Tudor's 20-bed Stonewall Memorial's town of Aspermont has a population of 1,021, while DeFoore's 25-bed Stamford Memorial Hospital is in Stamford, population 3,636. CEO Ted Matthews' 45-bed Anson General Hospital serves a town of 2,556, and CEO Randy King's Throckmorton County Memorial is in Throckmorton, a town of only 905.
Tudor says he's prohibited under contract from revealing what the system, ChartAccess Comprehensive EMR from Prognosis, will cost. But he notes that because it will satisfy meaningful use criteria, "Each hospital will benefit from federal stimulus dollars. Overall, we'll be able to recoup our investment."
The system even has an iPhone app that allows physicians to access patient records remotely. That's a big change for this area, where health records now are all on paper.
The CEOs acknowledge that working together to make such a big purchase decision was not easy; they each had boards of directors to convince. "Even with rural hospital administrators, egos get in the way," says DeFoore. "We're all used to calling our own shots. To get around that, we've all taken leadership roles with different pieces of the project," he says.
How are the doctors responding to the idea? Most are enthusiastic, the CEOs say, but some are taking a "wait-and-see" approach, DeFoore says. "They know we're pushing this now because of the stimulus dollars."
The EMR system has the capability of providing computerized physician order entry (CPOE), and when the doctors heard that, "their eyes got big," DeFoore says. Dillon Miller, MD, a newcomer to Aspermont who is one year out of family medicine residency at the University of Alabama in Tuscaloosa, sees amazing potential for this EMR.
"All the towns in our RHIO system are within 25 minutes of each other, and there are lots of people working on ranches who may be closer to our hospital than the ones near their own homes," he explains. By having a system that links all the hospitals and clinics with each other, each hospital district can share patient health histories wherever they may show up."
And there's the potential to save money too, Miller adds. By being able to find out whether the patient just had an X-ray or a CT, and what their medical history says about their health, "we can treat the patient much more efficiently," he says, and avoid needless expense.
Even with the competition, Miller says, "If we're working together, it really helps everyone. If the patients are happy, and they know they can get good care at any of the facilities, then it's a win-win situation for everyone."
DeFoore says that there's another happy, although unintended, consequence of this alliance. "Since we've been talking about this the last six months, the four hospitals in this RHIO have also met to discuss common purchase of medication equipment, mutual contracting in payer negotiations, and we've discussed the purchase of another nurse call system for each hospital."
Saving money in rural healthcare settings is essential because without such efforts, many other rural hospitals will go broke, he says.
"We're positive this will work," says Tudor, 29, who says he's the youngest hospital CEO in all of Texas. "There's no doubt in my mind that it will meet meaningful use criteria. I'll put my reputation on the line."