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HealthCare.gov lesson learned: Know what you don’t know

HPE-SW-Guest on ‎12-16-2013 05:23 AM

Stewart Brand, IT thought leader and editor of the Whole Earth Catalog, said, "Once a new technology rolls over you, if you're not part of the steamroller, you're part of the road." As I have been following the trials and tribulations of the healthcare.gov roll out, I wonder if we—as Brand observed—have become part of the road.


I am one of those business guys who, in the early 1990s, was brought in to run IT in order to provide more business focus (alignment as it was called in those days). I recall that during our Y2K preparations, because we were a large research organization, we had literally hundreds of laboratory instruments, many with imbedded software. No one could give me a straight answer as to whether or not any of this stuff was date-sensitive. Would the HPLC continue to work after December 31, or would it turn on one of our scientists and devour him? We couldn’t get answers. Scary! Being a non-IT guy who spent some of the most challenging years of his career running large IT organizations, I have learned a thing or two about the importance of knowing what you don’t know. Here is one thing I do know: Knowing what you don’t know, admitting it and having a plan to find the answers is perhaps one of the most important skills for avoiding disasters in today’s world.


I have found that a lot of headaches can be avoided if planning, crisis management and technology strategy sessions address the following four questions:

  1. What do we know?
  2. What do we not know?
  3. What must happen if we are to be successful?
  4. What must we do?

I sometimes approach these by drawing four columns on a whiteboard and bullet pointing the responses. Being very clear about what is unknown (question 2) and what must be true if you are to be successful (question 3) is critical. Don’t assume; deal only in facts. No question is too dumb or naive if you don’t know the answer. Involve a variety of people representing all of the involved disciplines and be careful to avoid groupthink, which is always a danger. Never leave without answering the last question. Make sure that you have a plan and that every action has an owner. Finding answers to the items raised by question 2 may be some of the most important immediate tasks. No assumptions, just facts.


I don’t know what happened with the healthcare.gov site, but I do know one thing for sure: Nobody really understood the whole thing. A lot of people understood parts, but those understandings apparently didn’t meet anywhere. Apparently some brave souls stood up and tried to tell those in charge that there were problems, but those cries went unheeded. The same thing happens on a smaller scale in many organizations, both large and small, all too frequently. Don’t let it happen to you.


This business has never been easy and it isn’t getting easier. Recognizing and addressing unknowns has never been more important. It’s your choice: Are you the steamroller or the pavement?


Related links:

Modernization can be a lifesaver for CIOs drowning in the maintenance pool

The paradox of personal privacy

The CIO's game-changing skill


Joel H. Dobbs is the CEO and President of The Compass Talent Management Group LLC (CTMG), a consulting firm that assists organizations with the identification and development of key talent and with designing organizational strategies and structures to maximize their ability to compete in the business worlds of today and tomorrow. He is also an executive coach and serves as Executive in Residence at the University of Alabama at Birmingham School of Business. Joel is also a popular and frequent contributor to the Enterprise CIO Forum where a version of this article was first published.

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