholder creep. FINDINGS: Stakeholder creep contributed to an unexpected increase in time (3-month delayed go-live) and effort (68% over expected HIT work hours). Four main clinician/researcher misconceptions were identified that contributed to the development of stakeholder creep: 1) that EHR IT is a single group; 2) that all EHR IT members know the entire EHR functionality; 3) that changes to an EHR need the input of just a single EHR IT member; and 4) that the technological complexity of a project mirrors the clinical complexity. HIT project stakeholders similarly perceived clinicians/researchers to hold these misconceptions. The proposed stakeholder planning tool was perceived to be feasible and helpful. CONCLUSIONS: Stakeholder creep can negatively affect HIT project implementations. Projects may be susceptible to stakeholder creep when clinicians/researchers hold misconceptions related to HIT organization and processes. Implementation tools, such as the proposed stakeholder checklist, could be helpful in preempting and mitigating the effect of stakeholder creep.
Authors: Clement J McDonald; J Marc Overhage; Burke W Mamlin; Paul D Dexter; William M Tierney Journal: J Am Med Inform Assoc Date: 2004 Mar-Apr Impact factor: 4.497
Authors: Hajar Mozaffar; Kathrin M Cresswell; Lisa Lee; Robin Williams; Aziz Sheikh Journal: BMC Med Inform Decis Mak Date: 2016-02-24 Impact factor: 2.796
Authors: Mark E Zehner; Julie A Kirsch; Robert T Adsit; Allison Gorrilla; Kristine Hayden; Amy Skora; Marika Rosenblum; Timothy B Baker; Michael C Fiore; Danielle E McCarthy Journal: Implement Sci Commun Date: 2022-10-08