CareGroup

CareGroup was a team of health-care professionals dedicated to providing the best quality care to patients in a highly personalised manner. 

• world renowned academic health centers 
• outstanding community hospitals
• physician offices
• community health centres

October 1, 1996

• CareGroup was formed (merger of The Beth Israel Hospital, the Deconess Hospital and the Mount Auburn Hospital)
• produced $1.6 billion in revenue after merger
• reasons to merge was due to the intense compeititive environment in the Healthcare industry in the mid-1990s
• The hospitals felt that they need to bulk-up negotiating power to push back against the HMO(individual patients and employees and hospitals and patients)*
• HMO is also under great financial pressure from various Banks
• aim to drive down medical costs

The factors that brought CareGroup together

• contacting power needed by the hospitals against the HMOs(increase in size, increase in negotiation and contacting power)
• the possibility of developing integrated services across the hospitals(the hospitals exchanges knowledge with each other and can conclude the most effective methods of healthcare in terms of quality and costs. Thus improves quality of services and drives down costs.)
• The need for a strong balanced sheet in a complex price war(maintain competitveness)

Quick note on the parade state: 

CareGroup has currently 13,000 employees and 2000 medical staff

::Food for thought:: With such a wide scope in their business, how are they going to cope with all the data required? 

My opinions: There is a need for a good IT System to manage the Human Resource side at least. There is a large number of employees in this CareGroup and there is a need to monitor their statuses, and payrolls etc. It is an uphill task if all these are to be done manually, because of the large number of employees. 


Dealing with Issues:
There were alot of financial pressure faced by the CareGroup under two CEOs. 

1. Mount Auburn Hospital - the most profitable hospital for the past 15 years suddenly produced a $10 million loss,and had to reengineer its operations
2. While salvaging MAH, Beth Israe Deaconess began to lose significant amounts of money. 
3. Mid 2002, a change of CEO, he did recover abit, however, Baptist Hospital suddenly incurred a $20 million loss, thus there was a change of new management

However as time passes, each hospital was managed by a different CEO, and financial stability issues went negligent. 

1. Operational coordination across hospitals were difficult (due to history of independence)
2. However, the joint contracting with the HMOs had been very successful(Good)
3. There is an unexpected success in the development of an integrated technology system that linked the entire group together.

Food for thought: It was great that they actually developed an integrated technology system which helps the organisation to work more efficiently. The unexpected success will probably lead to more revenues for this company. 

One of the business processes : IT support by CareGroup

It is able to deliver ample IT support to the hospitals associated with them. This helps to deliver a greater efficiency to the Healthcare hospitals in general and also generate more revenue. Instead of focusing on it's primary job scope, Healthcare, CareGroup actually expanded its scope on IT side. 

November 1, 1998 

CareGroup was given a $41 million project to deal with the Y2K problem. 

Halamka became CIO of CareGroup. Halamka is a talent. 

• Developed a software company at an age of 18
• well educated
• headed a group of 50 data analysts and Wed soecialists developing Web applications for CareGroup

Therefore, with Halamka taking over as CIO, it actually serves as an asset to the company. It can greater enhance the company's already good IT System. 

CareGroup IT

Before Halamka took over: 

• IT organisation was decentralised, nonstandardised operation
• each hospital ran its own system that predated the merger
• complicated computer systems
• antiquated lab system with hand typed results
• 10 yr old homegrown system with non integrated lab and radiology systems
• problematic lab system
• self developed payroll system
• failed operating room system installation
• limited network incapable of remote access

After Halamka take over:

• Common system with Meditech software at the centre
• all had state-of-the-art email, networking, PCs, and clinical/financial informations at costs similar or reduced.
• drop in IT budget(there isnt a need for this budget)
• believed to have the most advanced network in healthcare
• all applications Web enabled - able to access patient's personal health records, X-rays, and records of office visits for the past decade
• three backup generation, tried and tested with lightsout - did not suffer and data outage

Pros:

It made the whole network more organised

Consolidating of data is much easier

Obtaining information of individual patients were much faster and easier

Increased productivity

Increased efficiency

Drop in cost

Cater for larger needs

Cons:

Should there be any crop ups, there are no ready instant information at hand for backups. 

(to add on)

Boxes

HP/Compaq were initial suppliers

Chaned to IBM because they offered better deals

more efficient IT

Outsourcing

CareGroup outsourced their Logistics to PeopleSoft.

- Handle HR, payroll, accountspayable and other logistics 

2002, Halamka suggests modernising the network

wrong decision as there was a significant impact and thus lead to his departure.

CareGroup 

had managed to cut capital budget expenditures by 90%, within 3 years from 2003.

• recognised to provide the best knowledge management service in the United States BUT

13 November, 2002

NETWORK COLLAPSED

why?

• something happened to the monopolised switch
• important part of the network
• algorithms for computing alternative data paths could not operate correctly

Areas affected

• physicians who are accustomed to using technology to prescribe and identify drugs had to do it manually
• doctors, nurses, employees are too dependent on network, had quite abit of problems using paper and write

Despite many recoveries, there network stability remains, failures continued to occur

Outsourced to CISCO

to help solve the problems.

Why CISCO?

They had adequate equpiments ad team to build an entire core network to get CareGroup systems up and running again. 

• CAP Process
• there were flaws

Decision to remain on Backup Procedures