The authors' research suggests that understanding the underlying dynamics of project status reporting can help limit the chances of nasty surprises. In particular, they identify five "inconvenient truths" about project status reporting: 1. Executives can't rely on project staff and other employees to accurately report project status information and to speak up when they see problems. Many employees have a tendency to put a positive spin on anything they report to senior management. When the organizational climate is not receptive to bad news, truthful reporting can be inhibited 2. A variety of reasons can cause people to misreport about project status. Executives tend to attribute misreporting to poor ethical behavior on the employee's part. In fact, employees misreport for a variety of reasons; individual traits, work climate and cultural norms all can play a role. 3. An aggressive audit team can't counter the effects of project status misreporting and withholding of information by project staff. Executives may conclude that the best way to address the problem of misreporting is to rely on auditors to make sure that project status reports are accurate. However, once auditors are added to the mix, negative organizational dynamics can lead to a dysfunctional cycle that results in even less openness. 4. Putting a senior executive in charge of a project may increase misreporting. Although having a senior executive as a project sponsor often proves wise politically and can help in securing resources for a project, the involvement of senior leaders does not make it any easier to track project status.

The Telemonitoring at Visiting Nurse Health System case presents one home healthcare organization's efforts to use telemonitoring to improve the quality of care provided to at-risk patients who were discharged from hospitals and needed home care. After two years of using the Health Buddy system for telemonitoring at-risk patients, Mark Oshnock, President of Visiting Nurse Health System (VNHS) must decide whether to invest in buying more Health Buddy units. While Oshnock believed that there were real benefits associated with telemonitoring, he was having difficulty quantifying those benefits and he was concerned about VNHS' ability to continue investing resources in telemonitoring given the realities of the health care reimbursement environment in which they operated. While several studies had demonstrated the benefits of telemonitoring, Oshnock felt that the long-term benefits accruing to the health system as a whole were not immediately quantifiable or visible to the hospitals and insurance companies. Without external support for the telemonitoring initiative from insurance companies, it would be difficult for VNHS to keep up the momentum and ramp up telemonitoring through additional purchases of Health Buddy units. From a purely financial standpoint, such an investment would be very difficult for VNHS to justify. The irony was that with the new regulatory pressures and increased focus on preventative healthcare, telemonitoring pointed to an effective tool in managing and reducing acute care hospitalizations. However, balancing these benefits against limited financial support from other key players in the health care system would be challenging.

The Computerized Provider Order Entry at Emory Healthcare case presents one hospital system's efforts to implement computerized provider order entry (CPOE) across all of its hospitals and the challenges they faced in doing so. Issues such as standardization of care, how to handle medication reconciliation, and unexpected challenges (e.g., changes to the post-op ordering process, lack of a human gatekeeper to monitor order flow, increase in lab orders). Dr. Bill Bornstein, Chief Quality and Medical Officer of Emory Healthcare in Atlanta is responsible for the smooth implementation of CPOE at Emory Healthcare, which is a vital part of their $50 million electronic medical record initiative. By June 2009, CPOE had gone "live" at Emory University Orthopaedics and Spine Hospital, Emory University Hospital, and Wesley Woods Hospital in a staged rollout. While Dr. Bornstein felt good about how the implementation had gone thus far, as he looked ahead next month to July 13, 2009, the fast approaching go-live date for Emory University Hospital Midtown (EUHM), he was concerned about the challenges and possible perils that lay ahead. He considered what additional actions he should take to prepare for go-live at Midtown, and if Midtown was ready for CPOE at all. One thing was certain; this hospital was different. The Computerized Provider Order Entry at Emory Healthcare case presents one hospital system's efforts to grapple with the challenges of implementing CPOE and the reactions that result. Issues such as how to deal with a workforce that has mixed views about the value of implementing such systems, the pros and cons associated with standardization of care, as well as how to deal with unexpected changes to work processes are brought out in the case. The case also allows for discussion of how to plan a phased implementation with adequate time for organizational learning to occur between the time that various sites "go live."

Any seasoned executive knows that information technology (IT) projects have a high failure rate. Large IT projects can become the business equivalent of what astrophysicists know as black holes, absorbing large quantities of matter and energy. Resources get sucked in, but little or nothing ever emerges. Of course, projects do not become black holes overnight. They get there one day at a time through a process known as escalating commitment to a failing course of action. Without executive intervention, these projects almost inevitably turn into black holes. This article sheds light on the insidious process through which projects that devour resources, yet fail to produce business value, are created and gradually evolve into black holes. It presents a framework that explains the creation of black hole projects as a sequence of three phases: drifting, treating symptoms, and rationalizing continuation. The framework is illustrated through two cases: EuroBank and California DMV. The article then presents recommendations to prevent escalating projects from becoming black holes and provides a means for detecting problems at an early stage.

Real options can be a powerful tool for quantifying the value of strategic and operational flexibility associated with uncertain IT investments. However, they also constitute a new way of thinking about how projects can be organized and managed to maximize upside potential while minimizing downside risk. Explains how practitioners can incorporate options thinking into contemporary IT project management. Options thinking means recognizing real options and how they add value. Just as important is managing projects so that the option value that exists in theory is realized in practice. Several real-world examples illustrate how the value of embedded real options can be realized through active project management. There are pitfalls associated with each option, as well as benefits and limitations of different approaches to valuing options. Organizations must decide whether to undertake the challenges of adopting options thinking as a project management philosophy.

LaGrange, GA was the first city in the world to offer free Internet access to citizens. The city manager and mayor must assess the project and decide whether to continue. This case chronicles the city's efforts to build a telecommunications infrastructure and offer broadband Internet access to its citizens. Students are presented with information concerning adoption and use of the system and must decide whether the project has been successful and whether further continuation is warranted.

This is an MIT Sloan Management Review article. Project failure in the information technology area is a costly problem, and troubled projects are not uncommon. Executives become so strongly wedded to a particular project, technology, or process that they persist in committing their companies, continuing to pour in more resources. Escalation of commitment to a failing course of action is particularly common in technologically sophisticated projects with a strong IT component. There is little research on de-escalation, or the process of breaking the cycle of escalating commitment to a failing course of action. Through de-escalation, managers may successfully turn around or sensibly abandon troubled projects. During the past eight years, the authors examined more than 40 cases of IT project escalation. The authors present a process framework for de-escalation. The framework reveals that de-escalation is a four-stage process: problem recognition, re-examination of the prior course of action, the search for an alternative course of action, and implementation of an exit strategy. To show its general applicability, the authors apply the framework to a well-documented case study of de-escalation: the London Stock Exchange's Taurus system. The authors offer a set of recommendations for disengaging from a failing course of action.

This case provides a realistic, current, and detailed view of software procurement in an international business environment where the competition in enterprise-wide software solutions is growing. Focuses on the selection of packaged software to serve multiple sites within the context of a multinational company. Describes the creation of an RFP and the selection of a software vendor. Two software proposals are presented.

When BellSouth Enterprises decided to aggressively pursue the international cellular market, it needed new software in order to cope with the complexities of cellular billing and the country-specific variations in the international cellular market. BellSouth made the decision to enter into a strategic alliance with TeleSciences. This case explores why it made this decision and what the ramifications of this decision were for BellSouth and TeleSciences.

Describes Du Pont's attempt to follow a "small is beautiful" type approach toward implementing expert systems technology. Intended to illustrate that there is no "one right way" to implement expert systems and that the small systems approach can be a viable strategy provided that it fits the organization's culture, knowledge profile, and resource structure. Can also be used to illustrate the more general issues associated with end user adoption of new technology.