What are the principal risk factors in information systems projects, and how can they be managed?

We have already introduced the topic of information system risks and risk assessment in  Chapter 8 . In this chapter, we describe the specific risks to information systems projects and show what can be done to manage them effectively.

Dimensions of Project Risk

Systems differ dramatically in their size, scope, level of complexity, and organizational and technical components. Some systems development projects are more likely to create the problems we have described earlier or to suffer delays because they carry a much higher level of risk than others. The level of project risk is influenced by project size, project structure, and the level of technical expertise of the information systems staff and project team.

· Project size. The larger the project—as indicated by the dollars spent, the size of the implementation staff, the time allocated for implementation, and the number of organizational units affected—the greater the risk. Very large-scale systems projects have a failure rate that is 50 to 75 percent higher than that for other projects because such projects are complex and difficult to control. The organizational complexity of the system—how many units and groups use it and how much it influences business processes—contributes to the complexity of large-scale systems projects just as much as technical characteristics, such as the number of lines of program code, length of project, and budget. In addition, there are few reliable techniques for estimating the time and cost to develop large-scale information systems.

· Project structure. Some projects are more highly structured than others. Their requirements are clear and straightforward, so outputs and processes can be easily defined. Users know exactly what they want and what the system should do; there is almost no possibility of the users changing their minds. Such projects run a much lower risk than those with relatively undefined, fluid, and constantly changing requirements; with outputs that cannot be fixed easily because they are subject to users’ changing ideas; or with users who cannot agree on what they want.

· Experience with technology. The project risk rises if the project team and the information system staff lack the required technical expertise. If the team is unfamiliar with the hardware, system software, application software, or database management system proposed for the project, it is highly likely that the project will experience technical problems or take more time to complete because of the need to master new skills.

Although the difficulty of the technology is one risk factor in information systems projects, the other factors are primarily organizational, dealing with the complexity of information requirements, the scope of the project, and how many parts of the organization will be affected by a new information system. The Interactive Session on Management about the UK National Health Service’s move toward paperless recordkeeping illustrates a project with some of these risks.

Change Management and the Concept of Implementation

The introduction or alteration of an information system has a powerful behavioral and organizational impact. Changes in the way that information is defined, accessed, and used to manage the organization’s resources often lead to new distributions of authority and power. This internal organizational change breeds resistance and opposition and can lead to the demise of an otherwise good system.

A very large percentage of information systems projects stumble because the process of organizational change surrounding system building was not properly addressed. Successful system building requires careful  change management .

The Concept of Implementation

To manage the organizational change surrounding the introduction of a new information system effectively, you must examine the process of implementation.  Implementation  refers to all organizational activities working toward the adoption, management, and routinization of an innovation, such as a new information system. In the implementation process, the systems analyst is a  change agent . The analyst not only develops technical solutions but also redefines the configurations, interactions, job activities, and power relationships of various organizational groups. The analyst is the catalyst for the entire change process and is responsible for ensuring that all parties involved accept the changes created by a new system. The change agent communicates with users, mediates between competing interest groups, and ensures that the organizational adjustment to such changes is complete.

Interactive Session: Management Can the National Health Service Go Paperless?

The National Health Service (NHS) is the United Kingdom’s publicly funded national healthcare system. Funded primarily by taxation, NHS provides free or low-cost healthcare to all legal residents of the United Kingdom. NHS services include hospitals, family doctors, specialists, dentists, chemists (pharmacists), opticians, and ambulance service. Medications are subsidized as well. Specific policies vary among England, Scotland, Wales, and Northern Ireland.

The UK Department of Health oversees the NHS. Patient records are maintained by healthcare providers, who must ensure confidentiality of patient data and compliance with regulatory standards. Like other healthcare systems, such as in the United States, patient records were primarily paper-based. Physician and hospital offices had shelves full of folders and papers devoted to the storage of medical records, making patient and treatment information very difficult to access or share. Just pulling the notes for NHS patients to be seen in the morning was a nightmare.

In January 2013 Health Secretary Jeremy Hunt called for making the NHS paperless by 2018 to save billions, improve services, and help meet the challenges of an aging population. Hunt and many others believe that patients should have compatible digital records so their health information can follow them around the health and social care system. Whether patients need a general practitioner (GP), hospital, or care home, the professionals involved in their treatment should be able to see their history at the touch of a button and share crucial information. Improved use of technology would allow health professionals to spend more time with patients and help patients take control of their own care, saving more than £4 billion.

Hunt announced the following goals:

· Paperless referrals: Instead of sending a letter to the hospital when referring a patient, the GP can send an e-mail instead.

· Secure linking of the electronic health and care records wherever they are held, so there is as complete a record as possible of the care someone receives.

· Ability of those records to be able to follow individuals, with their consent, to any part of the NHS or social care system.

· Ability of individuals to get online access to their own health records held by their GP by March 2015.

· Digital information fully available across NHS and social care services by April 2018 unless individuals opt out.

Paperless solutions can lead to a reduction in treatment/medication errors, quicker time to diagnosis, shorter time to treatment, more collaborative diagnostics (allowing a wider range of specialists to be involved), and better overall patient care.

However, many working in the NHS and private sectors—including those within the technology industry—believe that a paperless NHS is not achievable within a five-year time frame. This is an extremely ambitious target, and critics question how much this will really improve NHS services, if it’s worth the cost of implementing new IT systems, and if it’s even achievable.

According to S. A. Mathieson, an EHI Intelligence analyst, the English NHS is made up of several hundred organizations with greatly differing IT capabilities as well as thousands of independent GPs. All of them would have to acquire new software and hardware and convert their paper records to digital form. To make the new system effective, they would also have to change their procedures (business processes) to take advantage of the new technology. Answering patient phone calls, examining patients, and writing prescriptions will need to incorporate procedures for accessing and updating electronic medical records; paper-based records will have to be converted into electronic form, most likely with codes assigned for various treatment options and data structured to fit the record’s format. Training can take up to 20 hours of a doctor’s time, and doctors are extremely time-pressed. In order to get the system up and running, physicians themselves may have to enter some of the data, taking away time they could be spending with their patients. When the United States tried to implement electronic medical records in healthcare nationwide, many physicians complained about the time and effort required to make these changes. NHS has experienced some of this resistance.

The UK doctors’ union, the British Medical Association (BMA), says there are several challenges to be overcome in order to make the NHS paperless and is skeptical about the extent of the benefits such a system can offer. According to the BMA, the biggest challenges to making the NHS paperless by 2018 are funding, resources, prioritization, and the choice of

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