If I were a CIO, the trend that would disturb me most is the growing disintermediation of both training and support. IT is being deliberately bypassed-for both strategic and economic reasons-as its end users increasingly rely on subcontracted help desks and outside consultants for training and help. Let’s not ignore the dirty little secret that help desks and power users in the next cubicle are often the real technology trainers in larger companies.

On the surface, this seems to be merely another example of outsourcing. Dig deeper and what we find is that, bit by bit, IT risks losing whatever core competence it has in managing innovation within the company. That’s dangerous because digital innovation isn’t what IT says, it’s what the users actually adopt.

Consequently, the abdication of end user support has not only political repercussions for the organization, it has knowledge management repercussions as well. Perverse incentives are in play. CIOs can legitimately ask if it makes sense for their technical experts to spend time educating people who frequently view upgrades as necessary evils. Outsourcing education, training and support has a definite appeal.

But the impact on effective implementations quickly becomes apparent. Corporate IT has come to resemble the dehumanizing aspects of many large for-profit hospitals. These are high-tech operations filled with technically competent professionals working against the clock and against the odds?but too often, their bedside manner is nothing short of atrocious. Sure, there’s the rare person who takes the time to discuss and explain. But, essentially, the patient is viewed as a problem to be solved rather than a human being who might have better things to do than be bedridden.

There are excellent reasons for this. After all, how many HMOs and health insurance plans reimburse doctors and hospitals for their bedside manner and the ability to explain diagnostics and therapies to patients? To my knowledge, none do.

Of course, the more enlightened hospitals understand that no matter how busy things get, informing and supporting patients can be just as important as treating them. No doubt some of that is done to mitigate the risk of malpractice suits, but there’s also a growing recognition that those sorts of practices make for happy and healthier patients. CIOs had better become similarly enlightened.

To be sure, IT?intensive companies spend fortunes on their end user training budgets. But the internal economics are shockingly confused. Should training and support really be IT’s responsibility? Why shouldn’t HR and marketing kick in? Maybe we should go the chargeback route and have departments pay for their own training and support on an as?needed basis. Or maybe we should simply declare this an enterprise function and charge it to overhead. That way, everybody’s responsible but no one’s accountable.