In Reply: Drs Harrison and Young criticize
the source of the estimate for IT project failures. This is understandable
because most of what we hear about, and most publicly reported information
including the research literature, tends to be biased in favor of successes.1 In addition, when does a system “fail”—when
it is rejected by users, when it does not perform as was promised, or when
its implementation costs 3 times the budgeted figure? Good estimates are hard
to find, and we opted for a conservative one. Other sources are comparable.
Surveys of chief information officers conducted yearly since 1994 have suggested
that only 15% to 30% of IT projects are completed successfully, on time, and
within budget. About 30% are abandoned uncompleted, and the remainder have
serious cost or time overruns (by a factor of 2-3) or are seriously deficient
in their ultimate functionality.2,3 A
Computer-based Patient Record Institute study in 1998 showed a dismal 95%
failure rate in the case of electronic patient records.4 Finally,
even if the proportion of successful systems is higher than we thought, that
is no reason for comfort, because the system studied by Koppel et al5 would have been considered a “success”
by most accounts. We agree, though, that more research is required into the
area of success and failure. At the same time, we also argue that there is
already much known about these failures, but that understanding is at risk
of being ignored in the current climate of enthusiasm.
Computers and Clinical Work—Reply. JAMA. 2005;294(2):181–182. doi:https://doi.org/10.1001/jama.294.2.182
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