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Case study · Go-live rescue

The one they wanted to cancel.

A county safety-net hospital in California · EHR implementation rescue

The call came from the president of my organization: the client was in a horrendous spot, the project had failed to execute, and I was flying out the next day.

This was a county hospital — a safety-net facility with a C-suite in the building and county oversight above it. When I arrived, the county board and the hospital's executives were waiting. What they told me was blunt: the vendor had failed, they wanted to pull the contract, and they had no faith I could change anything — but they were being told I might be able to drive results. Then the question: what will you do to put us on the right path?

I didn't pretend to have the answer in the room. What I said was closer to this: I can't tell you in this moment exactly what's wrong, and any resolution path I invented right now wouldn't deserve your trust. My next steps are to audit current state, review the contract, build relationships with your teams, and come back inside a week with a proposed plan. And one thing I do know: this only works if we reset the relationship and drive the project together — that's the only way the SMEs and end users ever adopt it.

They agreed. A week later, they had the plan.

What followed was, in effect, an accelerated redeployment — without deleting anything and starting over. We refined the data-collection workbooks. We audited the build. We reviewed every contractual obligation and realigned where the work had drifted from it. We negotiated the approach openly, rebuilt trust with better recurring updates and real status packages, retested, retrained, and ran real scenarios against test patients to audit clean-claim rates before anyone said the word go-live.

Then we went live. By the end of the project I was auditing resource performance for the hospital, using data-driven storytelling to keep the county and the C-suite aligned, and helping audit hardware, workflows, and processes that outlasted the engagement. The system matured. It runs at scale today.

When it was over, they offered me the CIO seat. Timing and geography said no — but I've carried the lesson from that first meeting into every rescue since: you don't win a failing project back with a plan. You win it back with an honest read, a reset relationship, and a date that answers to evidence.

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