Say "database" and IT says "no, unless we spend a year reviewing requirements". This is only a failure story for every software development route that involves

Say "database" and IT says "no, unless we spend a year reviewing requirements". This is only a failure story for every software development route that involves procurement, which is every route except Excel. Those routes tracked, within the only timescale that mattered, precisely zero patients. You want to give smart users DB and DVCS tooling? I'm right behind you. Start asking why they don't have those things already.