In the movie The Empire Strikes Back, you may remember, the great sage, Yoda, tells Luke Skywalker, "Size matters not." But according to a group of IT leaders who met recently for the CIO 08: The Year Ahead conference (run by CIO.com's publisher), size certainly matters when we attempt to engage large information technology consultancy firms. These vendors don't seem to want to do business with small to midsize organizations, even though we have money to spend.

One IT leader who came from a large shop before landing in his current role said it was difficult to get phone calls returned from the once "cozy" vendor—whose sales reps were eager to talk to him when he commanded a larger budget. Another observed that the talent his vendor provided was "green." Finally, a few expressed disbelief at vendors' pricing; it appeared these vendors were geared only for large organizations with large IT budgets.

Vendor Help Wanted

I have experienced some of the same frustrations. For two years I have been employed as the director of information services at the nonprofit Sequoia Community Health Centers in Fresno. Sequoia's primary purpose is to provide outpatient care to the most disadvantaged citizens in the Fresno area. In 2006 alone, Sequoia healthcare professionals saw more than 37,000 patients.

Because we rely on grants and government funding, it's more difficult for us to fund strategic IT projects than it is for for-profit organizations; however, that does not mean IT gets a pass on providing outstanding technology to our colleagues. IT must provide strategic value to the organization and must be nimble enough to respond to changes in our organization.

Sequoia's IT team has nine members. With such a small shop I have to spend a great deal of my time maintaining operational excellence. However, my role must move from an operational one to one that is more strategic. During my first year at Sequoia I concentrated on improving the processes that affect operational excellence. With these processes largely working, I must now spend my time providing a technological vision for Sequoia. Because I am a member of the Executive Leadership Team (the primary operational management body), my CEO also expects not only technical vision but business vision as well.

As an example of this push to address strategic concerns, language was inserted into Sequoia's five-year strategic plan that mandates that a disaster recovery plan be completed by December 2008. As you can imagine, creating a fully functional disaster recovery plan requires an enormous amount of time—and, as I noted above, I've been focused on operational excellence, not long-term strategic planning. To provide me with more time, my CEO authorized me to hire an IT manager in early 2008 to maintain operational excellence. However, even if I had a fully trained IT manager in place already, I do not have the expertise to create a plan that can withstand the scrutiny of auditors and Sequoia's board.