RUNNING HEAD: MIS-535 Week 6 Case Study Analysis Table of Contents Summary………………………………………………………………………………….....Page 3 Support…………………………………………………………………………………...Pages 3-6 Evaluation………………………………………………………………………………...Pages 6-8 Questions………………………………………………………………………………....Pages 8-9 References…………………………………………………………………………………Page 10 Summary In 2010 cardiologist by the name of Duncan Dymond complained that too many patients were arriving at his hospital at incorrect times and in far worse shape and in need of different specialists. The reason for this issue is because in 2004 the National Health Service installed a system called the choose and book system. Costing nearly 200 million pounds. At first it sounded like a plan because it would basically help all doctors with appointments and ensure that they stay on track throughout their days weeks and months. It was also supposed to help patients be on time and at the right location. But because the system was pushed out too fast it had many glitches to overcome. The major problem that came of this was that the 2 major administration systems that the hospitals were already using was not compatible with choose and book and when something isn’t compatible it just doesn’t work. Choose and book was generally geared to be the go between the 2 systems (PAS and GP). The objective of Choose and book was supposed to be able to book 90% of all referrals by December 2006 and that objective was never met. Four years later choose and book was installed into 94% of all GP surgeries it was only used to book 54%. The major role for choose and book was to make everything easier in fact 100 million pounds incentive was issued and that did not help the situation because if doctors feel that it is too hard to use or too difficult they will revert back to their old habits. Support According to Bio med choose and book has been a complete failure. Choose and book was supposed to not only help doctors but it was also geared to help patience. The concept was for patience to be able to go online and book an appointment when and where they so choose. Among the Choose and Book patients, 66% (31/47; 95% CI 52 to 78%) reported not being given a choice of appointment date, 66% (31/47; 95% CI 52 to 78%) reported not being given a choice of appointment time, 86% (37/43; 95% CI 74 to 94%) reported being given a choice of fewer than four hospitals in total and 32% (15/47; 95% CI 20 to 46%) reported not being given any choice of hospital. A survey was completed to see how patients liked choose and book and the results were not in the favor of the system. A total of 104 patients took part in the study between 4 May and 9 August 2006. Of these, 47 were Choose and Book patients. This represents 44% of the 107 total Choose and Book patients seen at the Hillingdon site between these dates. A further 57 patients were referred through the conventional Partial Book ...

1. RUNNING HEAD: MIS-535
Week 6 Case Study Analysis
Table of Contents
Summary………………………………………………………………
………………….....Page 3
Support………………………………………………………………
…………………...Pages 3-6
Evaluation……………………………………………………………
…………………...Pages 6-8
Questions……………………………………………………………
…………………....Pages 8-9
References……………………………………………………………
……………………Page 10
Summary
In 2010 cardiologist by the name of Duncan Dymond
complained that too many patients were arriving at his hospital
at incorrect times and in far worse shape and in need of
different specialists. The reason for this issue is because in
2004 the National Health Service installed a system called the
choose and book system. Costing nearly 200 million pounds. At
first it sounded like a plan because it would basically help all
doctors with appointments and ensure that they stay on track

2. throughout their days weeks and months. It was also supposed
to help patients be on time and at the right location. But
because the system was pushed out too fast it had many glitches
to overcome. The major problem that came of this was that the
2 major administration systems that the hospitals were already
using was not compatible with choose and book and when
something isn’t compatible it just doesn’t work. Choose and
book was generally geared to be the go between the 2 systems
(PAS and GP). The objective of Choose and book was supposed
to be able to book 90% of all referrals by December 2006 and
that objective was never met. Four years later choose and book
was installed into 94% of all GP surgeries it was only used to
book 54%. The major role for choose and book was to make
everything easier in fact 100 million pounds incentive was
issued and that did not help the situation because if doctors feel
that it is too hard to use or too difficult they will revert back to
their old habits.
Support
According to Bio med choose and book has been a complete
failure. Choose and book was supposed to not only help doctors
but it was also geared to help patience. The concept was for
patience to be able to go online and book an appointment when
and where they so choose. Among the Choose and Book
patients, 66% (31/47; 95% CI 52 to 78%) reported not being
given a choice of appointment date, 66% (31/47; 95% CI 52 to
78%) reported not being given a choice of appointment time,
86% (37/43; 95% CI 74 to 94%) reported being given a choice
of fewer than four hospitals in total and 32% (15/47; 95% CI 20
to 46%) reported not being given any choice of hospital. A
survey was completed to see how patients liked choose and
book and the results were not in the favor of the system. A
total of 104 patients took part in the study between 4 May and 9
August 2006. Of these, 47 were Choose and Book patients. This
represents 44% of the 107 total Choose and Book patients seen
at the Hillingdon site between these dates. A further 57 patients
were referred through the conventional Partial Booking referral

3. process, 19 matched and 38 from additional clinics.
Figure 1 presents a flowchart of recruitment.
Data were collected on participants' gender, age, ethnic group
and specialty division; see Table 1. Age data was Normally
distributed; other variables are categorical. The two groups
were not statistically significantly different on gender, age or
ethnic group. The sample was compared with data obtained on
all first outpatient attenders at the Trust in the same time
period: χ2-tests showed no statistically significant difference by
gender, age category or ethnic group.
Variable
Categories
Choose & Book (n = 47)
Partial Booking (n = 57)
TOTAL
Test comparing groups (excluding missing data)
Gender
Female
29
38
67
Fisher's exact p = 0.7
Male
18
19
37
Age
16–29
10
9
19
Mann-Whitney z = 1.5, p = 0.1

4. 30–44
6
18
24
45–59
11
17
28
60–79
16
11
27
80+
4
2
6
Ethnic group
White British
30
41
71
Fisher's exact p = 0.6
South Asian
9
8
17

5. Other
3
7
10
missing
5
1
6
Specialty division
Ambulatory Care
10
29
39
Fisher's exact p = 0.008
Surgery
14
8
22
Women & Children
8
10
18
Medicine
11
6
17

6. missing
4
4
8
"How important to you is being given choice over where you go
to receive hospital treatment?"
Very important
21
27
48
Mann-Whitney z = 0.8, p = 0.4
Important
12
17
29
Slightly important
3
4
7
Not important at all
0
4
4
missing
11
5
16

7. With studies NHS has been able to update and fix glitches in the
systems. Choose and book is still being used today. It’s being
used because when used in the manner it was supposed to it is a
very reliable system. Part of the reasons it had difficult in the
beginning is because 1 it was new and 2 it wasn’t compatible
with other systems. Remember when cell phones first came out
or when computers themselves first came out no one wanted to
use them because they were difficult to understand or get used
to but once you did they worked amazing. Something happened
with choose and book. Upgrades have been done since and
upgrades will continue to come. As of today, more than 40,000
patients use the system every single day.
Evaluation
Information System projects are very difficult projects to
manage they are known as runaway projects they have a failure
rate of 40 percent. Projects are generally estimated to a specific
timeline and budget thou Information System project usually
fail to meet the time line and the specified budget. Per
Management Information System “A joint study by McKinsey
and Oxford University found that large software projects on
average run 66 percent over budget and 33 percent over
schedule; as many as 17 percent of projects turn out so badly
that they can threaten the existence of the company
(Chandrasekaran et.al.,2014).
Generally, information system projects have system failures
during implementation of new system mainly because they are
not used properly as planned. Most projects fail to meet the
needs of the business which does not allow the new system to
increase business performance. To properly manage a project,
you need a highly qualified project manager. The role of a
project manager captures the scope of the project and plan
activities that create a work breakdown structures. Which
indicates all the activities that must take place and tract the

8. time of deliverables and manage the budget. The project
manager will implement necessary tools and techniques to meet
the project objective. Of all the requirements that the
implementation of the system requires.
Organization Britain’s National Health Service Jettisons
Choose and Book System was not properly implemented it
failed to meet the time line of the project and went over budget
significantly. The new system was implemented in 2004 to
provide citizens of Britain easy access to book outpatient
medical appointments with assistance of their doctor. The
system was set up for a patient to enter their referral number
and code to the system to set up their outpatient appoint online
or call a centralized booking system. The implementation of the
system was estimated to cost 200 million dollars it went over
budget and the timeline was not meet. The new system was
initiated to decrease the timeframe for referral process, to go
paperless and have patients manage their health appointments.
The new system allows patients to manage their own health
appointments to decrease loss of patient no shows which was
yearly costing Britain’s 1.6 million dollars each year.
Britain’s National Health Services failed to meet the initial
information system plan the system had lots of glitches and it
was not user friendly for patients nor doctors to use. The
Choose and Book system failed to meet the initial goal of 90
percent of Britain’s citizens booking their referral appointments
online or using the call-in system by 2006. The new system
failed tremendously four years after implementation the new
system booked appointments were at 54 percent. The project
failed to meet the defined deliverables and mitigate risk in the
implementation of the new system.
Questions
1. Clarify and describe the problems of the NHS Choose and
Book System. What management, organization, and technology
factors were responsible for those problems?
All parties are responsible for the failed information system.

9. The managers of the project not properly managing the project
from beginning to end allowing the overruns. The stakeholders
of the organization failed to obtain a detail risk analysis to
decide if any issue that occur they can plan accordingly to fix
the problems of the failed system. The technology that was
designed slowed the system down and it was not user friendly
and it was not compatible with other systems that it needed to
interact with to pull patient data to make out patient referrals
through the system.
2.2. To what extent was Choose and Book a failure? Explain
your answer
Choose and Book was a failure because it failed to provide the
convenience of referral appointments. The new system was
supposed to get 94 percent of all GP surgeries but only booked
54 percent of the appointments. Choose and Book promoted
incentive to doctors to get them to use the service online or by
phone. They offered 100 million dollars’ incentive plan and
doctors were not interested in using the system because the
system was not user friendly. Doctors failed to stop patients
from traveling long distance to outpatient care facilities. The
system was running slow and had lots of glitches and were not
compatible to another system like Patient Administration
System and GP and clinical system were not compatible.
3.3 What was the economic and social impact of Choose and
Book?
The economic impact cost Britain 356 million dollars which
went over the budget by 156 million dollars. There were so
many problems with the system thou doctor and patients wanted
the service but they wanted the system to be user friendly. The
glitches in the system included missing appointment letters,
system canceling them appoints, phone bills increased because
the time on the phone making appointments. Which made
citizens very disgruntle with the free health care system.

10. 4.4 Describe the steps that should have been taken to make
Choose and Book more successful.
They should have identified what the scope of the project in
more detail. They should have included a plan to test the
interface system to ensure the system could talk to each other.
They should have a more realistic work breakdown structure
showing the deliverables and identify the critical path to getting
the project completed on time and on budget. They should have
had a more detail risk management plan to identify the possible
risk of the project and define the correct mitigation for the
sluggish delays in the system, the unfriendly user application to
the system that made users disgruntled. If they had an
experience information system project manager could have
identified the issues of the implementation of the system.
References:
·
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1
186/1472-6947-8-36
· http://www.computerworlduk.com/applications/nhs-warns-of-
33-known-issues-with-e-referral-service-launched-today-
3615745/
· Laudon, Kenneth C., Jane Laudon, Management Information
Systems: Managing the Digital Firm, 15th Edition. Pearson
Learning
Solution
s, 01/2015. VitalBook file.

11. 9
Due June 11
There’s an old adage that says that history is always written by
the winners. Although this is not always the case, it is true that
people's sense of historical events is often influenced by the
viewpoints of the historians who write about them.
During the Watergate scandal in 1974, many policy pundits
wrote columns demanding that President Richard Nixon resign
from the presidency because he was, in their view, clearly
culpable for the Watergate break-ins. Not all pundits felt this
way, however. Click here and here to read articles that offer
differing views of President Nixon at the height of the
Watergate scandal.
Complete the following for this assignment:
· Step 1: Summarize the arguments made in each of the two
articles regarding the conduct of President Nixon. How might
each of the author’s views impact the reader’s understanding of
the Watergate crisis?
· Step 2: Describe how the Watergate events changed American
views toward politics and politicians. In your view, how did

12. these events change the press coverage of politicians?
· Step 3: Speculate about how the Watergate event coverage
might have been different (better or worse) in the age of social
media and smartphones. Would it have lasted as long? Why or
why not? Are these innovations in technology helpful or
harmful to the way that people understand current events?
At least 2 credible sources are required for this assignment.
Your sources should be cited using APA format; both in-text
citations and references. Please use the CTU Undergraduate
Writing Style Guide for assistance on APA formatting.
References
Burch, D. (1974, May 14). In defense of Richard Nixon.
Retrieved from The Harvard Crimson Web site:
http://www.thecrimson.com/article/1974/5/14/in-defense-of-
richard-nixon-pithe/
The Washington Post. (1973, May 1). Editorial: Watergate: The
unfinished business. Retrieved from
http://www.washingtonpost.com/wp-
srv/national/longterm/watergate/articles/050173-2.htm