¶ … Telemedicine Solution Located in a rural region of the Midwestern United States, Grand Hospital is a relatively small yet well-staffed medical center comprised of 209 beds, serving a diverse geographic community. Grand Hospital is a community non-for-profit that offers a broad range of services, ranging from inpatient and outpatient services, employing approximately 1,600 individuals with the majority being full-time employees (1,250 employees) and 225 practitioners. Grand Hospital runs on an operating budget that often exceeds $130M and has a net asset base of $150M. It is also well managed from a financial standpoint, earning an A credit rating from Moody's, Standard & Poor's, and Fitch Ratings. Despite the rural location the hospital has over 100 comparable medical facilities within a close geographic proximity. At present, Grand Hospital is serving the needs of approximately 11,000 inpatients and 160,000 outpatients, managing to also address more than 36% of the primary service area's consumption for hospital services. Grand Hospital is also financing an expansion to service the community more responsively as well, with $57M currently budged for construction and renovation projects. Given the density of competition in their core market, Grand Hospital is also struggling to find qualified physicians for the increasingly large workload they are facing. All of these factors are contributing to a greater need for managing their information systems more effectively than before. The current IT systems structure includes the following: patient registration and revenue management; electronic medical record with computerized physician order entry; imaging via a PACS; laboratory management and pharmacy management. The potential for telemedicine to transform the Grand Hospital and make it more effective at anticipating and meeting patients' needs is clear with how diverse, distributed and disparate the systems are today. Transitioning...

What are the ways in which Grand's early adoption of other health care information system technologies might affect its adoption of telemedicine solutions?
There's going to be both strengths and weaknesses that Grand Hospital experiences as they move from traditional on premise health care information technologies to telemedicine solutions. The technological strengths of having already created a unified architecture to support the several systems today running in the hospital as defined in the introduction is a nascent or emerging strength. On premise and legacy systems often create a series of useful information taxonomies that can be used for better data management and the extrapolation of reporting requirements beyond the current limitations of often decades-old system architectures (Josey, Gustke, 1999). An added benefit of already having implemented healthcare information systems technologies is that Grand Hospital is already staffed with a team of experienced IT professionals who are accustomed to aligning IT systems to the unique requirements of the internal staff, physicians, administrators and changing patient needs. A third benefit of already having existing healthcare information technologies in place is the flexibility it gives the Grand Hospital in changing out the most obsolete and antiquated systems they had been relying on to this point. Finally the entire concept of having a cloud-based system that is capable of managing the diverse information needs of the hospital. The compliance and security requirements will continually be an issue and the selection of telemedicine providers will also…