Care Group

Background and History CareGroup, Inc. is the parent holding company of Beth Israel Deaconess Medical Center, Beth Israel Deaconess Hospital-Milton, Beth Israel Deaconess Hospital-Needham, Mount Auburn Hospital, and New England Baptist Hospital. On October 1, 1996 three prominent hospitals (the Beth Israel Hospital, the Deaconess Hospital and the Mount Auburn Hospital) in eastern Massachusetts merged together to form this organization. The organization was formed for three key factors.

Firstly, the intense competitive environment within the industry in the mid-1990s had driven many hospitals to join forces to gain contracting power against HMOs. Secondly, there was a strong demand for hospitals to strengthen their balance sheets in a complex price war due to excess supply. Lastly, merging hospitals had the opportunity to develop integrated services that could greatly improve the quality of health care as well as cut down costs.

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Originally formed as a care-delivery system of hospitals and physicians, CareGroup has evolved into a confederation model in the past decade in which affiliates jointly borrow and purchase common services such as IT support, but otherwise operate on a largely decentralized basis while still sharing a commitment to quality and patient safety. In 2012, Thomson Reuters recently named CareGroup as one of the five best large health systems in the United States, for the second year in a row. Although the road to success had been bumpy the company had produced $1.

6 billion in revenue and became the second-largest group of hospitals in eastern Massachusetts. One of the biggest achievements had been the development of an integrated IT system that linked the entire organization together. Issues and Analysis The case describes the circumstances leading to the four day collapse of a major hospital group’s IS capabilities. It talks about the technical reason for the failure, management steps in dealing with the problems and also the short term and long term lessons the organization learned from the incident. So what went wrong?

– In November 2002, a researcher in CareGroup was experimenting with a file sharing application. Upon finding that his wife was in labor, he suddenly left with the software running in an untested state and this new application began to explore surrounding networks and copied data in large volumes, eventually moving terabytes of data across the network. The entire network for CareGroup went down for four days. No one in IT department was able to identify the problem until experts from Cisco were called in. So what issues contributed to the Network Collapse?

– The overall network had high complexity- individual smaller networks had been added one at a time during the merger. The network gradually become “out of spec”. There was not an effective back- up plan for electronic downtime. Though the facilities had the forms and capabilities of operating on a paper based system but the staff were not fully trained and prepared. Networks component were not up to date. One of the network’s issue was an old model router which was over four years old and was replaced to bring the network back up.

There were no on-site experts to monitor the network. CareGroup wasted the first 24 hours attempting to diagnose and correct the problem because of no contract with a field expert. There was no second opinion- the network configuration was overseen by one single IT employee. There was also no outline for a change control process- CareGroup previously implemented large change to the network when they liked. I believe that it is impractical to believe that patient care was not affected because of the incident as mentioned in the case study.

After the crisis was over the staff was asked to report adverse clinical, twelve reports were filed; yet we don’t know the magnitude of this event. Patient complaints were reviewed but we do not have that information either. Recommendation and implementation Although the internal attempt to fix the problem did not solve the network failure, it would have been premature to call in the “Big Guns” so quickly. Since there was an existing contract for support and maintenance with Cisco, they should have been consulted from the get go.

Overall I think that this would have improved the timeline. Instituting a defensive approach to network functionality and security, along with a contingency plan to deal with failures or breaches to the system should have been in place. Without this incident, the medical center would never have realized the importance on investing in basic IT infrastructure. For this not to happen in future, an adequate IT budget meeting Benchmarks should be included in the strategic plan for the health care organization.

CareGroup needs to use Lean/Six Sigma techniques to improve IT services to better manage IT resources. They need to have an innovative system that auto-discovers the change made to an IT infrastructure constantly tracking/monitoring changes. Adequate firewalls should be installed along with antivirus software at the user end that is updated and maintained. The physical hardware of the network must be continually monitored and maintained. Establish a service desk that other service support processes can take advantage of from this single point of interface between IT providers and customers.

Develop a formal problem management process which will include- Document the problem, Filter the problem and Research the problem and outcome. Conclusion With an active and formalized problem management process, CareGroup can expect fewer problems and shorter time to recovery because all available data will be brought to bear identifying and solving those problems. It also ensures those problems are tracked well and that they feed into the organization’s change management process.

As problems are solved more quickly, the service desk will have less complaint about the same problem and productivity in other parts of organization’s operation will improve. References Lynda Applegate; Robert D. Austin; Deborah L. Soule (2009) Corporate Information Strategy and Management: Text and Cases 8/e (page322-337) http://www. computerworld. com/s/article/78803/All_systems_down? taxonomyId=83&pageNumber=5 http://www. caregroup. org/CGOverview. asp http://www. bidmc. org/About-BIDMC/Affiliates-and-Partnerships/CareGroup. aspx.


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