1.

Overview and history of the company

The Cedar Rapids Vision Centre was not equipped with information technology to
handle the growth spurt faced by the company where only manual systems were
being used for accounting and for clerical work, where the office was relatively small,
and this type of system functioned adequately at starting state.

However with the recent growth, the manual system was creating a substantial
increase in workload, a severe cash flow issue, which developed a serious accounts
receivable collection problem due to an inability to exchange timely and inadequate
accounts information.

2. Identify problem
A. Managerial problem

Planning and planning methodology

1. Arthur Berry, the business manager, is responsible to handle the business

affairs of the centre. In order for him to be successful in the centre, Berry
needs to have accurate and timely information.
2. Berry should form a task force team to work on the implementation of
information system.
3. As for medical stand point, Dr Todd realizes the important of technology for
business improvement, however from system perspective; Dr Todd does not
see any advantage on computer automation and think it is waste of time and
effort.
4. The office was small, and Dr Todd saw no need for the centre to invest on
technology as he saw as expensive and troublesome computers.
5. Due to largely to an inability to exchange timely and accurate data between
the centre and their billing provider (Medisyst), it caused cash shortage and
forced the doctor to defer his own salary on occasion.
6. Dr Todd should benchmark other established outpatient surgical centre in
order to understand their organizational structure as well as the effectiveness
of the operation system to support the company growth in long term.

Organizing

1. Due to the expansion of the centre and the increasing number of patient visits
annually, a few higher position should be hired to monitor and manage the
respective division; maintenance division, nurses as well as administration.
2. All staff should not be reporting directly to Arthur Berry as he needs to
oversee the whole business development from macro point of view.
3. Berry should hire an IT executive to monitor and maintain automated
information system.
Staffing

1. Berry, who was responsible in purchasing and account payable in his former
company being hired by Dr Todd to manage all business functions including
personnel, financial systems, and operations at centre. Berry participated in
information system as an end user rather than a project manager. He is not
equipped for project manager role.
2. Berry should hire an IT consultant to help him in implementation of automated
information system.
3. Berry should also hire an IT Executive/Engineer to monitor and maintain the
new information system.

Control

1. The implementation plan was not properly done where it did not being
communicated to all employees and inputs from the end users were not being
considered.
2. No proper financial plan has been discussed to cater for 10-15 year
expansion.

B. Technical Problems

1. Purchased of hardware & software was not driven by the end users
requirements. The decision was driven by cost because of Dr Todd’s financial
difficulties as well as due to Berry’s prior experience dealing with Apple.
2. The capability of hardware & software was not fully analyze to cater for
expansion & growth of the centre as Berry felt it was important to get the
lowest price, even if it meant getting only minimum capability.
3. The decision to have automated information system at centre was not being
communicated down to the employees.

C. Behavioural Problems

1. Dr Todd did not see computer automation and information system as a

reasonable means to expand the practice.
2. Arthur Berry was newly hired as Business Manager and saw the need of a
modern automated information system that would greatly improve office
efficiency, reduce costs and provide more information for management
decision making. The total approach was based from end user stand point
rather than project manager.
3. Sharon Gale, the account receivable clerk has been working for 10 years,
very competent, dedicated and very conscientious person however has no
thrilled with the automated system.

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 4. Celinda Avalos, the Practise receptionist has been working for 14 years has
least interest in anything to do with the new system or computers in general.
She had been made the backup to both Gale and Malone when either was
out of the office.
5. Starla Malone, the Practice’s Medical Secretary was hired by Berry had been
with the centre for only three months. Malone was the strongest supporter of
the new system project and was enthusiastic in many discussions about new
system. Her attitude made her less than popular with other administration
staff members.

3. Alternative Solutions

Alternative (1): To retain Arthur Berry

1. Retain Arthur Berry and engage a consultant to restructure the information
system; work on flexibility of the system in order to meet end users
requirements and to hire an IT Executive/Engineer to supervise/monitor,
maintain the functionality and flexibility of the system
2. Arthur Berry should form cross-functional teams, overcome the limitations
of the rigid organizational structure and contribute to achieve the
integration of the dissociated budgeting and local programming process,
and promote the use of the system and sharing of information across
management functions.

Alternative (2): Replace Arthur Berry

1. Replace Arthur Berry with new project manager with IT incline.

4. Evaluate alternative solutions

Alternative (1): Retain Arthur Berry in organization

Pro Con
1. Berry familiar with the company operations 1. Berry has to form cross
2. Get along very well with all end user functional teams and work
3. Able to fasten the learning curve of project closely with them.
management requirement 2. The implementation of new IS
4. Restructure the current organization chart will be longer than the initial
5. Restructure current implementation system expectation.
approach 3. Centre to allocate extra budget
6. Able to turn around current situation faster to hire IT consultant and
7. Experience as end user in information employ new IT
system is an added advantage executive/engineer for
maintenance and system
debugging.

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Alternative (2): Replace Arthur Berry with new project Manager who is IT incline
Pro Con
1. Able to integrate , diagnose the problem 1. Longer learning curve
faster 2. Behavioural unknown
3. Additional overhead cost
4. Selecting the right candidate
5. IT driven and not overall
company goal

5. Justification

Cedar Rapid Vision has better edge by retaining Arthur Berry rather than removal.
As clearly evaluated above, what is lacking in Berry is the hat of a project manager,
lacking to turn around problems identified to opportunity. By blending the support of
a consultant cum Berry’s knowledge of end user expertise will strengthen the loose
ends with much shorter cycle time. It will enable much faster turnaround from crisis.

Berry has the right attitude and much greater ownership to fix the problem that he
has created. Upper hand by knowing the behavioural pattern of employees, which
will facilitate in restructuring roles and responsibilities of the workers.

An IT executive is essential for the company in maintaining the system, as end user
support and tool for debugging purposes.

The cross-functional teams may contribute in implementation of new IS, promote the
use of the system as well as sharing the information across management functions
(Salazar, 2003a; 2003b)

To smoothly integrate both organization and technological systems, suggests that

the adaptation process is more related with work practices than formal structures
(Bygstad, 2005). In information system projects, introducing a new organization
chart without changing the work practices has often proved unsuccessful. Mutual
adaptation implies that it is possible to change structural properties of both the
organisation and the information system, creating ‘windows of opportunity’ (Bygstad,
2005).

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 6. Implementation plan

The implementation plan for new IS will take approximately 6 months to complete.
Detail of the project plan is as follows:
New Information System - Project Implementation Plan Week
Project activities Resp 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
Communication
Top Management meeting Berry
- Identify pilot line for new IS implementation
Communication session with all staff Berry
Task form team
Identify cross-functional team
Hiring IT consultant
Recruitment - IT Executive/Engineer Berry
Analysis and Requirement Confirmation
Requirement and analysis Team &
Review and confirmation Vendor
Requirement signed off
Content Migration
Database preparation Team &
Databank migration Vendor
Testing
Integration & Customization
Integration with accounting - pilot line Team &
Training Administration Modules Vendor
IS Deployment
Server and network preparation Vendor
IS Installation
System Commissioning
Content and User set up in new information system Vendor
Administrative training Vendor
Kick off pilot line Team
User acceptance test I (pilot) Team
Proliferation
Integration with scheduling/appointment + training Team &
Integration with medical records + training Vendor
User acceptance test II (proliferation)
System go live

7. References

Salazar, A (2003a) Business Process Improvement, in: Rodrigues, RJ., Oliver, N.C.
Monteagudo, JL., Hernandez, A. And Sandor, T. (eds) e-Health in Latinoamerica and
the Caribe: Trends and Emergent Themes, Pan America Health Organization with
Medical Informatics Foundation, and Instituto de Salud Carlos III, Washington , DC.

Salazar, A (2003b) Knowledge Management, in Rodrigues, RJ., Oliver, N.C.

Monteagudo, JL., Hernandez, A. And Sandor, T. (eds) e-Health in Latinoamerica and
the Caribe: Trends and Emergent Themes, Pan America Health Organization with
Medical Informatics Foundation, and Instituto de Salud Carlos III, Washington , DC.

Bygstad, B. (2005). Managing the Dynamics of Mutual Adaptation of Technology and

Organisation in Information Systems Development Projects.