Although the best solution to this problem had already been identified, who will bear the cost of solving the problem is now the main issue at hand.
Previously, the hospital operated using a six-year old computer system, which provided general accounting, patient accounting and patient registration. However, the the dissatisfaction of the hospital staff with regards to the performance of their old computer system motivated the change to a new IS. Unfortunately, no objectives were set by the hospital to guide each step the directors, the committees, staff, and others would take.
The board of directors seemed to be the one overseeing the steps toward a new IS, from determining the specifications needed, choosing the networking company, and assessing the new IS’s performance, since it was the one that provided the funding for those activities. It was the one that appointed a Director of Information Systems to oversee the installation and use of a patient information system, and mandated the senior managers to conduct a poll among medical staff regarding the performance of the old information system and the desirable features of a new system. However, aside from appointing people and funding the project, the board was detached from the decision-making regarding the project.
The DIS was the one who prepared the RFP to be shown to potential bidders, oversaw the selection of networking company, and monitored the installation of the networking system. He also seemed to have been the one to set the 3 sec. response time stipulated in the MOA. The basis of this was not provided. No moment during the preparation of RFP to the signing of MOA was the building of ambulatory surgery department ever mentioned. He also did not indicate in the MOA the need of the networking company to provide IS to give room for growth.