New Lobby or an EMR?

Carrie Vaughan, for HealthLeaders Media, February 27, 2008
How can I provide high-quality, comprehensive and affordable healthcare to my community with an aging facility, minimal staff and limited funds? This is a question that community hospital leaders grapple with every day--and it is why these executives are forced to make some difficult decisions. Should we remodel the lobby or invest in an electronic medical record? Should we get rid of a skilled nursing unit that is a money loser but ranks high on patient satisfaction surveys? The struggle to balance cost and quality is why leaders are continually searching for innovative ways to meet the needs of the communities they serve--visiting specialists, mobile MRI units, health fairs, telemedicine and educational programs come to mind, as well as cancer, dialysis and cardiac centers.

Likewise, we at HealthLeaders Media want to provide the most helpful, informative and timely content in a way that best suits the needs of our readers. To that end, our Community and Rural Hospital Weekly newsletter received a face-lift. First, we improved navigability. We also added audio interviews, links to additional content, live article commenting and RSS feeds. And now with the addition of my weekly column the transformation is complete. Don't worry, I will still be offering best practices and stories from healthcare leaders that have successfully implemented IT, recruited healthcare workers, financed new construction, or improved quality scores. But I will also try to capture the views and concerns of community and rural hospital leaders in this space.

Many top-of-mind issues appear unchanged since I left for maternity leave last year. Adequate reimbursement is still a major concern, of course--and will likely remain so given President Bush's budget proposal, which aims to rein in Medicare costs by cutting hospital reimbursement. Finding access to capital for IT projects, new construction or facility upgrades continues to be a headache, as does the recruitment and retention of physicians, nurses and other healthcare professionals. Many community hospitals are still struggling to measure and improve their quality, which is becoming increasingly important in light of transparency and public reporting initiatives. And determining which services to offer or discontinue as new partnership opportunities arise--or direct competition moves in next door--will continue to challenge healthcare executives who are trying to ensure their communities will have access to the care they need for years to come.

These are some of the topics that I will be exploring in the months ahead. But to ensure that I'm covering what matters most to you, I would like to hear from you, the reader, on the issues that top your list for 2008. What service lines are you growing? How are you financing new construction? What types of technology are you investing in? Please drop me a line at In addition, I hope that our readers will continue to submit opinions, analysis and solutions in our Leaders Forum section, and use our discussion board, Community Call, as a resource to connect with peers, post questions or offer solutions to the unique challenges that community hospital leaders face.

Carrie Vaughan is editor of HealthLeaders Media Community and Rural Hospital Weekly. She can be reached at
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