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27All for the Want of a Plan ...AnonymousThis account centers on an information system, MedCare, installed in several publichospitals in 1999 under pressure to achieve year 2000 (Y2K) compliance. MedCare hadbeen developed in another country; thus, the corporate office was overseas, and a smallregional office (in a state separate from the sites) managed the product locally. Thestage was set for conflict by all the usual factors accompanying a rushed informationsystem implementation, including poor planning, ambiguous contracts, and insufficienttraining. It took the entrance of a new player on the scene, Ms. Black, to ignite the escalatingconflict. The “sparks” involved two fairly trivial administrative tasks—preparingan enhancement estimate and completing a questionnaire.BackgroundMs. Black was hired by the state Department of Health Services (DHS). She wasresponsible for all information systems throughout the state. She did not personallyuse MedCare, or work in a hospital, but was politically powerful. The position wascreated subsequent to MedCare being installed, so she was not involved at the beginningof the process. Each hospital had a system supervisor who managed MedCare ateach individual hospital site and acted as the point of contact between that hospitaland MedCare’s regional office. Mr. Brown was employed by the MedCare regionaloffice to manage the system. He was the contact between the local hospitals and theMedCare overseas corporate office where all the development took place.Conflict FlashpointsThe Enhancements ProcedureThe enhancements procedure was the method by which the sites, in theory, could incorporatechanges into the software. Written into the contract with the state wasMedCare’s commitment to provide twenty-five “free development days” annually tobe used for adding enhancements to MedCare. This meant that enhancement requestshad to be agreed on and prioritized among all the sites and approved by MedCare.The enhancement procedure included the following steps:1. Each site’s system supervisor completes an enhancement request template for eachenhancement they would like.242