Emergency Department Information Systems
Solving rural America’s healthcare challenges
Bunkie General Hospital deploys a stand-alone EMR in its emergency department and achieves signifi cant fi nancial and clinical gains.
By Linda Deville R
ural hospital emergency departments (EDs) face a number of major social, economic and cultural challenges among their patients, creating disparities in healthcare not seen as frequently in their urban
counterparts. With a higher percentage of self-employed and unemployed residents, rural EDs are less likely to have patients with healthcare or prescription drug coverage. Overall, rural EDs care for a more at-risk population due to lower incomes, educational shortcomings and longer travel distance to physi- cians for treatment or preventative care. Rural EDs must also struggle internally with shortages of qualifi ed workers and fewer capital resources that would enable them to implement advanced healthcare IT solutions such as EMR software and IT infrastructure. As the “front door” to their healthcare communities, rural EDs provide strong insight into the organization’s clinical performance and are a particularly vital component of the hospital’s fi nancial well-being. While many issues that stand in the way of success aren’t easily solved, recent government initiatives to spur regional growth may just provide the spark that small-town hospitals require to ease the discrepancies in healthcare delivery that often exist between rural and urban America.
Confronting the country’s lingering economic woes, the federal government recently emphasized the need for new capital, job training and additional investments in rural com- munities. Hospital EDs in these areas stand to benefi t from the Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) loans. These fi nancial accommodations are being made available to help more than 1,300 critical access hospitals recruit addi- tional staff and purchase software and hardware to implement healthcare IT solutions.
Bunkie General Hospital sees success in an EMR Bunkie General Hospital is just the type of facility that
has benefi ted from such initiatives. Located in Bunkie, La., a town of just more than 4,000 residents, the 32-bed hospital is a shining example of how a little fi nancial assistance can incite signifi cant improvements in revenue and clinical quality. These
12 December 2011
efforts have helped Bunkie General Hospital achieve a multi- million dollar annual windfall and be nationally recognized in U.S. News & World Report, where it received the gold and silver award for management of patients with heart failure. The road to achieving these as well as other major successes, however, was not an easy one.
The EMR software has placed Bunkie General squarely on the path to achieving meaningful use with a number of compliant functionalities, including an up-to-date problem list, active medication lists, quality measure reporting and medication reconciliation.
For many years, volume in the ED was highly inconsistent and patient and staff satisfaction levels were subpar. In spite of the organization’s enhanced focus on meeting regulatory com- pliance guidelines, the ED could not capture all of the charges, meaning that revenue was consistently left on the table. Not only did this prevent the hospital from investing in en- abling technologies, the ED was losing quality physicians who left the organization in search of a bigger paycheck. In order to achieve quality improvements; enhance patient, employee and physician satisfaction levels; and increase its fi nancial strength, Bunkie General’s administrators knew that the ED needed to signifi cantly reduce its dependence on paper and employ IT tools that would assist its clinicians in capturing the data needed to impact clinical and fi nancial quality. Understandably, Bunkie General was concerned about being able to make such an important investment.
The answer came in the form of a grant from the Agency for Healthcare Research and Quality (AHRQ), established to assess the impact that healthcare IT would have on the revenue cycle, clinical quality improvement, staff and patient satisfac- tion of rural Louisiana hospitals. With the grant in hand, Bunkie General’s leadership team purchased an EMR solution that
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