Case Summary: CareGroup Submitted By: Group F Ankush Saraff Gaurav Thakur Joybrata Roy Manbir Singh Tandon Nitish Sanadhya PallviGoyal
Case Summary: CareGroup The case CareGroup describes an interesting incident of how the health-care company CareGroups leading information technology (IT) systems had completely collapsed for around three and half days, what actions they took to recover, and how the hospitals temporary paper based system worked well. The author also summarized the lessons learned from this incident. CareGroup Overview CareGroup, formed in 1996 from the three way merger of loss making hospitals, offered a broad spectrum of health services and specialty services. The major driving forces behind this merger were intense competitive environment in the health sector, possibility to develop integrated services to improve quality while driving down cost and need for strong balance sheet in complex price war. The hospitals involved in the merger had experienced recent losses under their own separate management and the merger brought financial stability, operational coordination and central leadership. The merger was very successful as it became the second largest group of hospital with revenues of around 1.6 billion. One of the major factors in its success was the development of an integrated technology system to connect the entire group. It has not only reduced the ill-impacts of decentralization and nonstandardized operations, but also become one of the most advanced IT in health sector by the end of 2002. Its capital budget has also been reduced dras tically. They had the most advanced email system, voice/wireless system, data center and web infrastructure. Most of the work including personal health records, X-ray records, records of visits, X-ray reports, prescriptions, emergency department functionsetc was there in the PC. IT became the fundamental to the hospital operations. As the impact of IT infrastructure increased and push for paperless work environment continued, the dependence on IT infrastructure also increased. That is why they had a lot of difficulty when their IT infrastructure went down for three and half days. Network collapse By the end of the year, a problem came up which forced members of the major hospitals to revert to the backup systems designed. On November 13, due to negligence of a researcher, the whole IT infrastructure of CareGroup went down. The experimental application which had been left unmonitored in production environment led to the network failure. The CIO immediately arranged resources to minimize the effect and get the system operational. But when it did not work well, they called Cisco team due to which ultimately the system was in place. The Cisco team assigned it a cap status meaning that they are the ones who are going to freeze all changes and whole responsibility is now delegated to them. They were able to recover the services but it was evident that network instability remained and failures were continuing to occur
One of the major decisions taken by CIO was to remain on backup procedures till it is confirmed that the working of system is completely fine. It was clear that the frequent switching between backup and standard processes carried more potential risk to patient care than remaining on backup processes for a more prolonged period.Various other measures taken during this phase includes paper documentation, establishment of command center, briefing sessions, runners system etc. The computer network was restored on November 18, but processes were transitioned back to computer-based formats gradually and in staggered fashion. Paper-based systems were retired only after information systems in each area had functioned continuously. Although there were lots of challenges and travails involved in the process but in the end the paperbased systems and recovery efforts had worked well. Care to some patients had been delayed, but not a single adverse event related to the outage had been reported. Lessons learned Although the system was in place and the work has been restored to its previous position, but to avoid any such incident to occur in future, Mr. Halamka(CIO of CareGroup) has pointed out certain key lessons that he, his staff, and the CareGroup management team had extracted from the experience by this incident. The most important lesson learnt was that although IT was good enough resource, but total dependence on it can sometimes be detrim ental for organization. Other major lessons learned: y
There should be some backup procedure which is effective enough to operate for a prolonged period in case of any emergency.
y
Experimentation
with the existing IT resources should be monitored properly.
y
Need to maintain a robust technology infrastructure.
y
There needs to be constant monitoring of the outside environment in order to assess its possible impact of IT infrastructure. Proper channel should be there by which any changes to the network can occur.
y
Need to balance customer-centricity with the risks to the network and IT systems posed by requests to support new technologies.
y
Network components should be replaced every four years.
