Conduct a case study analysis The Electronic Medical Record: Efficient Medical Care or Disaster in the Making? Dale Buchbinder You are the Chief Information Officer (CIO) of a large health care system
CASE STUDY ANALYSIS
Based on over two decades of experience using the case study method in the classroom and in faculty workshops, we recommend that students work in teams and use the following guidelines for case studies.
• Read (or watch) the case carefully several times. The first time you read it, read it quickly, trying to pick up the high-level issues and players. In successive readings, become absorbed in the situation in such a way that you see yourself intimately involved with the personalities, problems, and conflicts.
TIP: Highlight sentences that may be important in identifying the main issue or theme of the case, as well as strike out those sentences that are “nice to know” but not critical to the issues in the case. This will help you to filter out the “noise” in the case.
• As the case starts to become more familiar to you, begin to ask yourself the following types of questions and jot down your thoughts:
1. What is really going on in this case? Generally speaking, what types of managerial issues are there (e.g., human resources, leadership, legal, confidentiality, quality control, conflict management, etc.)?
2. Can you describe in one sentence the major issue/problem? Make a list of all of the problems you can identify. Analyze this list to see if you can determine how these problems interrelate to each other. Are some problems the cause of other problems? If so, highlight the causal problems to see if a pattern develops. For example, a problem that is usually rather easy to identify is a loss of revenue, but you must dig deeper—why is there a loss of revenue? What is causing it?
• This will lead you to begin to understand the secondary, or underlying, issues. It is important to note here that you may end up with more than one “major” problem; your challenge is to identify the one that has the greatest potential to alter the situation for the better if addressed successfully.
TIP: Sketch out the relationships between your major and secondary problems in a flowchart-like manner. Apply reasoning to how and why the problems developed; always answer the question “WHY?” While we only know what the case tells us, we need to think about underlying motivators while we read. Play “devil’s advocate” to test these causal relationships to help ensure you are on the right track.
• Conduct some initial research on your identified major problem/issue. The research will likely help frame the major problem and reinforce its relationships to your potential secondary problems. For example, if the problem you have identified deals with employee supervision, research what types of things need to be considered when supervising employees (e.g., performance reviews, hiring/firing processes, related potential legal issues, discrimination and/or diversity issues, mentoring, confidentiality, etc.). Be sure to consider any potential diversity issues and the impact they may have. Only by gaining an understanding of the relevant management issues surrounding the major problem can you begin to develop potential solutions.
TIP: Utilize the academic and trade journals as the major focus of your research. Websites can only get you so far, and academic/trade journals will provide you with more in-depth and directly relevant information!
• IMPORTANT NOTE: If you are working in teams on the case study, we highly recommend you complete all of the above steps individually, and then come together as a group to compare notes. This will help to ensure you have done the best job of analyzing the case.
• Now that you have identified the major problem, decide on what management level you want to “solve” the problem from. Is the problem best addressed from a departmental perspective (e.g., supervisor, director, manager), a senior executive perspective (e.g., vice presidents), an organizational perspective (e.g., CEO, Board of Directors), or perhaps is it best dealt with from an outside perspective (e.g., consultant)? Note that in order to best make this decision, you must understand the roles and responsibilities of each of these levels as they relate to the problem, and identify the strengths and weaknesses of each approach.
• Identify at least two, but no more than three, potential alternative “solutions” to address the major problem from the management level you have selected. This is where you are being asked to “think outside of the box.” Were there possibilities not suggested by the text? How would each of these solutions improve the situation, and to what degree? Identify the strengths and weaknesses of each approach. The best choice may not be affordable; as managers we have to “satisfice,” i.e., make the best choice available at that time. Is one more cost-effective than the other(s)? Would one of them take too long to implement before experiencing the needed results? Do you have the expertise and resources to implement the solution? In developing your alternative solutions, keep in mind the strengths and weaknesses of the organization as they relate to the major problem. Having a great community reputation, for example, will likely have little bearing on whether or not you should fire the head of surgery. However, significant financial reserves may be very relevant in trying to increase access for patients in outlying areas. Remember, there is no one right or wrong solution, only better or worse solutions. The difference will be in how you analyze and present them.
• Select the best alternative solution to implement. In the step above you analyzed each potential alternative in terms of the strengths and weaknesses of each. Through this process it should have become evident which alternative has the best chance of successfully addressing the major problem. Your final challenge is to identify how and when you will know whether your proposed alternative solution worked. To do this, you must identify ways to evaluate your solution. For example, if the desired outcome of your solution is increased revenue, when will this occur, and to what degree? Increased revenue will be one of your evaluation metrics, but you will need to outline specifically what you expect to happen. A sufficient response in this example could be, “increase revenue by 5% by end of third quarter.” Note that regardless of which metrics you choose, you need to be able to measure them. At this point in the case it may be necessary to “assume” some things. For example, if a desired outcome is increased patient satisfaction, you can assume the organization already measures this and simply state your expected quantitative improvement and time-frame (e.g., “improve patient satisfaction by 10 percentage points within six months”). However, be sure to state any assumptions you are making (e.g., “We assume the organization already tracks patient satisfaction, and it is currently at 30%”).
