With Its New Hospital, Rural Utah Gets A Fancy EMR (And A Sacred Hogan)

HealthLeaders Media Staff, September 30, 2009

On Google Earth, one can spiral quickly into the geologic wonderland of Blanding, Utah—a part of the old frontier canyonlands—where scenes for John Wayne westerns, Thelma and Louise, and the TV classic Maverick were filmed.

With only 3,100–5,000 people, the town is about as rural as it gets. It sits in the corner of large and expansive San Juan County, which boasts only 1.8 people per square mile, about as sparse as can be in the contiguous U.S.

It is, frankly, a surprising spot for the development of one of the newest, most modern, technologically savvy small hospitals in the U.S.

Yet 78 days ago, the 11-bed critical access facility, Blue Mountain Hospital, opened its doors, the dream of the late Jim Redd, MD, a local family practice physician, and Donna Singer, CEO of the Utah Navajo Health Systems, a network of community clinics.

Sadly, Redd took his own life a few weeks before the hospital was set to open.

With a price tag of $18 million, the 45,000-square foot facility has a completely digital phone and instrument system with electronic medical record access in every room, two enormous surgical suites, and "one of the largest, most spacious emergency rooms of any hospital I've ever seen," says Blue Mountain's new CEO, Lorin MacKay.

The hospital's seven emergency bays act like a trauma center for the region because of the large numbers of car accidents along the region's winding two-lane roads. "Even though our volumes aren't yet very large, the type of patients who come through the door are usually very critical, with fairly heavy trauma from a lot of auto accidents in the area," MacKay says.

"In the state of Utah, 85% of human fatalities are caused by collision of a car with wildlife," says Cherrie Evans, director of the hospital's clinical services.

Each patient room is private and large, with sleep chairs to accommodate visiting family members. "The culture in the area is to have large families, and we've accommodated them if they wish to spend the night," Evans says.

MacKay adds: "I'll tell you, I've been in this field for 28 years, and this is the nicest small rural hospital in the entire U.S., and I'm not bragging."

It has an eight-station dialysis center to care for the large numbers of patients with diabetes (Native Americans are said to be 13 times as likely to have diabetes than Caucasians). "Because of that, we have a high incidence of end stage renal disease and are providing dialysis to about 30 patients," MacKay says.

Here the population is 60% Native American Indian, mainly Navajo and Ute. And health needs are real. According to the Association for Utah Community Health,

  • 85% of the population served "has no running water, electricity, telephone or central source of heat
  • 56% are unemployed
  • Per capita income is $4,106
  • 57% of the population is below the Federal Poverty Level

Prior to July 15 when the facility opened, patients had to drive as far as two hours in each direction for dialysis, for a four-hour treatment three times a week.

Out of respect for Native American cultural beliefs, the hospital also has a traditional medicine healing building called a hogan, a 40-foot-diameter circular just outside the front door.

"It is representative of the Navajos, with doors facing to the east, windows for light to come in, a dirt floor and a ventilation system so Native Americans can have their fires. The open beam roof built of poles of teepees, and patients and their families can bring traditional medicine men to perform their faith healing rituals," MacKay says.

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