EHRs go rural
By Nathan Tudor, September 1, 2011West Texas RHIO comes together to help hospitals conquer the digital divide — and then some.
"Anything you can do I can do better. ... I can do anything better than you."
Certainly, I — along with the other founders of the West Texas Regional Health Information Organization (RHIO) — never expected to be singing the lyrics of this famous Irving Berlin song when we launched the cooperative venture in early 2010. But as the model takes hold, the words have become more than apropos.
Indeed, the impetus for the RHIO was a bit more modest. The four founding hospitals (Anson General Hospital, Stamford Memorial Hospital, Stonewall Memorial Hospital and Throckmorton County Memorial Hospital) came together simply to do what larger providers were doing: implement electronic health record (EHR) systems.
The CEOs involved, myself along with Ted Matthews, Rick DeFoore and Randy King, came up with the concept because we realized that small hospitals typically struggle to get EHRs up and running. As a matter of fact, a recent study from the Harvard School of Public Health shows that only 6.5 percent of critical access and rural hospitals have implemented basic EHRs, while 14.9 percent of other hospitals have done so. The report claims that the inequity is one of the reasons that rural care still trails behind the care delivered at other facilities across the country.
We wanted to do something about this digital divide, so we banded together to create a model that would bring advanced technology to rural communities.
To jump start the initiative, Matthews worked closely with Dave Darnell, senior program administrator at the Texas Department of Rural Affairs, to secure funding. Matthews wrote a grant proposal and secured about $500,000 in funding to help overcome some initial financial hurdles.
We realized, however, that finding the right technology was key to our long-term success. After reviewing several options, we selected the ChartAccess Comprehensive EHR from Prognosis Health Information Systems, a Houston-based company. The solution was designed using the latest Web-native innovations and is delivered via a cloud-computing model, where the software applications are made available as a service over an encrypted health information network. The EHR is intuitive and easy to use. It has built-in analytics and health information exchange (HIE) capabilities, and it really helps critical access and community hospitals like ours provide consistent, high-quality patient care.
The EHR was purchased under one license, and each of the provider organizations tap into one centralized solution. The model is ideal for smaller hospitals due to their limited data center capabilities. And, because we are sharing the technology, start-up and on-going maintenance costs are more affordable.
By making it possible for small hospitals to tap into an EHR, the RHIO is dismantling the digital divide that plagues the industry. In addition to the four founding organizations, four other hospitals have jumped in and are leveraging the advantages of EHRs (see chart).
Simply bringing such technology to rural organizations was the intent of the program. However, the RHIO is exceeding our original expectations by providing a model that is actually enabling us to do EHRs "better" than many other hospitals.
Here are just a few of the ways in which the RHIO model is helping our hospitals outperform others:
Quicker implementation. Most of the hospitals have gone from project kickoff to go-live in less than 120 days — putting them on the fast track toward meeting the government's meaningful-use requirements. As a matter of fact, three of the hospitals have already attested to "meaningful use," and one has already received incentive funds. The move toward EHR implementation at other hospitals sometimes takes years.
Better use of human and intellectual resources. With the RHIO in place, there's no need to reinvent the wheel, making the system implementation much less draining on each individual hospital. "There is strength in numbers, and by coming together we can accomplish so much more," says Matthews. "Instead of developing protocols for an EHR eight times, we just do it once. Instead of conducting eight training programs, we have the same training program at all of the facilities."
More comprehensive access to clinical data. Authorized physicians can retrieve patient records from any of the hospital databases once they are verified with user name and password. In contrast, most emerging health information exchanges across the country involve competing organizations, usually with different records systems, creating a network from scratch to share certain patient information.
Improved clinical care across the region. While many EHRs lead to improved care at individual provider organizations, our RHIO is enhancing care throughout the region. When a patient shows up in an emergency department or is transferred to any of the hospitals in the RHIO, doctors and other clinicians can provide care with access to complete information, which, in turn, enables them to make the best care decisions and save lives in the process.
And what could be better than that?
About the author
Nathan Tudor is CEO, Otto Kaiser Memorial Hospital. For more information on Prognosis Health Information Systems solutions: http://www.prognosishis.com.
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