Chapter 17 Technology in Long-Term Care Learning Objectives 1. Identify and define potential applications of an information technology system 2. Discuss issues dealing with privacy and access to information 3. Understand how technology can benefit long-term care providers, consumers, and the system as a whole Learning Objectives (continued) 4. Identify barriers to the successful use of information technology 5. Identify and define options for acquiring and using information technology Introduction  Technology is becoming ever more important to long-term care  The ways in which technology can be used in long-term care fall into two broad categories: applied technology and health information technology (HIT) Applied Technology  Artificial functioning  Remote monitoring/telehealth  Emergency notification  Telemedicine Health Information Technology Applications:  Clinical  Administrative  Strategic support  Networking  Systemwide Clinical Applications  Admission, assessment, care planning  Consumer safety • Scheduling and tracking ancillary services  Record keeping  Quality measurement Administrative Applications  Staffing  Financial management Strategic Support Applications  Planning  Operational decision making  Performance measurement  Marketing Networking Applications  Involvement in integrated health systems  Coordination of information  Patient scheduling  Managed care contracting Systemwide Applications  Electronic health records • Automated patient records • Personal health records  Quality measurement and improvement  Consumer information and education Privacy Concerns and HIPAA  Encourages use of information technology in transactions  Protects the privacy of consumers’ health information  Creates standards governing electronic transfer of information Cyber Security  IT systems are vulnerable  More systemwide applications increase vulnerability  Information losses could be catastrophic  Need to be proactive Benefits of HIT  For the long-term care system  For providers  For consumers Barriers to Use of HIT  Lack of commitment  Lack of understanding  Financial investment  Need to upgrade old technology  Changing operational systems  Obtaining HIT expertise Options for Acquiring HIT  In-house development  Purchasing software  Outsourcing Guidelines for Selecting a Vendor 1. Analyze the business requirements 2. Conduct a vendor search 3. Request proposals and quotes 4. Evaluate vendor proposals and make a vendor selection 5. Negotiate a contract Summary Technology, particularly HIT, has become indispensable to the successful operation of long-term care organizations, and it will become even more so in the future. Slide 1Learning ObjectivesLearning Objectives (continued)IntroductionApplied TechnologyHealth Information TechnologyClinical ApplicationsAdministrative ApplicationsStrategic Sup ...

1. Chapter 17
Technology in
Long-Term Care
Learning Objectives
1. Identify and define potential applications
of an information technology system
2. Discuss issues dealing with privacy and
access to information
3. Understand how technology can benefit
long-term care providers, consumers, and
the system as a whole
Learning Objectives (continued)
4. Identify barriers to the successful use of
information technology
5. Identify and define options for acquiring
and using information technology
Introduction

2. important to long-term care
used in long-term care fall into two broad
categories: applied technology and health
information technology (HIT)
Applied Technology
Health Information Technology
Applications:
e
Clinical Applications
• Scheduling and tracking ancillary

3. services
Administrative Applications
management
Strategic Support Applications
Networking Applications
health systems
Systemwide Applications

4. • Automated patient records
• Personal health records
Privacy Concerns and HIPAA
technology in transactions
health information
electronic transfer of information
Cyber Security
increase vulnerability
osses could be
catastrophic

5. Benefits of HIT
-term care system
Barriers to Use of HIT
chnology
Options for Acquiring HIT
-house development
Guidelines for Selecting a Vendor
1. Analyze the business requirements
2. Conduct a vendor search
3. Request proposals and quotes
4. Evaluate vendor proposals and
make a vendor selection
5. Negotiate a contract

6. Summary
Technology, particularly HIT, has become
indispensable to the successful operation of
long-term care organizations, and it will
become even more so in the future.
Slide 1Learning ObjectivesLearning Objectives
(continued)IntroductionApplied TechnologyHealth Information
TechnologyClinical ApplicationsAdministrative
ApplicationsStrategic Support ApplicationsNetworking
ApplicationsSystemwide ApplicationsPrivacy Concerns and
HIPAACyber SecurityBenefits of HITBarriers to Use of
HITOptions for Acquiring HITGuidelines for Selecting a
VendorSummary
Chapter 19
Into the Future:
Trends To Watch
Learning Objectives
Understand the forces that have brought the long-term care
system to its current state
Identify ways in which the challenges have been met and to
what degree
Identify challenges that have not been met

7. Learning Objectives (continued)
4.Identify changes that have been brought on by the solutions to
earlier challenges
5.Identify the trends that will affect the long-term care system
in the future
Challenges Met
Consumer desire for higher quality of life has led to new,
innovative forms of care
Integration has improved effectiveness and efficiency of care
Consumers now have much more say
in their care
Culture change movement has grown
New Challenges Created
by Old
Solution
s
Desire for cost-effectiveness helped create managed care with
improved efficiency, but it created quality and service
complaints
Integration improved services and efficiency; some providers
haven’t survived
New, consumer-friendly services have created additional
demand

8. Challenges Not Met
System is still reimbursement-driven
Accessibility is not universal
System is highly fragmented and
“user-unfriendly”
The number of elderly is growing faster than the system’s
ability to meet their needs
Trends to Watch
Changing consumer demographics
The aging of society
Increase in chronic conditions
Greater cultural and ethnic diversity
A consumer-driven system
Focus on quality and outcomes
Quality of care
Patient safety
Quality of life
More Trends to Watch
Changes in the workforce
Growth in demand

9. Aging of the workforce
Staff shortages
Blending of professional roles
Changes in organization and delivery
Toward a seamless system of care
Consumer-directed care
Technological advances
Even More Trends to Watch
More and better clinical applications
Innovative delivery methods
Special care units
Informal caregivers
New organizational relationships
Among providers
Between providers and payers
Institutional to noninstitutional care
Efficiency
Still More Trends to Watch
Changes in financing and reimbursement
Increase in overall healthcare spending
Decrease in employer-sponsored insurance

10. Public payers continue to struggle
Providers continue to struggle
Innovative financing
Public/private partnerships
Still More Trends to Watch
Ethical dilemmas
Life-and-death issues
Allocation of resources
Regulation
Health system reform
Summary
The long-term care system is constantly changing, and each
change – even if in one small segment – is soon felt throughout
the system. These changes will continue and will present both
challenges and opportunities for all involved.
Long-Term Care: Managing Across the Continuum, Fourth

11. Edition
John R. Pratt
CHAPTER NINETEEN: INTO THE FUTURE: TRENDS TO
WATCH
CHAPTER HIGHLIGHTS
Introduction - the field of long-term care has gone through, and
is still experiencing, a time of
great change.
appropriate setting and the desire
for a high quality of life have led to development of more and
better alternative
services.
ional care providers have done much to make their
facilities more homelike

12. and conducive to a high quality of life.
care is delivered, the cost
of delivering it, and the way it is used by consumers.
say in their care.
-
supporting the creation of
environments where residents and their caregivers are able to
express choice and
practice self-determination in meaningful ways at every level of
daily life.
health care expenses

13. beyond their ability to cover, they found relief in the form of
managed care.
-term care system
with other problems:
-
effectiveness while trying
to maintain high quality.
© 2015 Jones and Bartlett Publishers, LLC 1
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
organizations (MCOs) put
cost savings ahead of choice or quality.
positive step overall, but it

14. has been fatal for some
providers.
resolution.
-term care system is still essentially reimbursement
driven.
reimbursement available.
pay for it.
-term care services continue
to be areas of
shortcoming.

15. Future Directions - where the system is likely going and why.
- the demographics of
long-term care consumers
have been changing faster than the system has been able to
adjust.
influence on the system for
years to come.
million by the
year 2030 – nearly twice what it is today.
fold.
continue to do so.

16. © 2015 Jones and Bartlett Publishers, LLC 2
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
of the medical care
they have received.
young adults have
been effectively eradicated.
– heart disease and
cancer – have
declined.

17. lifestyles.
aging of the baby
boomers
significant than any
other population cohort seen to date.
system and
learning how to use it wisely.
ct of the aging of society on long-term care, will be
twofold.
long-term care
services.

18. significantly more
than at present.
-term care may be needed for many years.
ages.
ve one or more chronic
conditions.
© 2015 Jones and Bartlett Publishers, LLC 3
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt

19. dramatically with age.
be an increase in “new” diseases – actually,
existing diseases with new
prominence: Alzheimer’s disease, macular degeneration,
osteoarthritis,
osteoporosis, dementia, cardiovascular disease, and diabetes.
- long-term care consumers
are also changing in
terms of their cultural, racial and ethnic backgrounds.
and some unfamiliar
diseases.
be
more sensitive to
different cultural practices.

20. as polio and tuberculosis,
have begun to appear as people emigrated from other parts of
the world.
-Driven System - the most important descriptor
of the future health care
system is that it will be a system that is consumer-driven.
care they receive and in
how their dollars are spent.
be better educated and informed
than those of the recent
past.

21. more conscious that
they are paying for their care, either directly or indirectl y,
consumers will want the
ability to shop around.
© 2015 Jones and Bartlett Publishers, LLC 4
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
many years will want to
continue those lifestyles as much as possible in their later years.
particular lifestyles, even
extending to alternative medicine and self-care.

22. ed to accommodate their desires.
Focus on Quality and Outcomes - consumers of long-term care
are learning how to judge
quality as it pertains to them and will continue to as they
become better informed. They will
judge the system and its providers by how they are affected.
- Quality concerns fall into three distinct but related
categories:
– consumers are concerned about the quality
of care they receive.
across the U.S.
raises concerns.
about the effects of

23. cost-cutting cause consumers to have their doubts about quality
of care.
ty - patient safety will assume new prominence,
both in acute care and in
long-term care.
they will become less
and less forgiving of clinical errors or lapses in care.
nue to insist on fewer errors.
which can help them
collect and manage relevant information to avoid errors.
© 2015 Jones and Bartlett Publishers, LLC 5
Long-Term Care: Managing Across the Continuum, Fourth

24. Edition
John R. Pratt
including requiring that
all skilled nursing facilities have sprinklers as part of their fire
prevention and
control systems.
-term care – at least newly realized –
has come about
because of the damage caused in recent years by hurricanes such
as Katrina and
Rita.
- Quality of life will assume a high priority
with tomorrow’s long-
term care consumers.
hey want care that is either provided in their homes or in

25. surroundings and in a
manner that is as close to home as possible.
ala carte menus,
home-like living settings, and flexible treatment regimens.
remote monitoring
and safety call systems that allow more of them to actually stay
in their homes.
look around until
they find it.
Outcomes - Payers and regulators are beginning to understand
outcomes measurement and
will rely on it more in the future.

26. structure, not outcomes. Both
government regulators and private accreditation agencies are
moving toward outcomes-
based quality measurement systems
© 2015 Jones and Bartlett Publishers, LLC 6
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
from judging how care is delivered
to assessing it based on
what it accomplishes.
Changes in the Workforce - The long-term care workforce will
change dramatically in the
future. The trends to watch in relation to the workforce are:

27. d - Health care (including long-term care) is
already one of the largest
and fastest-growing occupations.
- The workforce is getting older,
paralleling the aging of society
in general.
hat is the largest age
cohort we have.
-baby boomers are a smaller group, providing fewer
people for the
workforce.
- we are facing a serious shortage of staff to
care for the growing number
of elderly needing care.
ending of Professional Roles - If the kind of changes in

28. organization and delivery that
are foreseen here are going to be accomplished there will have
to be some breaking down
of the artificial barriers created by health care professionals.
ans moving from the traditional medical model
toward more of a holistic
model of care.
Changes in the Organization & Delivery of Long-Term Care -
There will be many changes in
the way long-term care is organized and delivered in the future.
No single delivery system is
likely to emerge as the one best system
© 2015 Jones and Bartlett Publishers, LLC 7
Long-Term Care: Managing Across the Continuum, Fourth

29. Edition
John R. Pratt
- There is already
significant movement toward a
more seamless system of care.
stretched to the
breaking point will continue to emphasize efficiency.
care available to them
will lead to a continuum that is more user-friendly, reducing
much of the
fragmentation and confusion that exists today.
care is the melding of
what are now essentially separate systems of health care and

30. social support
services.
will depend on
advances in technology
-Directed Care - consumers of the various forms of
long-term care will
expect to direct their own care as much as possible.
–
direct their own health
care and supportive services.
- , long-term care providers
have made significant
strides toward meeting the needs of consumers for convenient,
homelike living

31. situations.
© 2015 Jones and Bartlett Publishers, LLC 8
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
Technological Advances - perhaps the most significant and
unpredictable factor in determining
the shape of health care in the future will be the continued
explosion in technology.
t to keep up with the rapid

32. changes in technology,
organized and managed.
accessible through technology.
with the use of technology.
More & Better Clinical Applications - over the next decade or
two, there will be new clinical
procedures that we cannot even begin to imagine today.
Innovative Delivery Methods - coming decades will see a
continuation and escalation of the
changes that have occurred lately in how care is delivered.
planning, and efforts to
become more consumer oriented have all improved the lot of the
consumer of long-term

33. care.
- there will be an increase in special care
units designed to treat
people needing highly specialized care.
- the long-term care system will (finally)
find ways to make
better use of informal caregivers.
New Organizational Relationships - in trying to secure their
share of a particular market, long-
term care providers will find many new and innovative ways to
deliver care.
- integrated care systems will dominate
because they will have the
ability to provide more of the seamless system of care
© 2015 Jones and Bartlett Publishers, LLC 9

34. Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
different types and levels of long-term care
services will get together
to meet consumer needs.
strategic business
units.
- providers will find new ways
to work more closely in
partnerships with payers.

35. grow.
-Institutional Care - the shift that has
been taking place from
institutional to community-based or noninstitutional care will
continue.
- we will see delivery methods that are more
efficient—that are more
responsive to the needs of consumers —without significant loss
of quality.
s will not take place easily if not properly
supported by regulators
and payers, especially the federal government.
Changes in Financing & Reimbursement - the critical role
financing plays in the delivery of
long-term care will not only continue, but will intensify.

36. - both public and
private reimbursement
sources will find it difficult to keep up.
-Sponsored Insurance – employers are
also trying to reduce
costs, particularly in the recent economic situation.
© 2015 Jones and Bartlett Publishers, LLC 10
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
– government payment
sources are also finding it
difficult to survive.

37. - due in part to the difficulties
their most significant
payer sources are having.
- the future will also bring innovations
in health care financing.
contracts will continue
and grow.
ant form of
payment for long-term care
providers.
-for-
performance initiatives

38. - the key to future financing of
the health care system may
well be public-private partnerships.
Ethical Dilemmas - both the number and scope of ethical issues
that will arise and need to be
resolved will increase.
– clinical advances have created
additional issues concerning life
and death.
onger than before
© 2015 Jones and Bartlett Publishers, LLC 11

39. Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
ders (not making
providers provide care
not in keeping with their own beliefs)
clash in values.
them fairly
financially viable in order to
meet the needs of consumers.

40. Regulation – will definitely increase.
ity
Health System Reform – the fragmented system needs reform,
primarily financing reform.
want them to run health
care
Affordable Care Act (ACA).
Only time will tell how it work out.
© 2015 Jones and Bartlett Publishers, LLC 12
CHAPTER NINETEEN: INTO THE FUTURE: TRENDS TO

41. WATCHCHAPTER HIGHLIGHTSIntroduction - the field of
long-term care has gone through, and is still experiencing, a
time of great change.Future Directions - where the system is
likely going and why.Changing Consumer Demographics - the
demographics of long-term care consumers have been changing
faster than the system has been able to adjust.The Aging of
SocietyThe growth in the number of elderly will be a driving
influence on the system for years to come.Increase in Chronic
ConditionsGreater Cultural/Ethnic Diversity - long-term care
consumers are also changing in terms of their cultural, racial
and ethnic backgrounds.A Consumer-Driven System - the most
important descriptor of the future health care system is that it
will be a system that is consumer-driven.Focus on Quality and
Outcomes - consumers of long-term care are learning how to
judge quality as it pertains to them and will continue to as they
become better informed. They will judge the system and its
providers by how they are affected.Quality - Quality concerns
fall into three distinct but related categories:Quality of Care –
consumers are concerned about the quality of care they
receive.Studies have shown that quality of care is not equitable
across the U.S.Patient Safety - patient safety will assume new
prominence, both in acute care and in long-term care.Quality of
Life - Quality of life will assume a high priority with
tomorrow’s long-term care consumers.Outcomes - Payers and
regulators are beginning to understand outcomes measurement

42. and will rely on it more in the future.They have previously
focused primarily on process and structure, not outcomes. Both
government regulators and private accreditation agencies are
moving toward outcomes-based quality measurement
systemsThey will gradually move from judging how care is
delivered to assessing it based on what it accomplishes.Changes
in the Workforce - The long-term care workforce will change
dramatically in the future. The trends to watch in relation to the
workforce are:Growth in Demand - Health care (including long-
term care) is already one of the largest and fastest-growing
occupations.Aging of the Workforce - The workforce is getting
older, paralleling the aging of society in general.Many of them
are baby boomers since that is the largest age cohort we
have.The post-baby boomers are a smaller group, providing
fewer people for the workforce.Staff Shortages - we are facing a
serious shortage of staff to care for the growing number of
elderly needing care.Blending of Professional Roles - If the
kind of changes in organization and delivery that are foreseen
here are going to be accomplished there will have to be some
breaking down of the artificial barriers created by health care
professionals.This means moving from the traditional medical
model toward more of a holistic model of care.Changes in the
Organization & Delivery of Long-Term Care - There will be
many changes in the way long-term care is organized and
delivered in the future. No single delivery system is likely to

43. emerge as the one best systemToward a Seamless System of
Care - There is already significant movement toward a more
seamless system of care.Consumer-Directed Care - consumers
of the various forms of long-term care will expect to direct their
own care as much as possible.Technological Advances - perhaps
the most significant and unpredictable factor in determining the
shape of health care in the future will be the continued
explosion in technology.More & Better Clinical Applications -
over the next decade or two, there will be new clinical
procedures that we cannot even begin to imagine
today.Innovative Delivery Methods - coming decades will see a
continuation and escalation of the changes that have occurred
lately in how care is delivered.Special Care Units - there will be
an increase in special care units designed to treat people
needing highly specialized care.Informal Caregivers - the long-
term care system will (finally) find ways to make better use of
informal caregivers.Among Providers - integrated care systems
will dominate because they will have the ability to provide more
of the seamless system of careBetween Providers and Payers -
providers will find new ways to work more closely in
partnerships with payers.Institutional to Non-Institutional Care
- the shift that has been taking place from institutional to
community-based or noninstitutional care will
continue.Efficiency - we will see delivery methods that are
more efficient—that are more responsive to the needs of

44. consumers—without significant loss of quality.Changes in
Financing & Reimbursement - the critical role financing plays
in the delivery of long-term care will not only continue, but will
intensify.Overall Spending on Health Care Increasing - both
public and private reimbursement sources will find it difficult
to keep up.Decrease in Employer-Sponsored Insurance –
employers are also trying to reduce costs, particularly in the
recent economic situation.Public Payers Continue to Struggle –
government payment sources are also finding it difficult to
survive.Providers Continue to Struggle - due in part to the
difficulties their most significant payer sources are
having.Innovative Financing - the future will also bring
innovations in health care financing.Public/Private Partnerships
- the key to future financing of the health care system may well
be public-private partnerships.Ethical Dilemmas - both the
number and scope of ethical issues that will arise and need to be
resolved will increase.Life and Death Issues – clinical advances
have created additional issues concerning life and
death.Allocation of ResourcesRegulation – will definitely
increase.Health System Reform – the fragmented system needs
reform, primarily financing reform.
Long-Term Care: Managing Across the Continuum, Fourth

45. Edition
John R. Pratt
CHAPTER SEVENTEEN: TECHNOLOGY IN LONG-TERM
CARE
CHAPTER HIGHLIGHTS
Introduction
-term
care.
-term care
fall into two broad
categories: applied technology and information technology (IT).
Applied Technology - technology has much to offer in
maintaining or improving a person’s
functional independence. In several ways, including:
– devices to provide assistance from
wheelchairs to robots.

46. –panic buttons to notify when help is
needed.
- remote monitoring of a consumer’s condition,
conferencing among
health care professionals, and consultation with specialists.
Information Technology - the application of certain types of
technology to the collection and
use of information.

47. © 2015 Jones and Bartlett Publishers, LLC 1
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
Operational Decision Making

48. lectronic Health Records
© 2015 Jones and Bartlett Publishers, LLC 2

49. Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
Privacy Concerns and the HIPAA
Portability and Accountability
Act (HIPAA) is to protect the privacy of consumers’ health
information.
HIPAA creates a set of national standards governing such
electronic transfers to protect
the privacy and confidentiality of consumers. These standards

50. cover the following areas.
e of personal medical information
Cyber Security
concerned about cyber security.
tional information could
greatly disrupt the ability to
provide high-quality care.
Benefits of IT

51. -Term Care System
© 2015 Jones and Bartlett Publishers, LLC 3
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
-term care, acute care and
home-based settings to
efficiently collect, manage and share vital information about
their clients’ medical
histories and care regimens.
se of clinical
guidelines and quality
measurement tools.

52. saves money and avoids
waste.
administrative methods.
to provide consumers with the information
they need to make care-
related decisions.
and allows them to
optimize their resources.

53. -term care facilities and
their families - helping
to reduce isolation among seniors and caregivers.
s living at home benefit by being able to access
information about
providers, services, and eligibility using the Internet.
Barriers to Use of IT
© 2015 Jones and Bartlett Publishers, LLC 4
Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
– if it is to work effectively, providers
must commit to really
using it.

54. – that commitment must be based on a
full understanding of
what IT can do and not do.
– making use of IT is not inexpensive
(but the outlay is worth it).
– most providers getting
into or maximizing use of
IT must scrap their old systems or invest in a significant
upgrade.
– operational systems must
change, not just technology,
if it is to be successful.
– most providers will need outside
assistance.
Options for Acquiring IT - providers have several options
available to them when they decide

55. to acquire new IT or upgrade existing systems:
-house system.
terminals, etc.).
to a contract firm.
Guidelines for Selecting an IT Vendor
© 2015 Jones and Bartlett Publishers, LLC 5

56. Long-Term Care: Managing Across the Continuum, Fourth
Edition
John R. Pratt
© 2015 Jones and Bartlett Publishers, LLC 6
CHAPTER SEVENTEEN: TECHNOLOGY IN LONG-TERM
CARECHAPTER HIGHLIGHTSIntroductionApplied
Technology - technology has much to offer in maintaining or
improving a person’s functional independence. In several ways,
including:Artificial Functioning – devices to provide assistance
from wheelchairs to robots.Emergency Notification –panic
buttons to notify when help is needed.Telemedicine - remote
monitoring of a consumer’s condition, conferencing among
health care professionals, and consultation with
specialists.Information Technology - the application of certain
types of technology to the collection and use of
information.Clinical Applications:Admission, Assessment, and
Care PlanningConsumer SafetyRecord KeepingQuality
MeasurementAdministrative Applications:StaffingFinancial
ManagementStrategic Support ApplicationsPlanningOperational
Decision MakingPerformance
MeasurementMarketingNetworking Applications:Systemwide
Applications:Quality Measurement and
ImprovementOSCAR RAI/MDSOASIS Consumer Information

57. and EducationPrivacy Concerns and the HIPAACyber
SecurityBenefits of ITBenefits for the Long-Term Care
SystemBenefits for ProvidersBenefits for ConsumersBarriers to
Use of ITLack of Commitment – if it is to work effectively,
providers must commit to really using it.Lack of Understanding
– that commitment must be based on a full understanding of
what IT can do and not do.Financial Investment – making use of
IT is not inexpensive (but the outlay is worth it).Need to
Upgrade Old Technology – most providers getting into or
maximizing use of IT must scrap their old systems or invest in a
significant upgrade.Changing Operational Systems – operational
systems must change, not just technology, if it is to be
successful.Obtaining IT Expertise – most providers will need
outside assistance.Options for Acquiring IT - providers have
several options available to them when they decide to acquire
new IT or upgrade existing systems:Guidelines for Selecting an
IT Vendor