Despite being rural and relatively small, Duncan (OK) Regional Hospital has been a leader in health IT for years, first installing Meditech financial and clinical systems for acute care nearly 20 years ago. The latest IT project for the 167-bed facility in southwestern Oklahoma is to improve workflow and quality in the emergency department and better coordinate emergency care with care delivered elsewhere. This summer, Duncan Regional is deploying T SystemEV Stat, an upgrade to an earlier management system from Dallas-based health IT vendor T-System, because the hospital has had problems managing paper records that came from other providers. The hospital also has been experiencing a steep increase in ED volume, according to Roger Neal, Duncan Regional's VP and CIO.