The best EHR implementation I ever saw was not run by IT.

Working on the vendor side, I delivered the same software to organizations that got very different results from it. The product was not the variable. The consequences were.

In most implementations I delivered, the project lived inside IT. The business case justified the purchase, then went into a drawer. Department leaders showed up for demos, signed off on timelines, and reappeared at go-live to ask why things looked different.

The project team carried the weight, and when adoption lagged, it was treated as a training problem. The executives who approved the spend were rarely the ones accountable for the return. The most commonly blamed party was the vendor. Their poor implementation was why adoption struggled. It was not the whole story.