Rural and community hospitals should develop an effective plan of action that unites IT departments, internal administration and clinical providers to have the best chance of meeting meaningful use, according to a new brief from Stoltenberg Consulting.

The challenges for these smaller and often cash-strapped facilities are daunting, and can "extend across the entire organization and impact all staff and patients along the continuum of care," said Char Wray, vice president of clinical operations and information systems, and chief clinical and information officer at Elyria, Ohio-based EMH Healthcare.

[See also: Meaningful use Stage 2 crunch starts now.]

"There is a requirement for expertise in multiple areas to support the build and implementation of the solution and the significant change in the workflow of the clinicians," she added. "It can be difficult to balance all of the demands while delivering on our primary mission to provide quality care in a cost effective manner."
Other challenges for community hospitals discussed in the Stoltenberg brief include the upfront investments required for technology and slow-to-receive reimbursements. "In addition to an investment in technology, there's the cost of actually utilizing it," said Wray. "For example, there's the cost of educating end-users and effective change management."

The brief also looks at issues around having minimal IT staff onsite and an infrastructure that does not support the required expansion in electronic health records  systems. And it seeks to show how approaching IT implementation as not just an "IT project" but a "clinical transformation" requiring significant buy-in and effort from the top down.


The College of Healthcare Information Management Executives has noted the need to "reach out to rural and community hospitals in a really pointed way," according to Fred Bazzoli, CHIME's senior director of communications. "These smaller hospitals have to put aside competitive differences and stay in contact with each other to facilitate information transfer."

[See also: 2012: The year meaningful use took hold.]

In order to better prepare to meet meaningful use, the Stoltenberg brief says rural and community hospitals should prioritize what they need, including:

• Putting in place a strong foundation to deliver on all care requirements.
• IT teams reaching out to develop stronger relationships with physicians and clinical staff.
• Establishing the logical sequence for what needs to be deployed and in doing so, developing milestones and setting tangible goals.


"The new MU requirements are instrumental in guiding a change in the way patients engage with their healthcare teams," said Wray. "This is a huge transformation in the way we traditionally interact, and it keeps me up at night. I want to make sure we engage patients in a meaningful way, so that they can be an active partner in their healthcare decision making with their healthcare team."

"Proceeding toward Stage 2 and Stage 3 MU requirements will become more challenging for rural and community hospitals," said Sheri Stoltenberg, founder and CEO of Stoltenberg Consulting. "Such challenges require the support of the entire industry in order for these facilities to remain viable and continue to provide the type of meaningful and relevant care that is offered by larger facilities."