West Coast University Medical Center

(This is a true story.) West Coast University Medical Center (Pseudonym) is a large university teaching and research hospital with a national reputation for excellence in health care practice, education, and research. Always seeking to sustain that reputation, the senior executive board at the Medical Center (WCMC) decided to install a comprehensive medical diagnostic system. The system would be linked to WCMC's computer servers and be available to physicians via the computer network. Because every physician's office at WCMC has a PC, doctors and staff could access the system from these offices as well as from their homes or private-practice offices. By simply clicking icons to access a medical specialty area, then keying in answers to queries about a patient's symptoms, medical history, and so on, a physician could get a list of diagnostics with associated statistics.

The senior board sent a questionnaire to manager in every department about needs in their areas and how they felt the system might improve doctor's performances. Most managers felt it would save the doctor's time and improve their performances. The hospital computing and information systems (CIS) group was assigned to investigate the cost and feasibility of implementing the system. CIS staff interviewed medical-center managers and software vendors specializing in diagnostic systems. The study showed high enthusiasm among the respondents and a long list of potential benefits. Based on the study report, the senior board approved the system.

The CIS manager contacted three well-known consulting firms that specialized in medical diagnostic systems and invited each to give a presentation. Based on the presentations, he chose one firm to assist the CIS group in identifying, selecting, and integrating several software packages into a single, complete diagnostic system.

One year and several million dollars later the project was completed. However, within a year of its completion it was clear that the system had failed. Although it did everything the consultants and software vendors had promised, the few doctors that did access it complained that many of the system "benefits" were irrelevant, and that certain features they desired were lacking.