Rural Texas Hospitals Work Together to Boost Care

Houston, TX – A regional health information organization formed by four Texas hospitals could serve as a model for electronic health record adoption in rural areas across the country, say its participants.

Officials said the RHIO, which flipped the switch on a ChartAccess Comprehensive EHR from Houston-based Prognosis Health Information Systems in October, is showing that small community hospitals can band together to tap into the clinical and operational benefits associated with EHRs—and work toward reaching the meaningful use milestones required to receive incentive funds through the American Recovery and Reinvestment Act.

Ted Matthews, who until last month served as CEO of 45-bed Anson General Hospital, helped establish the RHIO with Rick DeFoore from 25-bed Stamford Memorial Hospital, Debra Meador from 20-bed Stonewall Memorial Hospital in Aspermont and Randy King from 14-bed Throckmorton County Memorial Hospital.

The CEOs at the four hospitals—which are located within 35 miles of each other—put aside competitive concerns and are banding together to overcome the financial and operational hurdles typically associated with technology implementations.

“It’s been a little difficult at times,” said King, who also works as a nurse practitioner. He said he expects the group will help iron out some of those difficulties, and Prognosis is also working with the hospital leaders to smooth out the wrinkles.

King said there had been documentation issues, but Prognosis agreed to implement changes in a December revision.

“They listened to us,” he said.

To jumpstart the initiative, Matthews wrote a grant proposal and secured about $500,000 in funding to help overcome some of the initial obstacles to implementing an EHR system.

The four hospitals will maximize efficiency by learning from each other and standardizing training, protocols, procedures and policies.

“There is strength in numbers and by coming together we can accomplish so much more,” Matthews said. “Instead of developing protocols for an EHR four times, we just do it once. Instead of conducting four training programs, we have the same training program at all of the facilities. We are putting aside our competitive concern to become stronger and to better carry out our clinical care missions.”

To support the model, the hospitals are collectively tapping into the ChartAccess Comprehensive EHR, a shared, Web-native EHR solution. Delivered via a cloud-computing model, where the software applications are made available as a service over an encrypted health information network, the EHR provides clinicians with a complete view of patient data. Users access the system thrpugh a standard operating system and a secure browser.

King said the hospitals had reviewed four options. One appeal of ChartAccess was its access via the Internet, he said.

The fact that all four hospitals tap into one centralized solution remotely has made it much easier to get the system up and running, Matthews said. Because Prognosis is hosting the solution in a HIPAA-compliant environment, the ChartAccess support team maintains all applications.

The EHR is also integrated with billing, laboratory, pharmacy, radiology and other ancillary systems at each hospital, which allows it to serve as a data repository for all clinical information. The system is designed to provide a continuum of care for patients not just as they receive care in one hospital, but as they receive care across the entire region. Within the year, the information also will be available electronically at outpatient clinics in the area, making it possible for various providers to share information.

“The fact that these four rural hospitals are leveraging the technology to truly improve clinical care in their communities illustrates just how much can be accomplished when the right technology is utilized in the right way,” said Ramsey Evans, CEO of Prognosis Health Information Systems.