CPOE Implementation Failure Case Study

This case analysis of Stanford’s Hospital and Clinics (SHC) electronic medical record (EMR) system implementation will focus on how the healthcare organization focused on resolving a problem to meet regulatory pressures and responded to an opportunity to create operational efficiency, by capitalizing on the use of information technology to help reduce costs. We will discuss the organization’s IT problems, opportunities, and the alternatives available to address each. We will summarize an analysis of potential alternatives including the organization’s EMR system of choice and conclude with a recommendation to the Board on how to rollout the new system.

In mid-April 2000, Sherri Worth was faced with some very unsettling news about Pate Memorial Clinic’s future with a competitor potentially moving into the area. Worth was the assistant administrator at Pate Memorial Hospital (PMH) and was also responsible for the Pate Health Clinic (PHC). A study by the competitor was being done to see whether sufficient demand existed to establish a clinic 5 blocks north of PHC. The two biggest concerns in regards to the new competition were:

The healthcare industry consists of many strengths and weaknesses during the improvement of patient safety, efficient operations, reduction of medical errors, and ensuring that they provide timely access to all patient information. This will have to still comply with all legal guidelines as they control costs and protect patient privacy. The adoption of advanced information technology is a popular strategy being used in the healthcare industry because it allows their weaknesses to be progressively diminished as they gain and use the opportunities necessary as an analytical tool. This would allow their capabilities to be further developed with the new technologies and processes used as they unify the adoption of IT standards. In order to stay competitive within the healthcare industry, then there must be specific actions and measures that must be taken to ensure a positive outcome. This includes external opportunities to increase the capability of the IT infrastructure in a national environment as the growth of industry standards are met in order to decrease the pressured threats of legal compliance through patient trust and the high cost of IT. The growing recognition of strategic leadership often leads to both improved financial stability and contact accessibility of the system. Some challenges that may occur within the healthcare system may cause issues in a hospital setting because of the centralized society of an organization. This is because of the different visions and

The Methodist hospital of Indiana was undergoing organizational and leadership change in 1988. Their longtime head had retired and William J. Loveday became their new CEO. He brought in a whole new management team to help him implement new ideas and create a new culture there. His new CFO was in charge of the IS department and after discovering that the department was in shambles with no real direction, he hired Walter C. Zerrener to become the Chief Information Officer. Zerrener found that the Methodist Hospital had spent about $20 million to install a state-of-the-art proprietary patient management system called TDS in 1970s but had done no upgradation after that . The IS department was solely focused on keeping the TDS

In a project the communication level is a very important part from the beginning to the end of project close out and completion stage. This method in the plan is extremely necessary and it is a needed tool that helps assist the project team, the stakeholders, and the executive team of Enterprise. This tool is effective and it makes sure all members involved with the project is on the same level of understanding, it makes sure all involved stays updated on the

The federal exchange and the local governments launched their affordable healthcare system on October 1, 2013. Their system crashed, timed out and or froze before consumers could were able to complete their applications. There was one state that outperformed the federal government’s exchange. This state had the only up and running system since the beginning. This was the state of Kentucky. Kentucky, under the advisement of Sparx, their outside contracted IT experts, used a reusable framework which gave them a head start to this large statewide project. This project duration was little over 27 months of constant planning, designing, and development of this state level exchange.

When developing a new information technology system such as a health documentation system, a team will work through a series of steps “in order to conceptualize, analyze, design, construct and implement a new information technology system”. (Morris, 2009). Traditionally, there were five phases to developing a new system, but it has been found that having seven phases can provide analysts and developers create a system that can more precisely meet the needs of a company. The stages include: planning, systems analysis, systems design, development, testing, implementation and

Information systems assist Patton-Fuller Community Hospital in setting and accomplishing it goals of improving and collaborating interdepartmentally with management, employees, staff, and customers (Apollo Group, Inc, 2013). Proficient information systems objectives are to provide effective and efficient services; add profit and cost-avoidance; and social responsibility (Blue Avenue Associates, 2010). Patton-Fuller objectives are to improve the efficiency of the hospital operations, relationship with current and future patients, and support finance management (Apollo Group, Inc, 2013).

1. Why don’t information systems projects work out as planned? What causes the differences between the plan and reality?

Central Hospital in Tempe, Arizona decided to implement a computerized Medication Administration Record (MAR) into one of their small locations before rolling it out to the entire organization. Art Baxter, the Chief Information Officer in charge of Medical Information Systems (MIS) at Central Hospital assigned Kate Cohen, a programmer and analyst, as the Project Manager. Kate formed a project team but failed to include representatives from departments that were going to use the system. Unfortunately, the key stake holder/users did not have a seat at the table. Even though the

The variation in information needs across any healthcare provider organization forces healthcare information technologies (HIT) platforms, systems, processes and procedures to align its design to support the unique information needs of each department and role. The greater this alignment of HIT systems and technologies to specific administrator, doctor, nurse and lab technician roles, the higher the level of overall systems performance and results attained (Agrawal, Grandison, Johnson, Kiernan, 2007). Just as an enterprise has strategic information needs that help to define the future direction of the business, healthcare provider organizations also have a comparable set of strategic information needs. The administrative roles in healthcare providers need to have a consolidated view of the organization from a cost, quality management, service level, patient recovery rate, patient satisfaction and profitability standpoint as well (Middleton, 2005). All of these factors are often gathered together in a dashboard that administrators often rely on to manage the core areas of their healthcare business (Leung, 2012). Administrator's information needs are also longer term in nature and more oriented towards the development of strategic initiatives that will last several years, requiring

The successful implementation and subsequent meaningful use of information technology solutions within a health care organization is a challenging and iterative process. The organization must engage in careful and ongoing strategic and tactical planning to ensure that the implemented technology will ultimately be effective and beneficial for its practitioners, staff, and patients.

Using the AtekPC case as an example, it is evident that the first obstacle in implementing a PMO is whether the corporate culture will accept it. Within this case, from project initiation to the way things “got done”, the culture of the IT department was very informal. Projects were typically initiated through an informal process where users would directly request IT services through the Lead Analyst, and she just tells the work force to work according to the requests. There is also an indication of lack in consistency across IT groups with project methods, documentation, practices, and tools being individualized by Lead Analysts (Applegate Pg. 465). In addition, the informality was attractive to both the customers of IT as well as the IT section. The customers liked that the IT people were responsive to their needs and by that relationship; tasks were done in a timely fashion. There was no cost tracking or performance records kept on projects, so IT found that appealing. It becomes very difficult to implement the PMO into a system where the soul of an operation would reject it. In this case, it might fail. John Strider commented and said, “If you fight the culture at every turn, you will lose”. He also compared to it swimming upstream. There were also knowledge barriers to compound the with the informality issue. Many of the staff, including

AtekPC is a mid-sized U.S PC maker with sales of $ 1.9 billion and employed 2100 full time employees and additional 200 part time workers. This case discusses most of the obstacles to establishing a PMO (Project management Office) are beyond the CIO and PMO Manager's control. We see a lot of problems faced by the CIO in implementing a PMO in the enterprise. Regardless of the technical challenges during the implementation, the core of the problems seems to be that the PMO is lacking organization support, from the top to the bottom. There is not enough executive stakeholder support, there is no visibility of the program, there is a conflict of interests within departments

In some situation, a system too large to build without an overall plan that coordinates the people working on it. According to Sharon Florentine, senior writer of CIO.com, 50 percent of businesses experience IT project fail in 2012. The most common reason, responded by 74 percent of interviewees, is a lack of resources to meet project demands [4]. Three years later, the failure number increased that 55 percent of businesses surveyed experienced an IT project failure within last 12 months [5].