VISTA Enterprise Network - Successful Implementation, World Class Support

Thursday, July 2, 2009

Point 3: VISTA Requires Many Authorities, Not One

Dear Reader,

An unimaginable amount of expertise went into creating VISTA, and that same degree of expertise is required to manage it. Managing the VISTA software lifecycle requires more expertise than you have, more than I have, more than anyone has, but it also requires more speed and accuracy than any group is capable of. Any individual in charge of VISTA would be ignorant of 99% of the subjects needed to manage all of VISTA, and in any group large enough to include all the experts needed, 99% of them would just be in the way for 99% of the decisions. There is no form of centralized authority capable of managing VISTA effectively, no matter how you divide up the code into repositories.

That's why VISTA's second name, before "VISTA," was the Decentralized Hospital Computer Program, because no central authority can manage it, no matter how smart or powerful or well funded they are or how good their intentions. VISTA authority must be decentralized.

However, history has demonstrated that VISTA authority also has to be efficient and responsive enough to keep up with the changing needs of medicine, has to avoid the chaos of a free-for-all, and has to avoid the endless debates over trivia to which democratic communities are all too prone. Each VISTA authority must have near-tyrannical powers over their chosen part of VISTA to ensure maximum efficiency. That is, VISTA authority must not only be decentralized, it must also be concentrated.

VISTA also requires a third element in its governance. Each VISTA package is so complex it can only be effectively managed by dedicated expert programmers who can focus on mastering their chosen package over very, very long periods of time, like a decade or more. Most VISTA packages are too complex for any single expert programmer to manage, certainly too complex for dilettantes to manage effectively, so teams are required. And so, VISTA authority must also be expert.

The resulting form of governance, to have authority decentralized and concentrated into the hands of many near-tyrannical, permanent expert teams, is so weird there isn't even a name for it - for now let's call it the VISTA model of authority - but history has proven that whatever you call it, it is capable of managing VISTA better than any other authority structure.

So here's a vital part of the VISTA lifecycle recipe: decentralize authority, divide it up by subject, and allocate it to teams of expert programmers. Each team manages one VISTA package's code repository, with the senior experts in charge of each team.

This part of the recipe is necessary but not sufficient. After all, who is in charge of the senior experts? Who decides what the priorities are? That's the subject of my next post.

Yours truly,


Rodney H. Kay said...

What you are describing is almost an oxymoron, but an accurate one. Working at what was the Birmingham Information Center for a couple of years I know how frustrating it can be to be a part of a part of an authority. There were those weeks and months that if I actually got to write two lines of code, I felt lucky. It was one of the main reasons I left the ISC and went to work at the Tampa VA - so I could do what I did best at the time; write code.

You are absolutely right in that it has to be decentralized authority, but with a centralized concept and direction. These factors by themselves are difficult to achieve. Together that are close to impossible. It was achieved during the development of VistA due to it's unique structure. Trying to get that back will be an interesting challenge.

Do you think World Vista or the VSA are up to the task?

Rick Marshall said...

Dear Rodney,

Not in their current forms, but then they don't have to be. They each have a crucial role to play already. It's an easy mistake for an organization to make to try to be too many things at once. It's better to pick a core mission and do those things that advance or develop that mission.

VSA can function as a trade association, and our community needs one. If it does its job right, that will keep it too busy to manage a software lifecycle.

Likewise, WorldVistA can and should function as a community hub, a member organization, the public face of the VISTA community, a VISTA users' group. WorldVistA's biggest problem right now, other than internal organizational issues, is that it wants to be everything, with predictable results. We need a community hub, a place that can give us a sense of belonging, a public space in the community, and WorldVistA is well placed to become that organization. I believe that done correctly such a mission would keep WorldVistA busy full-time and beyond.

When I formed the Network, I did so specifically to create a hands-on, technical VISTA organization, which I saw and still see as otherwise missing. Its mission requires it to invest in those things that may not be profitable but that we all need for VISTA to survive and do its job of improving patient health.

To that end, I envisioned the Network doing VISTA education, standards, and hands-on technical work. Under my model for VISTA, this requires the Network to practice the VISTA model of authority itself.

So, yes, the Network is becoming AN authority under the classic VISTA model, but I have no desire for it to become THE authority. We don't need or want just one.

Yours truly,