Rather than fight a lonely, uphill battle, he developed a number of strategies to garner support. For starters, he held regular meetings with AMC's medical staff to involve them in the decision-making process on everything from software and hardware purchases to ISP and networking selections. In this way, Kelly sought to reduce potential friction and encourage a sense of collective ownership of the project. Next, he hired a project manager with extensive physician office billing and management experience to lend expertise, credibility and an objective voice. Finally, the IT department held training classes for end users, including hospital sponsor meetings, at 7 a.m. or at 5:30 p.m. to accommodate the physicians' schedules.

"Our physicians now understand that IT projects are very complex and very time-consuming," Kelly reports, "and, as a result, they've become our biggest fans."For good reason: since introducing the EHR system last year, some of AMC's private practitioners reportedly have been able to treat an average of five additional patients a day -- 20 additional patients a week. By tracking patients' visits electronically, AMC has managed to cut the time it takes its many of its physicians to be reimbursed by 20 percent. And plans include building a patient portal (scheduled for a 2009 release) so that patients can take a more active role in their health care choices.

Making the Change

While no strategy -- whether it's getting ground-floor support, forging alliances or collecting feedback -- can fully prepare a CIO for the rigors of a customer-focused IT undertaking, or guarantee its ultimate success, understanding the nature of the beast can make a huge difference.

AMC's Kelly, for example, knew that physicians won't stand for being dictated to. Columbia Business School's Peters understood that implementing anything for a group of academics was as much about managing their expectations as it was about devising an implementation plan, no matter how sophisticated. IT accomplishments in higher education are often measured by alumni support and school spirit -- customer satisfaction -- not simply by dollars alone. "The returns we get are very different from a corporation," Peters says.

In all cases, however, CIOs who are embarking on customer-facing projects need to remember something no businessperson ever forgets: the customer is always right.