Written in APA format. Must have a Title page, Abstract, use of Level I and II headings, a Conclusion section, and a References page. Use the template provided. Length 3-5pgs excluding Title, abstract, and reference pages.

Background Information:

Grand Hospital is located in a somewhat rural area of the midwest.It is a 209-bed, community, not-for-profit entity offering a broad rangeof inpatient and outpatient services, employing approximately 1,600individuals (1,250 full-time equivalent personnel) and having a medicalstaff of more than 225 practitioners. Grand has an annual operatingbudget that exceeds $130 million, possesses net assets of more than $150million, and is one of only a small number of organizations in thismarket with an A credit rating from Moody’s, Standard & Poor’s andFitch Ratings. Operating in a remarkably competitive market (there areroughly 100 hospitals within seventy-five minutes’ driving time ofGrand), the organization is one of the few in the region – proprietaryor not-for-profit – that have consistently realized positive operatingmargins. Grand attends on an annual basis to the healthcare needs ofmore than 11,000 inpatients and 160,000 outpatients, addressing morethan 36 percent of its primary service area’s consumption of hospitalservices. In expansion mode and currently in the midst of $57 million inconstruction and renovation projects, the hospital is struggling torecruit physicians, both to meet the heawlthcare needs of the expandingpopulation of the service area and to succeed retiring physicians.

Grand has been an early adopter of healthcare information systemsand currently employs a robust, proprietary healthcare informationsystem that provides the following (among other components):

• Patient registration and revenue management
• Electronic health records with computerized physician order entry
• Imaging via a PACS
• Laboratory management
• Pharmacy management

Information Systems Challenge:

Since 1995, Grand Hospital has transitioned from being aninstitution that consistently received many more inquiries than could beaccommodated concerning physician practice opportunities, to a hospitalat which the average age of the medical staff has increased by eightyears. There is a widespread perception among physicians that because ofsuch factors as high malpractice insurance costs, an absence ofsubstantive tort reform, and the comparatively unfavorable rates ofreimbursement being paid physician specialists by the region’s majorhealth insurer, this region constitutes a “physician unfriendly” venuein which to establish a practice. Consequently, a need exists for Grandto investigate and evaluate creative approaches to enhancing itsphysician coverage for certain specialty services. These potentialapproaches include the effective implementation of informationtechnology solutions.

The findings and conclusions of a medical staff development plan,which has been endorsed and accepted by Grand’s medical executivecommittee and board of trustees, have indicated that because of theneeds and circumstances specific to the institution, the first areas ofmedical practice on which Grand should focus in approaching thischallenge are radiology, behavioral health crisis intervention services,and intensive care physician services. In the area of radiology, Grandneeds qualified and appropriately credentialed radiologists available tointerpret studies 24 hours per day, 7 days per week. Similarly, itneeds qualified and voluntary medical staff to attend to the needs ofpatients admitted by staff members such as some ED personnel. It alsoneeds to have intensive care physicians available around the clock toassist in assessing and treating patients during times when members ofthe voluntary attending staff are not present within or immediatelyavailable to the intensive care unit.

The leadership at Grand Hospital is investigating the potentialapplication of telemedicine technologies to address the organization’sneed for enhanced physician coverage in radiology, behavioral health andcritical care medicine.

Discussion Questions:

1. What do you see as the most likely barriers to the success oftelemedicine in the areas of radiology, behavioral health and intensivecare? Which of these areas do you think would be the easiest totransition into telemedicine? Which would be the hardest? Why?

2. If you were charged by Grand to bring telemedicine to thefacility within eighteen months, what are the first steps you wouldtake? Whom would you involve in the planning process and why?

3. How would you go about conducting a needs assessment for theorganization? Which parameters or system requirements would be mostimportant to include in the needs assessment and why?