For these reasons, too, all stakeholders must be on the same page, so for instance Markson's group had to wait for consensus from a certain department before building the software but this consensus resulted in a much safer, more standardized process.

3. Unique challenges that face this company. Are they different from challenges in other environments?

Challenges to this company might have been unique in that their IT system was homegrown and customized for their particular hospital environment. In this way, they had challenges that other companies may not have had, such as having to know when to halt implementation and which software packages to install.

On the other hand, even though they employed a vender for only a short time, they did not run the risks of security and infiltration in database that another company may have had. Possibly, too, devotion of their team may be ascribed to the fact that their system was home-grown.

4. Some of the key systems and IT initiatives that I would recommend to company

I would recommend tools that will improve the services that physicians and other health-care workers (including the nurses) are providing. Updated technology may include video conferencing, electronic records storage and informational webinars as well as forums, blogs, and a confidential system where patients and employees can drop opinions and recommendations for change. The hospital may also implement a means of keeping in touch with the public, and another system that would serve as its research base for conducting research on the hospital itself (e.g. surveys to monitor popularity of doctors or average wait time of patients for appointments). There may also be an outreach, education, and marketing guide,...

Meaningful use, privacy, and security should be the buzzwords of implementation of these programs.
5. Which initiatives make sense? What would I add?

The coop/internship program that was implemented to recruit and train new talent is a good idea as is their plan of medication reconciliation, which compares patient-reported data of prescribed medication to the list in the OMR. Another idea was to use RFID tags for all patients and employees, as well as to bar-code inpatient drugs. This would allow for the development of an electronic medication administration record. There were programs in the offing that would make it easier for Beth Israel to cooperate with external partners and third parties.

My recommendation would be a system that keeps track of casualties that occurred in the hospital as well as hospital's actions to preventing those problems. I might specially center on problems that are crucial and prominent in health care such as CLABSI (central line-associated blood stream infection). Here, I would accumulate data such as demographics of incidence with CLABSI, previous clinical episodes of care and casualty with CLABSI, as well as case incidents related to other health care institutions. Aside from, potentially, putting Beth Israel at the forefront of crucial research, such a database may also help them with PR, as well as attract clients to their system, and aid their fun-raising activities in this particular matter.