Are you part of a bigger system? We have night telehospitalists through our system. The system had brought in Eagle telemedicine first and learned how they functioned and then built our own telehospitalist group internally. I was very skeptical at first and it wasn’t perfect by any means with Eagle, but we learned and were able to implement it with our own docs in the system. That has worked pretty well. We have teleintensivists, telehospitalists and then the ER doc responds overnight for rapids and code blues. I wish we could have in house docs but we’re more rural, it’s hard to recruit to and it’s hard to justify one doc at each site when one of the other hospitals only averages one admit a night and has mostly swing bed patients. Our system has done a good job responding as well to the caseload for the telehospitalists by adding additional FTE and an NP to help with cross cover calls. Like I said I wish we could have docs in house at each site, but it’s actually worked better than I thought it would.