Tim:

<<I think that is an excellent exposition of the effects of scale, and I
agree with everything you say. My only comment is that any project with
more than 10,000 function points is just too large, and the Big IT
bosses need to learn to be content with smaller successes (but more
often).>>

Just as a point of reference Microsoft Word is approximately 5,000 function points.  Linux is approximately 50,000 funtion points and Windows Xp is over 100,000 function points in size.

What if the EHR is really a large software project (ie, over 10,000 function points) and it requires a different way of thinking about the software engineering process to succeed?  What if large software requires a qualitatively different way of thinking and managing to be succesful as opposed to the way small or medium projects are done?   Then perhaps the reason why most of the big IT projects in healthcare fail is because most of the people involved in managing and thinking about them have only been involved in small or medium projects and don't realize that a different approach is necessary to succeed at large projects.

Just some food for thought.

DaveR

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