We have already shown how IT can transform organizations and industries when used in strategic applications. Examples in this chapter, plus our earlier discussions of the securities and airline industries, demonstrate the power of modem information technology to change businesses. As technology becomes integrated with strategy, the nature of business changes. Baxter Laboratories spun off Allegiance, a firm dedicated to providing hospital supplies and to helping hospitals manage their costs through information technology. A few years later, Cardinal Health Care bought Allegiance ! Rosenbluth Travel, a firm discussed in this chapter, changed its focus from providing bookings and tickets to helping a company manage its travel costs through the creative use of technology. Technology and strategy are responsible for major changes in the structure and operations of the organization . A recent poll of more than 200 executives showed that they feel information technology is key to a competitive advantage. However, 52 percent of these managers also feel that they are not getting their money's worth from the technology. Andersen Consulting conducted the study, which involved chief executives, chief operating officers, and chief financial officers representing companies with annual sales ranging from $250 million to $20 billion. This chapter discusses how technology can be used to gain a strategic, competitive advantage. We believe that many of the problems expressed by the executives in the survey just mentioned come from their failure to actively manage IT in the firm. After we disc uss IT and strategy, we present some ideas on how you should manage technology so that it can contribute to corporate strategy.

Serious medication errors are common in hospitals and often occur during order transcription or administration of medication. To help prevent such errors, technology has been developed to verify medications by incorporating bar-code verification technology within an electronic medication-administration system (bar-code eMAR). We conducted a before-and-after, quasi-experimental study in an academic medical center that was implementing the bar-code eMAR. We assessed rates of errors in order transcription and medication administration on units before and after implementation of the bar-code eMAR. Errors that involved early or late administration of medications were classified as timing errors and all others as nontiming errors. Two clinicians reviewed the errors to determine their potential to harm patients and classified those that could be harmful as potential adverse drug events. We observed 14,041 medication administrations and reviewed 3082 order transcriptions. Observers noted 776 nontiming errors in medication administration on units that did not use the bar-code eMAR (an 11.5% error rate) versus 495 such errors on units that did use it (a 6.8% error rate) — a 41.4% relative reduction in errors (P<0.001). The rate of potential adverse drug events (other than those associated with timing errors) fell from 3.1% without the use of the bar-code eMAR to 1.6% with its use, representing a 50.8% relative reduction (P<0.001). The rate of timing errors in medication administration fell by 27.3% (P<0.001), but the rate of potential adverse drug events associated with timing errors did not change significantly. Transcription errors occurred at a rate of 6.1% on units that did not use the barcode eMAR but were completely eliminated on units that did use it.