Inside a Critical Access Hospital's IT Decision-Making Process

Plus, he rattles off all of the functions he did not want his staff having to work on: "hardware, operating systems, application software, and all of the responsibilities of the endless updates to the operating system, the application updates, the hardware updates, the backups, the recoveries."

"I wanted to engage some vendor to do all of that for us," he says.

After interviewing several vendors, Ellenville chose the Nashville-based Healthcare Management Systems, which provides cloud-based, hosted and managed IT to hospitals and healthcare systems across the country. Kelley says because hundreds of hospitals are hosted on the same system, the costs are spread out, too, which is important to a small critical access hospital.

"I just think there's huge economy of scale," Kelley says. "It doesn't cost that much more to add another hospital's worth of data. And if they're updating the operating system, they're updating for all the hospitals at once."

Avoiding the upfront costs of onsite implementation also allowed Ellenville Regional Hospital to pay for the solution using existing capital. Kelley says the hospital hasn't borrowed any money for the venture and has been planning for it for a very long time.