Fresh from a long, grinding political season at the local, state, and national levels, I’m sure that everyone has been inundated with bureaucratic spin, popularity polls, political promises, and the like. Now that the elections are over, we continue to hear and read about our differences on social and political issues. Several pundits are concerned over the emotion, zealousness, and nature of individual viewpoints. In a purely partisan world, if I am right, then you are wrong. It’s us against them, blue versus red. However, diversity of opinion is meant to improve the quality of the decision-making process. When polarization occurs, it can create instability and long-term discord.
When preparing to move forward with a PACS project, one must be very cognizant of the underlying politics within his or her organization. A PACS purchase can be viewed like a political election. There can be several political divisions or constituencies to prepare for: administration versus IT versus radiology versus individual radiologists, and so on. In fact, divisions can occur that are internal to each aforementioned group. And, most importantly, your political season never ends.
An accurate assessment of the political landscape at the beginning of a PACS project can save you a lot of stress and grief. Do your homework and understand the who, what, and why of the polarizing issues for your facility. If different committee members or departments fervently believe that there is either a winner or a loser in the vendor-selection process, then the selection process becomes inwardly focused and not driven by strategy or initiative. This situation weakens the decision-making process, often mandating a project to fail.
For example, at times, a PACS committee can follow a detailed selection process in which the due diligence includes a request for information (RFI), request for proposal (RFP), product demonstrations, and site visits. Then, when the PACS committee selects its preferred vendor, the administration department informs the committee that it was “a nice try, but the wrong answer.” The committee and its passion and commitment to the project has just been gutted. This reason is why it is critical to understand all of the political initiatives that a PACS project will face.
The most successful PACS committee will have members who work together to achieve a common vision for a vendor that is the best fit for their organization. Each member of the team must understand the enterprise as a whole and the specific functional role that his or her department plays in supporting a project solution. The IT department needs to understand what the radiology department requires to maximize the PACS’ impact on its day-to-day workflow and to address the current pinch points that inhibit or slow the timely delivery of patient care.
On the other hand, radiology needs to understand that IT has vendor experience, resource expertise, and/or strategic business partners for the enterprise that can be leveraged in a PACS purchase. Only then can both radiology and IT work together with the radiologists to effectively narrow the field of vendors to a preferred two or three, and then discuss which is the best, or most acceptable, match for the facility’s PACS project. In a true democracy where bipartisanship, through a diversity of needs and inputs, maximizes the quality of the selection process, the healthcare organization and, most importantly, patients win.
Unfortunately, many times a strong personality or a “my way or the highway” stakeholder drives a decision that is purely focused on achieving the goals of only one group or department. Decisions reached in this “vacuum” undermine the commitment and support to the project’s success, resulting in a project that is destined to fail. I have consulted on projects where the vendor that wasn’t chosen has suggested to the client that he or she talk to staff at a similar type of facility that is unhappy with the selected vendor’s PACS. If unchecked, animosity can run rampant throughout the enterprise, and the complete team commitment to making the vendor solution successful is lost.
In extreme cases, certain key stakeholders hope for or work toward vendor failure if their preferred vendor is not chosen. Typically, this predicament occurs due to a breakdown in the selection process and could have nothing to do with a chosen vendor’s product and capability. Pure politics and polarization can drive resentment across the stakeholder community. It is a by-product of an inability to compromise and achieve this shared understanding of each functional stakeholder’s needs that minimizes the quality of the decision. It is important to realize that whenever multiple departments and people need to come together to make a consensus decision, there could be many reasons a project fails-black or white, us against them, blue versus red.
By going in with your eyes open, understanding what the divisive issue(s) will be, and figuring out the severity of the issue(s), you will be better able to select a vendor that your stakeholders will support and that will not erode the success of your project. With proper political due diligence and preparation, you can avoid the pitfalls that have been outlined previously. Forming a team that consists of members from the administration, IT, and radiology departments, and including the radiologists themselves-all of whom understand their multipartisanship, that each group has its own nirvana, and that compromise will be required-will set the appropriate expectations of your committee and, more importantly, maximize their commitment to ensuring the product selected has the support and dedication of each functional department.
Polarization and the inability to listen to the views of others, or even consider other viewpoints, is damaging to any political process. Issues that could potentially divide are to be understood and managed but not manipulated. Ultimately, a successful PACS project will transcend the differences of the individual members/departments for the good of the team and facility.
Michael Mack is VP of business development at the Thomas Group Ltd (Anaheim, Calif). Having more than 20 years of experience in the medical imaging industry, Mack now specializes in PACS planning and implementation.
