Rural Wisconsin Hospitals Provide Lesson in Innovation

John Commins, for HealthLeaders Media, October 8, 2008

A small group of hospitals in western Wisconsin is providing a lesson in innovation for rural hospitals everywhere.

The Rural Wisconsin Health Cooperative Information Technology Network will get $1.6 million over the next three years as its share of the FCC's $400 million Rural Healthcare Pilot Program. The first-of-its-kind grant will be used to offset the cost of building a collaborative information system and electronic medical records initiative.

While the FCC pilot is providing funding for the telecommunications upgrade, the federal Health Resources and Services Administration is providing another $1.6 million for software and EMR hardware, says Louis Wenzlow, chief information officer for the Wisconsin project. The funding is expected to underwrite about 85% of the cost to establish collaborative broadband networks that will support telemedicine services for the cooperative's four small critical-access hospitals, and two physician clinics in the traditionally underserved rural areas. The cooperative members will pick up the remainder of the costs through monthly fees.

Wenzlow says the collaboration will allow the hospitals to negotiate better discounts from vendors, reduce datacenter costs and software licensing fees, and tap into a pooled technical support staff—services that might otherwise be prohibitively expensive for one small hospital acting on its own. "It's really extraordinarily expensive for a hospital to implement a full EHR system. By creating value that way, they are better able to spend more money on telecommunications down the road," he says.

The four hospitals in the cooperative are now live on a shared system that was implemented over the summer and includes financial systems, and departmental systems like lab and radiology, order entry and scheduling. Wenzlow says the cooperative is preparing an "aggressive" roll out of advanced clinical systems that are scheduled to go live early next year.

Philip Stuart, CEO of Tomah Memorial Hospital, located about 45 miles east of La Crosse, in western Wisconsin, says his 25-bed hospital had already implemented many of the IT upgrades the cooperative was promoting, but decided to join because of the potential savings. "The advantage to us is the savings on the back end in terms of software licensing fees, being able to participate in grants for our interconnectivity with telecommunications lines, and computer redundancy for data storage. That's now cost-sharing for us."

Stuart says that Tomah could save about $80,000 over the next five years by joining the cooperative. The pooled technical resources also allow Tomah to leave unfilled a technical support position that was recently vacated. "We view the ROI as being very positive," Stuart says.

Even though Tomah was upgrading its IT system on its own, Stuart says he wanted to be involved in a cutting-edge project that is serving "a common good." He says small hospitals shouldn't be intimidated by the idea of joining together on such a project without the help of a bigger health system, because the formula for success is the same.

"I don't think it makes any difference if it's a critical-access 25-bed hospital or a 615-bed academic medical center," he says. "To make it work, the infrastructure has to be in place. You need to have the right mix of people with the technical savvy to do it."

"The up-front work saves you problems on the back end, too," Stuart says. "Anybody that gets into this needs to understand what it means and make sure the medical staff and the end users are part of the planning processes and are intimately involved or it won't work."

The other members of the cooperative are: Boscobel Area Health Care; Memorial Hospital of Lafayette County, in Darlington; St. Joseph's Community Health Services, in Hillsboro; and two physician clinics in Wonewoc and Elroy.

John Commins is the human resources and community and rural hospitals editor with HealthLeaders Media. He can be reached at
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