A Tall Order

A story about prisons may, at first blush, seem peripheral to this magazine’s mission. Most of our readers work for commercial entities; for most, the goal at the end of the day is to increase profits and grow the business.

Yet CIOs in all sorts of large, complex organizations will appreciate the challenges faced by the California prison system’s IT leaders. The politics and uncertain funding, the turf battles and resistance to change. In one sense, “Health Care Behind Bars” takes most CIOs’ project challenges and exaggerates them into high relief. “It’s all there, only more dramatically in the prison system,” says John Hummel, who was CIO for the system’s receivership from 2006 until he resigned in February.

But in other ways, this IT project stands apart, writes Senior Editor Kim S. Nash: “How do you set up a wide-area network among buildings made of stone walls three feet thick and reinforced with steel? When it’s time to install a telecom switch, can you get the OK to schedule armed corrections officers to guard your tools from thieving, violent prisoners?”

Add in wholesale turnover in leadership (the original receiver was fired in January; the new one, former California CIO Clark Kelso, got rid of 10 other top people, including the CFO and communications director) and an ethics debate about providing adequate medical care to criminals, and it becomes clear this is not your typical IT turnaround.

This story is about something bigger than that. Bigger and grittier and, perhaps, harder to look at. It’s about how we treat the people who have wronged us—if not individually, at least in a collective, societal sense. People we may fear or even despise. It’s about saving lives that many of us just don’t value.

Ultimately, this story is about goals and priorities. No undertaking of this scale can succeed without a common understanding of and buy-in to the desired outcome. Even if you get rid of incompetent doctors and manage to run a WAN through a prison compound and share medical records from one prison to another, it won’t amount to much if Kelso can’t convince wardens (the prison system’s version of business unit heads) that eliminating unnecessary deaths matters.

In the context of the overall prison mission, some wardens, guards and other prison staff just may not see things that way.