Executives and clinicians at small rural hospitals across the country are eager to adopt more information technology, but many are hard-pressed to find the right vendor, according to a new report from healthcare IT research firm KLAS.

The small, critical access hospitals, face the same deadlines for proving meaningful use of IT in order to qualify for available funds under the federal stimulus package, the report notes.

"Among the three vendors rated in the report, Healthland's EMR solution earned the highest score for having the needed functionality," said Paul Pitcher, KLAS research director and author of the new report. "But that score was still relatively low, with only 55 percent of customers satisfied.
 
"In addition, for all of the rated products, only about 50 percent of the provider comments regarding functionality and upgrades were positive, suggesting significant gaps with the current offerings," Pitcher said.

Closing the IT Gap: Critical Access to 50 Bed Hospitals highlights the experiences of more than 300 healthcare professionals at hospitals with 50 or fewer beds. Providers at these critical access facilities generally reported an appetite for software capability that exceeds vendors' ability to deliver, particularly in areas like computerized physician order entry (CPOE).
 
Only a handful of electronic medical record vendors specifically serve the critical access market, with CPSI, Healthland and HMS showing the most market share. Of those companies, Healthland received the highest performance rating but none of the vendors' solutions earned high marks for adequate functionality.
 
One of the foremost pieces of missing functionality, particularly in light of impending meaningful use requirements, is CPOE. The KLAS report notes that CPSI is by far the leader in delivering CPOE to critical access hospitals, with 17 live organizations that are likely to be the most ready for the federal government's criteria for meaningful use. In general, however, CPOE adoption is limited and shallow in this space, with a total of only 21 critical access hospitals known to be live on CPOE, according to KLAS.
 
Beyond the three leading vendors, a few companies that have traditionally served larger community hospitals are also having some impact among facilities with 50 or fewer beds. Hospital executives in smaller spaces are increasingly considering McKesson Paragon, and QuadraMed has a few Affinity clients, most of which are financial customers, in critical access hospitals. Although Meditech is known as a community hospital vendor, the cost of the Meditech EMR prevents the smallest hospitals from seriously considering it.