ABSTRACT
The health system was implementing new electronic health record features including computerized provider order entry, and the chief information officer wanted to improve clinician workflow with single sign-on and context management first. The vendor appeared to be more focused on the potential benefits of successfully developing and implementing software at a prestigious health system, rather than the reality that these benefits were unlikely to be achieved with resultant negative backlash. The health system had conducted an extensive selection process that included an open request for proposals, vendor technology demonstrations, and reference calls to existing health systems using the technologies desired. Custom software development is a high-risk endeavor for healthcare providers. Hospitals and health systems have business goals that revolve around optimizing patient care and meeting regulatory standards, goals that are often incompatible with the iterative cycles of requirements analysis, development, testing, and documentation that good software requires.
