"It was clear that there was no way we were going to fix this in one week," Glaser says. "We had to prepare for a series of lousy weeks."

Glaser quickly came up with a game plan. The technical people would continue trying to diagnose and fix the problem, focusing solely on this task. Other projects, such as compliance with the Health Insurance Portability and Accountability Act, would be put on hold. Glaser would provide cover if anybody asked questions about these temporarily neglected tasks. He also brought in a team of IBM consultants to help diagnose the problem.

In addition, all new EMR system deployments in outpatient physician practices would be put on hold, and a new working group, headed by Glaser's deputy Mary Finlay, was created to approve all application and infrastructure changes. Glaser, meanwhile, would face the music.

He was the one who had to explain to CEO James Mongan and the rest of the leadership exactly what was going on and what was being done about it. While these administrators made it clear that they were not happy, they didn't panic, giving the CIO time to fix the problem. Glaser also met with the physician leadership at Partners' hospitals and explained what was going on. "They don't want to know what you are doing on a day to day basis," he says. "But they want to know that you are taking it seriously."

On Aug. 11, Glaser sent out an e-mail to the entire Partners medical community. In it he acknowledged the recurrent slowdowns and said that fixing the underlying problem was his top priority. He tried to be as frank as possible. "You don't sugarcoat anything, even if it means that you have to look at yourself in the mirror and not like what you see," he says in hindsight. "If you screwed up, you need to be able to say so."

Absorbing the Anger

Glaser knew he had to be visible. "In situations like this, most formal communication has to come from me," he says. "I have to send this e-mail out; I can't delegate that. I have to be at the advisory board meeting. I have to meet with the leadership at MGH and the Brigham."

Sometimes his sole job at a meeting was to get yelled at by doctors. "They are angry and upset, and they want to yell at someone, and it has to be you," Glaser says. And some doctors took advantage, swearing at him to his face, and accusing him of hurting their patients. "You have to roll with it," he says. "You have to resist the temptation to fight back." By absorbing the anger himself, Glaser allowed his employees to solve the problems without interruption.