Implementation Story: Reality vs. A Great Presentation

A long time ago when I got my first real promotion that allowed me to actually make decisions and influence projects and people I found out the hard way the difference between reality and a great presentation.

I worked for a large company that did healthcare stuff. My particular area was more non-clinical patient focused. This translates into billing, customer service, scheduling and other stuff that deals with the patient.

We used a few different computer systems. One for billing, one for scheduling, one for follow up, something to route inbound calls and something to make outbound calls. There was a lot of other stuff done and the detail should be included, but I don’t want this to get too technical or boring.

A computer system we had been using for a few years was going to be replaced. We had a few hundred people on the system and we had been doing this process for many years.

The CEO and IT director found a vendor that had a product that would solve all of our worldly problems for around $500k. Services were discussed, hardware defined, contracts sent, edited and sent back for a few months. I found out this was pretty typical for the time.

During those few months myself and around eight other people from various parts of the company were tasked to come up with how we actually implement this and integrate it with what we did. The end result was to be a colorful slide show, user documentation, policies, procedures, charts, graphs and generally speaking a lot of paperwork that would be handed out.

I was kind of excited about this at the time. It was my first chance to do something that would not only make a difference, but would be a thing, that if it worked, I would receive some form of acknowledgement for my contribution.

I went out of my way to learn as much as I could about the new product, how it worked, what it could do, what we did now and why we did it. I spent a lot of hours researching this.

Eventually we get down to the last week before our presentation was due. It would be for pretty much all executive management, senior management and for the most part all operational management for all of our offices nationwide.

The eight of us got into our conference room with stacks of paper surrounding us. We had the last nineteen versions of the documentation out with all the redlines and revisions. In our minds we had created a better mousetrap than had ever been seen before. We knew the CFO at the time demanded high quality color slides as handouts and didn’t care about the cost. They just had to be perfect. No typos, all the same color and printed on a specific bright type of paper. We spent hundreds of dollars printing and re-printing things.

On what we thought was our last final-final version of this we sent out for more stuff to be printed and brought back to us for review.

The clerical person at the time, Mayra came back into the conference room with our final batch of paper and put it on the table. A few of us in the brain trust were talking about how this new technology was going to enhance what we were doing and push us into the 21st century. We kept saying how this technology was going to change our results and improve everything. We were going to be heroes.

We had taken all of our existing processes and worked the new technology into them.

Mayra starts passing around the stacks of paper and colorful printouts and asked me one question “What are you doing different {with the new technology}?”

I sat there for a moment and wanted to tell her about all the new pretty lights the computer had. I wanted to tell her about the real-time monitoring of staff we could do. I wanted to tell her about the auto chart function that would print out really nice charts every morning to show what we did the prior day. I was really excited to tell her the screens were larger and you could move windows around because it wasn’t the old AS400 green screen. But I didn’t say anything. I just sat there looking at her and looking at the piles of paper we had lying about. We probably were responsible for the clear cutting of 42 acres of the rainforest with all the paper we printed and were going to throw away.

Mayra gave me this strange look and said one thing that I will never forget “If that’s the way you have always done it, then it is probably wrong.” And she walked out of the door.

The lightning bolt from mount Olympus struck me. It hit one or two other people that heard her also.

We sat there dumbfounded with the simplicity of what she said and how utterly completely off the mark we had been.

Time stopped for me. I didn’t hear anything but the echoes in my head of Mayra saying “If that is the way you have always done it, then it is probably wrong.”

We had taken a $500k investment, the time, energy and collective brain power of eight different people and had managed to replicate what we were already doing for years past just with a new machine.

Nothing was going to change other than our charts, graphs and big monitors on our desk. Nothing at all.

Our entire presentation was based on the concept that we were going to do the same thing we did yesterday and expect a different result. A definition of insanity comes to mind as I recall that moment.

I didn’t really say anything that day and the people that had the same feeling as I did also remained quiet. We went home and just wondered what happened and how we missed this. How did one random clerical person have the forethought to ask this and none of us did.

The next meeting a few of us decided to broach this subject with the rest of the group. As expected there was a lot of resistance from a few people because so much work had gone into this. I pulled out our old processes and paper work and taped them to the wall. I put up our new colorful processes and paperwork on the wall and in the middle I wrote on a piece of paper “What Changed?”

After a short amount of debate on our various states of denial we all agreed, nothing changed. We didn’t re-create the wheel, we just shined up the old one and called it new at the cost of $500k.

In essence what we did was take new technology and we made a really great presentation that had nothing to do with reality. We made no improvements in our processes, we didn’t change any staffing expectations. Our work flow was almost exactly the same. Other than shiny pieces of paper and new computer monitors we were going to do the exact same thing. There is more detail behind this, but you probably get the idea.

Ever since that time I have made it a point to start out any meeting that I was part of with the quote from Mayra. If you don’t start the implementation conversation with the basic question of “What changes?” then you may end up doing the exact same thing you did yesterday.

“If that’s the way you have always done it, then it is probably wrong.”

Some take away points


  • Ask what is changing. If the answer is nothing, then why are you doing this?
  • Start with the end in mind. How does this look when it is done?
  • What are the current benchmarks and what are they going to be six months after implementation?
  • Accept that you will make mistakes and bad assumptions along the way, but learn from them.
  • Listen to everyone about the process. It might be the one clerical person that shows you the light.