The Ten Commandments
of Healthcare Information Technology.
(or, What Moses downloaded while on the mountain top!)
By: Frank L. Poggio, President, The Kelzon Group, All rights reserved.
It is a little known fact that Moses was not only a prophet, but also a hospital CIO. That fact should
be self evident when you think about it. Prophets communicate critical information from a unique
source to the rest of the organization. What the organization does with that information is beyond
the control of the prophet. The prophet can neither require the masses to listen to it, nor does he
have the power to require the masses act on it. Sounds pretty much like today’s CIO!
So, thousands of years ago when Moses went to the mountain top what did he download into his
‘Rockberry’? Fortunately, Moses was big on backups and he would routinely transfer his electronic
files to stone carvings. Recently while excavating in a cave in the middle-east I came across his
backup tablets, which even included Moses’ original annotations!
HIT - Commandment 1
Thou shall never have enough project time.
Annotation: Actual project development always takes at least three times
longer than planned. God created the world in six days. That was the first
and last project ever completed on time, which is why s/he could rest on
Sunday, and you can’t.
HIT – Commandment 2:
Thou shall never have enough resources.
Annotation: All projects will exceed budget by at least a factor of two.
God made man a wasteful and inefficient being. Hence, there can never
be enough resources.
HIT – Commandment 3:
Thou clinical users shall constantly and continuously change requirements and medical protocols.
Annotation: Medical requirements will always be changing and usually at the worst possible time.
God created nature to be in constant change so why shouldn’t user requirements?
HIT – Commandment 4:
Thou shall always upgrade when least convenient and unprepared.
Annotation: New versions will always set you back a month and reverse all previous fixes. Failure
to install new versions will bring seven years of famine.
HIT – Commandment 5:
Thou shall sunset immediately.
Annotation: As the sun rises, so does the sun set. And clinical system vendors know this and
therefore will sunset their products immediately after sunrise (a.k.a. go live).
HIT – Commandment 6:
Thou shall forever run legacy systems.
Annotation: Once a system is installed and running it must live forever. To ignore this
commandment will bring a plague of bugs, glitches and gremlins on your hospital and all that work
HIT – Commandment 7:
Thou shall not worship newer technologies.
Annotation: There is only one technology and there will be no technology after it. True believers
know the next best technology never is, and cannot be. To believe otherwise is blasphemy and all
who do will be destined to spend all eternity in the hell of constant upgrades.
HIT – Commandment 8:
Thou shall not idolize the demo.
Annotation: The demo is Satan. To believe in the demo is the ultimate sin.
HIT – Commandment 9:
Thou shall never be trained.
Annotation: Your staff will never get enough training, the vendor will never deliver enough training
hours, and even if he did you could not afford to pay for them.
HIT – Commandment 10:
Thou shall never have enough support.
Annotation: Vendor support will always be insufficient, and if it
ever is sufficient, the vendor will quickly install a new release
(see Commandments 4 & 5).
During our archaeological diggings we could see that
there were more stone tablets but the erosion from
weather and wind made them all unreadable. I am sure
most CIOs can guess at what they said.
(This article was published in Healthcare Informatics, June 2002)