Case Study - Riverview University Medical Center (RUMC)

The case for Riverview University Medical Center (RUMC) and the implementation of OpChart had many contributing factors to its initial failure, and with the newer implementation underway as of 2003. This implementation will also undertake similar failures. Early on during the second attempt it is clear that there is still a major disconnect causing additional frustration. However, focusing on the initial rollout in 1996. We can identify key areas that primarily contributed to end user resistance, that will be consistent throughout the second attempts unless they are able to incorporate better end user feedback and involvement.

Major areas of failure during the initial implementation included a misconstrued assumption of the systems use, poor rollout and end user training, lack of end user support during implementation primarily from the pediatric unit, and technology issues (Hoot & Sanders, 2005). I believe these factors played a key role in creating resistance from the end user. What is important to point out is the lack of information relayed to the end user and the lack of end user input. Ammenwerth, Iller, and Mahler (2006) argue that the most software projects fail, and a clear disconnect between user, technology, and processes must be understood before undertaking a costly project. I would argue that the implementation process should have included a recruited team with end users from each department to contribute to the development of the system. Rather the approach taken was impromptu forum that met once or twice a month with no dedicated team or mandatory feedback. This sort of leeway does not create an opportunity to truly understand end user need. This in fact does the opposite and the results are wasted time and no true metrics to measure the success or needs for change.

As the second rollout began, I think a more agile approach should have been taken to implement the software. With all other areas within RUMC successfully using OpChart. The approach taken to implement the product within the West Medical Buidling (WMB) should have included communicating clearly a roll out process, develop a project team, establishing a formal interview process to obtain end user feedback relevant to the project, and review the previous attempt to implement the project to identify issues previously encountered. Tilley and Rosenblatt (2017) encourage a fact finding process during an SDLC. This helps to identify various ways the system will both effect the end user as it pertains to acceptance and workflow. Furthermore, incorporating a conceptual model during implementation would be ideal to evaluate previous problems, and monitor ongoing success of the project. With this sort of project directly impacting work flow a FITT model would be ideal. Essentially we are looking at the impact between attributes of user, technology, and task to look back at what went wrong and how we can prepare for a better implementation the second time around (Ammenwerth, Iller, & Mahler, 2006).

References:

Ammenwerth, E., Iller, C., & Mahler, C. (2006). IT-adoption and the interaction of task, technology and individuals: a fit framework and a case study. BMC Medical Informatics and Decision Making, 6(3), 13p.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1352353/pdf/1472-6947-6-3.pdf

Hoot, N. R., & Sanders, D. L. (2005). Case 8. Implementation ofOpChart in West Medical Building. In N. M. Lorenzi, J. S. Ash, J.Einbinder, W. McPhee, L. Einbinder (Eds.), Transforming Health Care through Information (pp. 81-91). New York: Springer. 

Tilley, S. R. & Rosenblatt, H. J. (2017).  Systems analysis and design (11th edition).  Boston, MA: Cengage Learning.