title: The handwriting was on the wall.
authors.affiliation: Sheppard Pratt Health System, Maryland, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Merkle
authors.forename: John
authors.initials: J
authors.lastname: Boronow
authors.forename: David
authors.initials: D
authors.lastname: Bush
mesh_terms: D017598:Efficiency, Organizational; D006751:Hospital Information Systems; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D008396:Maryland; D016347:Medical Records Systems, Computerized; D019982:Organizational Case Studies; D009936:Organizational Innovation