All Pine Medical Center
The basic problem in the Case Study is a conflict between legality and direct organizational authority. The CEO and the CIO have both given the task force, something that they feel contradicts their better judgment. Dr. Palmer wants easier access to patient files and the Task force feels what he wants violates patient confidentiality. Dr. Palmer from his position and longevity, is perhaps a bit too comfortable in position. Sometimes managers with a lot of authority forget that they are answerable to a higher authority in the medical industry.
The problem with The Chief Executive Officer and the Chief Information Officer telling the task force to appease Dr. Palmer is that the task force is responsible to look at both ethical and legal framework. They must have an open context to voice their opinion on the matter. They should be guided by principles instilled in them in the companies ethical policies, and the ethics embedded in the medical industry.
One metric that is not mentioned in the case study should be known. It should be quantified how much an ERH is saving time and how much time is the required login is costing it. From the Case Study’s overview of the problem, it does not require more than remembering and entering with every new patient up to 5 usernames or passwords. Presumably for someone with his or her MD, this is not an unreasonable request.
The situation is ultimately between the highest authorities in the organization and a body of employees that is being formally ordered to do something against what they feel the governing laws of the land legally allow.
There are a number of ways of handling the situation. The task force could 1) Appeal to an authority higher than that of the hospital. They could inform the state or federal governing body and let them know that they are being ordered to do something that they do not feel is in compliance with industry and/or legal standards. This would make those informing of the situation to be whistle blowers. This would certainly lead to a strong message that would shake up the organization and have a superseding entity interview. It is both a drastic and risky means of resolution of the conflict. Only problems that in no other way are solvable should be brought to this level.
2) They could appeal to the board of directors within the organization. This would be going above the authority of the CEO, the CIO and Dr. Palmer, but it would not be as drastic as going to legal bodies. This is still a bit drastic in the sense that the Task Force’s might find the executive team upset that the group went behind their back. It would however, be a good solution if the task force felt the third option listen below was not feasible.
3) The task force as a body could draw a line in the sand and say implementation of access to patient records as Dr. Palmer requests is something they have to demur on ethical grounds. If the task force as a team agrees to take this path and voice a communal opinion, that would put a fair amount of pressure on the CEO, the CIO and Dr. Palmer to justify their decision on legal grounds. The risk in this third options is that it could lead to actions taken against the employees.
3. Problem Solving
I would choose the third solution. The other two seem only good options if the third option was already tried and found wanting. It sends the right level of message. Employees in a good organization should feel able to raise such concerns to their superiors.
Once weakness is if the CEO, CIO and Dr. Palmer react negatively to the position of the Task Force. A good boss can make life wonderful, but bosses who are upset with employees make for a tense working situation.
How a message is delivered is often as important as the message itself. Perhaps a better way to deliver it would be a letter, or even an email. Typically, a new system frustrates new users because they are simply new. If the Task Force could delay by dragging its feet, it is possible that the new system will become the new normal and it will no longer be the frustration that it currently is.
I learned that I visualize people as basically good. There are a lot of assumptions here of professional courtesy and willingness to alter a decision. In the real world, people are often more dynamic than this. Ultimately, that is what is lacking in exercises like this. Much of the decision cannot be known unless the players involved are known personally. Luckily, in the real world, as part of such a Task Force, you would, presumably, be acquainted with the players involved.
Next time I would like to think of a scenario that assumes personalities of the people involved. This would give it a closer approximation to a real-life scenario.