Implementing a Telemedicine Solution – Grand Hospital Case Study

A Synopsis Of The Grand Hospital Implementing A Telemedicine Solution Case Study

Grand Hospital is a medium sized not for profit community health care facility that is located in Midwestern state countryside. The facility offers both inpatient and outpatient services and has a 209 bed capacity.Grand hospital employs approximately 1,600 individuals paid personnel and also relies heavily on volunteers. The hospital currently utilizes Picture Archiving and Communication System (PACS), & Electronic Health Records (EHRs) and is looking for potential application ofTeleradiology, Telepsychology, and Tele-ICU program.

Ways in which Grand’s early adoption of other health care information system technologies might affect the adoption of telemedicine solutions

Easier training.It is easier to train staff working in a facility that has already existing health care information systems in place than it is training employees of a facility that has no prior history of information technology use. Information technology has evolved significantly over the past decade and employees who do not have background knowledge might find it challenging to learn and adopt complex technology such as the one used in most telemedicine solution systems (Menachemi, Burke & Ayers, 2004). Having prior experience on conducting similar training will help in preparation of effective training sessions hence making the adoption process move smoother than it would have if the facility did not use Information technology previously.

Resistant staff.Just like it is the case with other technology related innovations, the end users have to embrace the technology for innovation process to be successful(Croteau&Vieru, 2002). If the end users feel threatened and uncomfortable with the technology, they are less likely to use it. Employees who are in an organization that already employs technology are less likely to feel threatened by the introduction of telemedicine solutions as compared to those in organizations that have no history of using such technology(Croteau&Vieru, 2002). The level of success of an innovation process is directly proportional to the level of acceptance hence the by adopting other health care information system technologies, Grand will be opening up the way for telemedicine solutions.

Barriers to the success of telemedicine in the areas of radiology, behavioral health, and intensive care

Telemedicine is increasingly taking an essential position in healthcare delivery. However, there are still a number of key barriers that continue to limit its widespread adoption. They include:

Legal requirements. One of themajor benefits of telemedicine is its ability to allow physicians to consult with their clients remotely, even across states(Menachemi, Burke & Ayers, 2004). However, physician is not allowed to legally practice across states unless he/she holds a medical license from all the states he/she intends to practice. The process of obtaining an interstate medical license is complicated, time consuming andan expensive venture thus representing a major challenge. Furthermore, all the physicians who are authorized to use telemedicine need to be accredited. This is also a cumbersome process (Croteau&Vieru, 2002). These two legal requirements leave most physicians and volunteers unable to use telemedicine solutions hence leaving only a limited number of healthcare providers who can use telemedicine.

Financial issues. Another huge barrier for telemedicine is the inadequacy of capital expenditure. Like the case with physician licensing issue, reimbursement methods vary from state to with each state employing its own by-law for private payers or not having any regulations at all.  Mid western state is not among the twelve states that have policies regulating private payer compensations for telemedicine. In addition, the government payers also have restrictions. For instance, Medicare and Medicaid are only allowed to compensate if the telemedicine is to be used in a non-metropolitan region that meets the criteria that was set under consultation codes, 2010 (Antoniotti, Drude & Rowe, 2014).  Lastly, there is no uniformity for telemedicine compensation making it undependable. Issues such as who reimburses for telemedicine remain unaddressed leaving the burden to the hospitals. These factors have largely contributed telemedicine poor adoption (Croteau & Vieru, 2002).

Which of these areas do you think would be the easiest to transition into telemedicine? Which would be the hardest? Why?

Easiest is Radiology. This is because the already existing X-ray system employs technology thus giving employees technology experience that will be useful in telemedicine adoption. Furthermore, the organization has most of the requirements, such as computers and laptops and Internet, already in place. Hardest would be Intensive care. This area of care is labor intensive and therefore would be affected by the barriers of telemedicine adoption including insufficient staff and inadequate finances.

The first steps of introducing telemedicine to the facility

Establishing a strategic plan. The plan will include mission statement, vision statement and strategic goals.  Having a clear plan would be the first step in order to ensure that the team working on the project understands what is to be achieved and how it is to be achieved the vision will also help them understand how the telemedicine program adds to the organization’s overall vision (Schroeder, Van de Ven, Scudder & Polley, 1986).

Building a Long Term Financial Plan Even though financial concerns are not the principal to the program, a solid justification of the project is still critical (Schroeder, e.t al., 1986). A thorough analysis would be conducted to ensure that the project is viable in order to boost chances of future funding and support.

Finding the best vendor for the facilities information system. Finding a good vendor is crucial for the success of the project. This is the most time consuming process and it could run into weeks or months (Schroeder, e.t al., 1986). Since getting the vendor who will deliver the best quality at the best price is the key, different vendors will be invited to bid, after close scrutiny, the best one will be awarded the job.

The process would involve the CEO of the organization, 3 physicians, 3 radiologists, 3 psychiatrists, 3 nurses, and the facility manager. Including these people in the committee will ensure that every department is represented and each department’s views, needs and concerned aired on time (Schroeder, e.t al., 1986).

Over the past two decades, the informatics community has made significant progress in evolving the health and Information Technology systematic approach (Menachemi, Burke & Ayers, 2004). These efforts have paid off with commendable achievements like the machine-level communications infrastructures, which have formed the foundation for the establishment of electronic health records and clinical evaluation support systems. These achievements are vital milestones for the regularization and the development of telemedicine applications.

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