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© 2016 Laureate Education, Inc. Page 1 of 2

Final Project Scenarios

Long-Term Care

Bethany Place is a 40-bed independent long-term care facility in the Pacific
Northwest. They have existed for over 50 years having come from a faith-based
background. With good investments and sound financial management, Bethany
place has grown and is executing a capital strategic plan. They are expanding
their 40-bed facility to purchase a nearby resident facility and expand into
rehabilitative care, adding another 30 beds. They are approximately six months
away from receiving the appropriate certificates and regulatory approvals as a
rehabilitative care facility for both chronic care patients and recovery of acute
head injury.

The rehabilitation facility and renovations to the independent long-term care
facility are scheduled to begin in the next six months and be executed over an
18-month period. Currently Bethany place has no electronic medical record.
There is a third-party service that is used to scan and send automated claims to
Medicare and private insurers. A local desktop IT services company was recently
contracted to provide managed services to Bethany place and provides the
website email and local desktop applications for staff. As part of this initiative a
robust new IT network design was implemented for both Bethany place and the
anticipated rehabilitation facility.

The lack of an electronic health record at Bethany place has created quality
issues and risk management issues particularly related to medication
reconciliation with patient transfers. The board and senior leadership have asked
the Bethany place management to evaluate information technology options in the
form of an electronic medical record, and patient management application(s) for
both Bethany place and the rehabilitation extension facility as part of executing
the strategic plan.

Critical Access Hospital Electronic Health Record

Bedford Hospital is a 25-bed hospital in rural Pennsylvania. They have recently
completed the process of being designated by CMS (Centers for Medicare and
Medicaid) a CAH (critical access hospital). Prior to this designation they were
part of a large academic health center but have since divested from that health
center. As part of that agreement their current electronic health record contract,
which is with Cerner Corporation as part of that medical center’s enterprise
agreement, will be expiring in 24 months. Currently all aspects of Cerner’s
inpatient product are implemented including documentation, orders, decision
support and electronic meds administration. Cerner’s registration admissions
discharge scheduling and patient identification products are also part of this
agreement as are the laboratory radiology and pharmacy systems.

© 2016 Laureate Education, Inc. Page 2 of 2

While Bedford Hospital was part of the academic center the Cerner product suite
was financially supported as part of the overall corporate structure. As part of the
divestiture agreement, the academic center has agreed to support Bedford’s
Cerner systems in total for a 24-month period, absorbing the Cerner software
and enterprise hardware costs in that timeframe. Bedford Hospital is taking
financial responsibility for three IT staff and day-to-day IT costs such as networks
devices email and Internet costs. The CEO and CFO of Bedford Hospital have
pulled together an interdisciplinary team to examine the technology options for
Bedford Hospital after this 24-month period.

Telemedicine for Rural-Based Health Facility

Canon hospital is a 189-bed hospital in rural Texas. The hospital is
approximately 100 miles and 150 miles away from two major medical centers of
excellence in Texas. As the CIO of Canon Hospital, you are aware that there are
capabilities to do telemedicine programs with tertiary care centers. Two of the
senior medical staff in the critical care and neurology departments at Canon
Hospital have approached you to investigate telemedicine capabilities related to
the management of ICU patients and the emergency management of patients
presenting with stroke symptoms.

These medical leaders would like to ideally preserve the appropriate services for
ICU patients and rehabilitative services for stroke patients in the canon hospital
community. They recognize that portions of these treatment plans must include
certified critical care and stroke certified providers from a tertiary care center.
They have ask you to examine both the business and technical aspects of
establishing telemedicine programs with one or two of the tertiary care centers
who have certified specialists in critical care and stroke certified physicians who
can administer TPA and other urgent stroke treatments.

Currently Canon hospital is transferring over half of the ICU patients and virtually
all of the patients who are presenting with stroke symptoms to these to either of
these tertiary centers. There is little to no follow up on those patients with regard
to treatment plans or services. In many cases, patients and caregivers are
relocated for step down and rehabilitative care to facilities outside of the Canon
hospital area. This creates both high level of dissatisfaction for patients and
families and revenue loss for canon hospital and its associated rehabilitation