The case:

The Cabbagetown Medical Services Group (CMSG) is a full-service heath facility serving a mixed community in downtown Toronto. Its clients are drawn from several nearby neighbourhoods and come from a wide range of socio-economic and cultural backgrounds.

CMSG operates three health-services facilities which offer primary medical care, both through appointments and in walk-in clinics; referrals to on-site and off-site medical specialists; dental care; laboratory testing; and counselling services.

Founded in 1963, CMSG maintains its records as paper files, with one file per client. It is under increasing pressure to convert to electronic files. Some of the pressure is internal:

Paper files take up a lot of space. Provincial regulations require physicians to keep files for ten years. If a client hasn't been seen for two years, the files are stored off-site, which requires that they be retrieved if needed.

CMSG has three locations. If a patient seen in one location is referred to a professional in another location, the file has to be transferred.

Newly-trained professionals expect to have access to electronic records, so using paper files has made recruitment of new employees difficult.

The Ontario government, which provides much of CMSG's revenue through OHIP, has mandated that primary-care physicians convert to electronic records.

CMSG is considering making the change. Use the balanced scorecard approach to evaluate the effects of doing this on CMSG; as part of this, think about how the effects could be monitored.

Questions:

You are a consultant . CMSG has asked you to comment on the idea of converting from paper records to electronic files. You always use the balanced scorecard approach to this kind of analysis. Consider the effects of the switch on CMSG's internal processes. What would you say to CMSG?