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Four Rival Texas Hospitals Bond For Meaningful Use And To Improve Care

Cheryl Clark, for HealthLeaders Media, March 3, 2010

Here's a tale about the unlikely collaboration among hospitals in four fiercely competitive and very rural towns in Central West Texas.

It starts with a meeting between four CEOs at four very small and very rural hospitals. Those I spoke with describe the towns' cultures as similar to that of "Friday Night Lights," a book and TV series depicting football-obsessed rivalries, all very similar to their own.

"The 'Friday Night Lights' football mentality is very much real here," notes Rick DeFoore, CEO at the 25-bed Stamford Memorial Hospital. He adds in some cases, town officials "have a tendency to be suspicious of folks in other communities."

When you mention the name of a rival town in conversation, DeFoore says, it's not unusual for even respectable officials to say, with a straight face, something like, " 'I hate that town. They beat us 10 years ago in football during regional finals.' That old rivalry is a reality for us in West Texas."

The towns–Stamford, Anson, Aspermont and Throckmorton–sit between 14 and 50 miles apart in a region occupied largely by cotton farms, ranches and oil fields.

Residents travel long distances to work, play and attend sports events, perhaps the area's most popular entertainment. And they tend to be loyal to their hometown hospitals, yet may need healthcare while they are at work on a ranch or farm in one of the neighboring communities.

"Every town has a school and a hospital, and each [area] has a lot of pride, and there is fierce rivalry between the schools," says Nathan Tudor, CEO of the 20-bed Stonewall Memorial Hospital in Aspermont, about one hour north of Abilene. "In sports, we play each other in football, basketball and track. You want to be better than them. And that's the way it is with the hospitals too. We compete for the same patients because we all serve the same area."

This territorial pride, however, didn't stand in the way of these CEOs forming what technology geeks call a RHIO, or regional heath information system, to grapple with issues like meaningful use. Through their alliance they selected and bought an electronic medical record system or EMR that they all could share to benefit their patients, and their hospitals' bottom lines.

They selected one system that could link all their hospitals, their clinics and their physicians with the medical records of all of their patients. Key parts – including inpatient records –­ should be implemented by October, although some pieces, such as links with the clinics, may take longer.

"Once the database is built, and one of our patients is treated in another hospital emergency room, the provider would be able to immediately identify that the next time a patient comes into any emergency room. 'Oh, I see you went to the emergency room in Stamford last month,' " DeFoore explains. "And once the clinics get up and running on the same system, that database will be available to them too."

All four CEOs agree that none of the hospitals could have afforded such a system without the collaboration.

"To have one hospital decide to do this alone; well, it just could not have been accomplished," Tudor says. "Working collaboratively, we're able to gain a lot of synergies, and now, it's very cost-effective for all of us."

Smartly, they looked to find strength in their numbers as a region.

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