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Wyoming's Winning Meaningful Use Strategy

 |  By Alexandra Wilson Pecci  
   September 07, 2011

It's not uncommon for critical access hospitals to think achieving meaningful use might be out of reach for their organization. But South Lincoln Medical Center in Kemmerer, Wyo., has confidently bucked that trend, becoming not only the first hospital in the state to achieve stage-one meaningful use, but also one of the first CAHs in the nation to do so as well.

"Realistically, we started the process five years ago," Eric H. Boley, CEO and administrator of South Lincoln Medical Center, said in an interview. "They hadn't come out with the HITECH Act and meaningful use wasn't even a catchphrase."

Instead, when the hospital first started investing in its health IT systems, its goal was to become paperless. But it really started to aggressively focus on meaningful use about a year ago, and because it already had much of the infrastructure, South Lincoln Medical Center had a leg up in some ways.

"Five years ago, we financed this thing and spent a million dollars," Boley said. "To actually meet the requirements, it didn't cost us a great deal of money because we already had all of the different components of what we needed in place."

However, the hospital did face other hurdles because of a lack of infrastructure in Wyoming.

"We had to jump through some huge hoops with the state just to meet some of the core measures," Boley said. "We had to build some interfaces."

The hospital actually worked with the state's Medicaid office to build one of the exchanges that they needed to submit data and information.

Doing so has helped South Lincoln Medical Center become an IT leader in the state. Wyoming's governor, Matt Mead, has given Boley a spot on his infrastructure workforce group, and "we're right on the threshold of signing an agreement to have a health information exchange available for all the hospitals in our state," Boley said.

Although South Lincoln Medical Center successfully proved meaningful use of its EHR, Boley says for any such system to be truly meaningful, it has to be part of a larger network.

"To have an electronic health record that means anything, everyone in the country is going to have to be able to take encrypted information and put it into their systems," he said. "We still have a long ways to go in having health information exchanges built that work, not only hospital-to-hospital, but statewide, and then, from state-to-state."

What worked in Wyoming

Every hospital is different, and critical access hospitals face in particular face special challenges. But Boley shares what worked for South Lincoln Medical Center and offers advice for other CEOs.

1.    Involve employees from the beginning: Boley not only made sure that all of his staff was on-board with the electronic system; he also involved them in deciding which product the hospital would purchase. "When a person who's supposed to be leading the organization makes a decision without consulting those who are going to be the end-users, a lot of times it doesn't go very well," he said.

So the hospital formed a committee made up of representatives from different departments, and the same group of people participated in every vendor demonstration. "Then we sat down and we did a debriefing, worked it out on a white board, with the pros and cons of each ones before we made a decision," Boley said. "All of the end-user departments, I felt, were fairly represented, including our medical staff."

2.    Take a "shotgun approach": Although this may not work for every hospital, Boley is happy that South Lincoln Medical Center chose to install a more advanced system right up front. "Instead of doing an installation where we just did one piece at a time, we basically did the shotgun approach," he said. "It's kind of like a Band-Aid: you just have to grab it and rip it off, go through the pain quickly…no matter how you do it, it's going to be painful. We just kind of figured if we did it all at once, bit the bullet, we'd be better off down the road, and it's paid off."

3.    Don't pass the buck: Although many of the responsibilities of implementation will naturally belong to the IT director, "the CEO's got to be right in the middle of it," Boley said. "It has to be a priority to the CEO to lead by example, and to get out in front, and let the entire organization and the community know what you're doing and why you're doing it."

4.    Remember there's no such thing as a perfect system: "I've watched the struggles of our state. We have 16 critical access hospitals in Wyoming and 27 total hospitals," Boley said. He says he's also watched as people struggle to choose a system. "There is no perfect solution out there for any of us. We had to take what we have and find ways to make it work."

5.    If it ain't broke, don't fix it: Boley chose not to upgrade to a brand new system, despite the federal incentives to do so. "To me it's a waste," he said. "We already have a system that was working."

Alexandra Wilson Pecci is an editor for HealthLeaders.

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