Discuss some of the trade-offs involved in managing health IT that are brought out in this case study. How could these trade-offs impact delivery of care? (i.e. why do they matter?) For example, centralization versus decentralization of IT management and support? Build versus buy decisions? Allowing physicians to override EMR workflow, alerts, or protocols in an EMR versus requiring clinicians to follow best practice or evidenced-based standards. What else did you note?
Compare the IT organizational chart for the BIDMC to the examples discussed in our text. Discuss difference and similarities. How typical is the focus or custom in-house development at BIDMC? Why did BIDMC elect to take this approach? How does the focus on in-house development influence the organization of IT at BIDMC?
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