Violating Conventional Wisdom

This is the story of how violating conventional wisdom resulted in successfully building a hospital clinical information system (Azyxxi) that was eventually acquired by Microsoft in August of 2006. Here are the lessons we learned:

Conventional Wisdom Azyxxi Approach

Electronic Chart:  Data Entry                    Access to Data:  Data Viewing

Buy Don’t Build                                                Build if Buy Doesn’t Work

Solicit Everyone’s Opinion                            Design by Two People

Design by Committee                                      Rigid Adherence to Core
Design Principles

Use Standard HIS Categories                        Solve More Specific and Granular Departmental Problems

Disseminate Broadly                                         Give System Only to Those  Who Want It

Disable the Old System                                     Side by Side Competition
Let people vote with their clicks

20% of Effort Devoted to Training               If It Requires Training, It is too Complicated

Plan, Plan, Plan                                                     Late Binding

Organizational Requirements to Support Innovation

• Protected sandbox
• Suspension of some rules
• Enlightened leader who believes in you and in the project
• Instant access to capital
• Discretionary budget
• Power to implement
• (Willingness to fail early, often, and cheaply)