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122 Section III. Implementationtechnological revolution that will result in advances that have already changed the businessworld in retailing, banking, and investing. The prevailing sentiment is that thehealth industry is lagging behind the corporate world. Questions about the hospital’sinformation system arose during negotiations. Mercer’s information services are comparablewith those of the other health systems in town, with the exception of its POEsystem. One of the competing medical centers has announced its plan to deploy a newPOE system. Syntel was impressed by this innovation and queried Mercer about itsplan for a POE system. Mercer’s CEO, loath to be upstaged by the other healthsystem, told Syntel that they also plan to implement such a system in the not-too-distantfuture.The PressuresTwo years ago, the hospital attempted to implement a nursing documentation systemcalled Physician Manager, and it ended in a disaster of grand proportions. The medicalstaff had opposed this system from the time they previewed it. It was implementedwithout any consideration of physicians’ opinions. After only 2 days of operation, ithad to be abandoned because there were so many technical problems. A substantialamount of money was wasted, the CIO nearly lost his job, and the information servicesdepartment’s image was severely tarnished. More recently, another system, calledCareReviewer, was deployed and the medical staff was challenged yet again by unwelcometechnology. In general, information service systems are seen by medical staffmembers as adding to their workload when these systems should be making jobs easier.Physicians are increasingly being pushed to see more patients in less time and with lesscompensation. Managed care is driving down their salaries. Professionals who had previouslyenjoyed a great degree of autonomy are now feeling like cogs in the healthcaremachinery, working to make more money for the top executives. All thesepressures are driving physicians to the breaking point.The corporation is under pressure as well. Negative publicity from a recent lawsuitcould damage Mercer’s position in the market and its managed care contracts. A 35-year-old woman, a promising new talent at Syntel, was admitted to Mercer, throughthe emergency department, for high spiking fever and rigors. Blood cultures, blood fora complete blood cell count, and appropriate samples were drawn in the emergencydepartment. The doctors were about to administer antibiotics when the patient’s bloodpressure dropped; she was rushed to the intensive care unit with a presumptive diagnosisof sepsis. The ordering systems in the emergency department and the intensivecare unit were separate, so new orders had to be written. A sleep-deprived physicianwho had been up for 27 hours quickly scrawled a stat order for ampicillin/sulbactam(a potent antibacterial medication). The order was issued in triplicate, with one copygoing to the pharmacy. The pharmacy read the medication as Acyclovir (an antiviralmedication) and filled it as such. A registered nurse from the float pool quickly hungthe intravenous medication, and it was administered. A seasoned intensive care unitnurse recognized the size IV medication bag as being the wrong size and caught theerror, but 2 hours had elapsed. Unfortunately, the young woman’s pressure continuedto drop, and she suffered irreversible brain damage.Information Services LeadershipAfter the PhysicianManager system failure and the resulting uproar from the physicians,the board of directors created the position of MDIS. This person would be a