Managing Success: An Information Systems Dilemma at Great Plains Health Care

Abstract

Success can come at a price. For Great Plains Healthcare, the success of their clinical data repository (CDR), particularly in the ambulatory environment, is causing a fundamental conflict between their affiliated physicians and their staff of employed physicians. It is also exposing disagreements and weaknesses within the corporate structure of Great Plains itself. These conflicts are being played out in the Great Plains western region where the regional director of medical informatics and the regional manager of information systems (IS) are aggressively introducing a scaled-back version of the current informatics system, utilized by the employed physicians, to the region’s affiliated physicians. The success of the scaled-back rollout has caused some of the affiliated physicians to request the full software suite that creates data for the CDR. The issue is not one of technology but of politics and an organizational structure that may have been caught off-guard by the request of the affiliates. For the affiliated physicians, access improves the quality of patient care. However, the employed physicians view this as an invasion of their proprietary system. Finally, some of the corporate directors are nervous about the financial and legal implications. The whole scenario is creating an affiliated-vs.-employed conflict and a corporate-vs.-regional conflict.