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Case Study 483
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Case Study—Memorial Health System CPOE Implementation

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

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