cloudy flexibility meets touchy-feely
> a top down project akin to building an aircraft carrier
The first step should be to kick all the IT people off this project. Stop thinking of it as a computer to help medical people and start thinking about what those people want to do. Then apply the least amount of technology that will meet the needs of the users.
Most people in the caring professions are there because they are drawn to the personal interaction with patients, they want to do tangible stuff (like sticking on plasters) that makes people better. The ones I have met do not want to spend their days as data-entry clerks, although last time an aged relative was admitted three different members of the nursing staff sat with AR at various times during the day and wrote down on paper pretty much the same information - most of which we could have done while sitting in the waiting room, waiting to be called in.
So if this project is going to be a success - and the odds don't seem to be in its favour - the starting point must be to create a system around the way the medical staff like, or choose, to work and to make THAT JOB easier. If it starts from an IT perspective of "let's give these people new practices and procedures that will make them more productive" than it will get sidelined and ignored, just like the previous failures.