Case Study Memorial Health System CPOE Implementation Failure This assignment is due in Week Four. Memorial Health System is an eight-hospital integrated health care system in the midwestern United States. The health system has two downtown flagship tertiary care hospitals, each licensed for more than 700 beds, located in the two major metropolitan areas served by the system. The remaining six hospitals are community-based facilities, ranging in size from 200 to 400 beds. These hospitals are located in the suburban and rural areas served by Memorial Health System. Four years ago, the system’s board of directors approved a multi-million-dollar initiative to install an enterprise-wide clinician provider order entry (CPOE) system intended to dramatically reduce medical errors. Today, the system is far from fully implemented, and, in fact, has been removed from all but one of the two tertiary care facilities, where it remains in pilot adopter status. At the time the board approved the CPOE initiative, the project was championed by Fred Dryer, the CEO, and was closely supported by Joe Roberts, the chief information officer (CIO) of the health system. Even during its proposal and evaluation by the board, the project was considered controversial by some of the health system’s stakeholders. For example, many of its physicians, who are community-based independent providers, were adamantly opposed to the CPOE system. They worried that their workload would increase because CPOE systems replace verbal orders with computer-entered orders by doctors. Dr. Mark Allen, a primary care physician commented, “The hospital is trying to turn me into a 12-dollar-an-hour secretary, and they aren’t even paying me 12 dollars an hour.” In securing board approval, Dryer and Roberts presented an aggressive implementation plan that called for the requirements analysis, Request for Proposal (RFP), vendor selection, and project implementation to be completed in less than 18 months in all eight hospitals. During the discussion with the board, several of the members questioned the timeline. One noted, “It took you two years to set up e-mail, and everyone wanted e-mail. This will affect every clinician in every hospital. Do you really think you can do this in 18 months?” In an effort to demonstrate results, Dryer and Roberts demanded results from the clinical and IT team formed for the project. By this time, a rushed requirements analysis had been completed, an RFP issued, a vendor selected, and a contract signed. The acquisition process took a little more than 6 months, leaving a year for the implementation. In protest, a number of prominent physicians took their referral business to the other health system in the area that seized on the controversy by promising that they would not use a CPOE. Shortly thereafter, the two leading champions for CPOE—Dryer and Roberts—left Memorial. The chief medical officer, Barbara Lu, who was a vocal opponent of the project, was appointed ...

1. Case Study
Memorial Health System CPOE Implementation Failure
This assignment is due in Week Four.
Memorial Health System is an eight-hospital integrated health
care system in the midwestern United States. The health system
has two downtown flagship tertiary care hospitals, each licensed
for more than 700 beds, located in the two major metropolitan
areas served by the system. The remaining six hospitals are
community-based facilities, ranging in size from 200 to 400
beds. These hospitals are located in the suburban and rural areas
served by Memorial Health System.
Four years ago, the system’s board of directors approved a
multi-million-dollar initiative to install an enterprise-wide
clinician provider order entry (CPOE) system intended to
dramatically reduce medical errors. Today, the system is far
from fully implemented, and, in fact, has been removed from all
but one of the two tertiary care facilities, where it remains in
pilot adopter status.
At the time the board approved the CPOE initiative, the project
was championed by Fred Dryer, the CEO, and was closely
supported by Joe Roberts, the chief information officer (CIO) of
the health system. Even during its proposal and evaluation by
the board, the project was considered controversial by some of
the health system’s stakeholders. For example, many of its
physicians, who are community-based independent providers,
were adamantly opposed to the CPOE system. They worried that
their workload would increase because CPOE systems replace
verbal orders with computer-entered orders by doctors. Dr.
Mark Allen, a primary care physician commented, “The hospital
is trying to turn me into a 12-dollar-an-hour secretary, and they
aren’t even paying me 12 dollars an hour.”
In securing board approval, Dryer and Roberts presented an
aggressive implementation plan that called for the requirements

2. analysis, Request for Proposal (RFP), vendor selection, and
project implementation to be completed in less than 18 months
in all eight hospitals. During the discussion with the board,
several of the members questioned the timeline. One noted, “It
took you two years to set up e-mail, and everyone wanted e-
mail. This will affect every clinician in every hospital. Do you
really think you can do this in 18 months?”
In an effort to demonstrate results, Dryer and Roberts demanded
results from the clinical and IT team formed for the project. By
this time, a rushed requirements analysis had been completed,
an RFP issued, a vendor selected, and a contract signed. The
acquisition process took a little more than 6 months, leaving a
year for the implementation.
In protest, a number of prominent physicians took their referral
business to the other health system in the area that seized on the
controversy by promising that they would not use a CPOE.
Shortly thereafter, the two leading champions for CPOE—Dryer
and Roberts—left Memorial. The chief medical officer, Barbara
Lu, who was a vocal opponent of the project, was appointed
interim CEO.
Although Lu opposed the project, many members of the board
still supported it. In addition, none of the board members
wanted to lose a substantial down payment to the vendor, so Lu
was instructed to proceed with implementing the system. Lu
appointed a close colleague, Dr. Melvin Sparks, to serve as the
interim CIO of the system. Sparks was both a practicing
radiologist and a degreed computer engineer, so Lu thought he
would be an ideal CIO for the system. Sparks hired Sally Martin
as the executive project manager overseeing the
implementation.
After evaluating the progress made to date and preparing a
detailed thousand-step project plan, Martin reported back to
Sparks on the status of the project with an exceptionally
detailed report. Several key points were noteworthy in her
report. Because of the rushed requirements analysis, several key
workflow and system integration issues were missed.

3. Consequently, to complete the project in the remaining 12
months, the organization would have to do the following:
• Double the IT staff assigned to the project from 16 to 32
people.
• Purchase approximately $500,000 in integration software
not already budgeted.
o Alternatively, the scope of the project could be reduced
from an enterprise deployment to something less than that.
o Alternatively, the duration of the project could be doubled
to 24 months, keeping the staff flat, but not avoiding the
$500,000 software cost.
Dr. Sparks did not respond well to the news, exhibiting a great
deal of anger at Martin, who was not working for the health
system when the project was scoped and budgeted. Sparks
yelled at Martin and told her never to come back into his office
with bad news again. Her job, Sparks screamed, was to “figure
out how to turn bad news into good news or no news.” As she
left Sparks’ office, Martin resolved never to convey bad news to
Sparks again, no matter how serious the issue was.
Over the next 12 months, the project progressed but got a bit
further behind schedule each week. Martin reminded herself that
she wasn’t conveying bad news to Sparks. In each status review
meeting, Martin always presented a project schedule that was on
scope, on schedule, and on budget.
During this time, the health system took on a number of other
important IT initiatives requiring human resources. Each time
another project fell behind schedule, Sparks took resources from
the CPOE project. From the 16 people originally budgeted, the
team was reduced to eight. The only positive aspect was that the
project, which was costing money even though it was making
little or no progress, was expending less cash as it made no
progress.
As the project went into its 16th month, two months before the
scheduled launch, nearly all the project budget had been
consumed, and—in an effort to save money—the end-user
training budget was cut to the bare minimum. At the same time,

4. some doctors who had not left the system attended the CPOE
vendor’s annual user group meeting. They saw the release of the
vendor’s most recent system and immediately decided they
wanted it for Memorial. Upon returning to the hospital, the
doctors met with Sparks and persuaded him that the only hope
for enlisting physician support for the changed workflow was to
adopt the newest version of the software, which was just being
introduced. The physicians told Sparks they had persuaded the
vendor to appoint Memorial as an alpha site for the new
software.
When Sparks informed Martin of the change in the scope of the
project, Martin was concerned, but remembering Sparks’
reaction to bad news, she kept her thoughts to herself. She
framed her questions in the form of the risks that such a major
change in direction might cause with so little time to recover.
Sparks smiled and told Martin, “Don’t worry; it will all work
out.” So, two months before the launch, Martin worked with her
team to alter the project work plan to install the new software,
test the software, configure the software and interfaces, and
train the users—all in two months, even though the same
activities had taken almost eight months the first time.
The scheduled date for the launch arrived, and all eight
hospitals went live on the new CPOE system on the same day.
The new software had flaws. The lack of end-user training was
apparent, and the many requirements missed during the analysis
became immediately obvious. Doctors could not log on to the
system, and nurses could no longer enter orders. Patients were
kept waiting for medications and tests.
After several days of this, Lu instructed Sparks to
decommission the CPOE system and revert back to the manual
procedures. An unknown physician was quoted in a major health
care publication—under the title “CPOE Doesn’t Work”—
describing the debacle at Memorial Health.
During the project postmortem, Sparks expressed surprise the
project was not going as planned and asked Martin why she had
not been more forthcoming about the problems, issues, and

5. risks. The vendor took six months to fix the flaws in the
software, and—30 months into the project—CPOE was launched
again. However, this time it was in one ICU in one of the
tertiary care hospitals. Four years after the beginning of the
project, this is the only unit in the entire health system in which
CPOE is operational.
Social Problems, SYG 2010
Paper Assignment 1: Systemic and Individual Explanations to
the Study of Social Problems
Suggested length: 2- 4 pages (double spaced, including
bibliography). Online submissions only.
Objective:
The main objective of the assignment is to introduce students to
the way sociologists study social problems that is
distinguishable from other methods of studying/explaining
social problems (i.e., explanations typically found in peoples’
everyday conversations, explanations provided by other
disciplines, or explanations provided by the media).
Specifically, this assignment is designed to introduce students
to the way of explaining social problems by looking at the
larger factors in society (“system-blame” explanations) versus
explanations that look at the attributes and actions of
individuals (“person-blame” explanations). In addition, this
assignment is designed to test student’s critical thinking and
communication skills.
The full set of the objectives of this assignment is listed below:
1. Defining two main theoretical approaches to study social
problems
2. Comparing different theoretical approaches to social
problems in terms of their strengths and weaknesses

6. 3. Demonstrating ability to identify and explain different
approaches to social problems used in newspapers’ editorial
pages
3. Demonstrating ability to apply theoretical concepts to real
life examples
4. Communicating the ideas effectively and in the format
appropriate to the discipline
Directions:
A.Define (in your own words) “system-blame” and “person-
blame” approaches to the study of social problems. 20 pts.
B.Analyzethree short “letters to the editor” published in the
U.S. Today (at the bottom of the guidelines) that provide
examples of different ways of explaining homelessness in the
U.S. 30 pts.
- identify the approach (“person-blame” or “system-blame”?)
used by the author of each letter.
- for each approach, list different causes of homelessness
provided by the authors.
- using your sociological insight, explain which of these
specific explanations contribute and which do not contribute to
our understanding of homelessness (provide two examples of
useful explanations and two examples of explanations that are
week. Remember, as we discussed in class, “weak”
explanations are ones that do not provide any factors that are
located outside of the individuals. “Strong” explanations look
at the characteristics of society that contribute to social
problems).
C.Apply your understanding of the system blame approach to
study of social problems by trying to explain causes of one
social problem in our society today (you need to find at least
one newspaper article about this problem). No credit will be
given for a discussion of the problem that was already discussed

7. in class and/or comes from the letters below). 30 pts.
D. Provide properly formatted (MLA, APA, or ASA formats are
acceptable) bibliography of all sources that you have consulted
for this assignment. You do not have to include the three letters
to the editor in your bibliography. 10 pts.
E.Communication of ideas, organization of the paper, grammar,
spelling, punctuation. 10 pts.
Important: Remember this is a short paper so please keep
quoting other authors/sources to the bare minimum. If you use
outside sources, you must acknowledge the origin of the
information/quotes in the body of your paper and in the
bibliography section. Any form of plagiarism will be punished
with a score of zero.
10 Points will be deducted for each day your submission is past
due.