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LMH has implemented Phase 1an enterprise-wide EHR system developed by Cerner Corporation at a cost of $20 million. Phase 2 of the project is to

"LMH has implemented Phase 1an enterprise-wide EHR system developed by Cerner Corporation at a cost of $20 million. Phase 2 of the project is to implement a new CPOE with decision-support capabilities. This phase was to have been completed previously but has been delayed because of the many challenges associated with Phase 1, which still must be stabilized and optimized. LMH does have a fully automated pharmacy information system, albeit older technology, and Pyxis medication-dispensing systems on all units in the acute-care hospitals. Computerized discharge prescriptions and instructions are available only for patients seen and discharged from the LMH emergency departments. Currently, the pharmacy and nursing staff members at LMH have been working closely on the selection of a smart IV pump to replace all of the health system's aging pumps and have put forth a proposal to spend $4.9 million in the next fiscal year. Smart pumps have been shown to significantly reduce medication administration errors, thus reducing patient harm. This expenditure would consume roughly half of all of the available capital dollars for that fiscal year. The CIO, Marilyn Chen, understands the pharmacists' and nurses' desire to purchase smart IV pumps but believes the implementation of this technology should not be considered in isolation. She sees the smart pumps as one facet of an overall medication management capital purchase and patient safety strategic plan. Marilyn Chen suggests that the pharmacy and nursing leadership team lead a medication management strategic planning process and evaluate a suite of available technologies that taken together could optimize medication safety (for example, CPOE, electronic medication administration records [e-mar], robots, automated pharmacy systems, bar coding, computerized discharge prescriptions and instructions, and smart IV pumps), the costs associated with implementing these technologies, and the organization's readiness to embrace these technologies. Paul Robinson, the director of pharmacy, appreciates Marilyn Chen's suggestion but feels that smart IV pumps are critical to patient safety and that LMH doesn't have time to go through a long, drawn-out planning process that could take years to implement and the process of gaining board support. Others argue that all new proposals should be placed on hold until CPOE is up and running. They argue that there are too many other pressing issues at hand to invest in yet another new technology."

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"Marilyn Chen, CIO, and Paul Robinson, director of pharmacy, have different views of how LMH should proceed. What are the pros and cons of their respective approaches? Which approach, if either, seems like an appropriate course of action to you? Explain your rationale."

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