For New York’s Ellenville Regional Hospital, 2017 was a year of change.
As less expensive outpatient procedures have become more popular, they’ve replaced more profitable inpatient procedures. Hospitals have had to adapt to the new paradigm in order to maintain healthy margins and encourage growth.
Ellenville saw new technology as an opportunity to spark fundamental organizational improvement. The hospital strategically invested in technology that reduced expenses, improved the quality of its patient care, and enabled the organization to develop exciting and important partnerships within their community.
CEO Steven Kelley sat down with us to discuss Ellenville’s transformation and what community hospitals must do to be successful in 2018.
What’s it been like for community hospitals in 2017? How do you think the landscape has changed?
The unfortunate reality is community hospitals have been struggling in a radically shifting market. With M&A-related activity doubling between 2011 and 2015, small hospitals often worry about being forced to lose their independence. One in three rural hospitals is at financial risk and more than 70 have shut their doors due to the challenges of independent care delivery and the pressure of consolidation.
Simply put, competition is the fiercest it’s ever been. Ellenville has been no stranger to this: 75 percent of our business is outpatient, so we’re constantly competing with outpatient purveyors on the same service—but they don’t also have the overhead of running a 24/7 ER and all the support departments necessary for ER operations. As the industry is weighed down by regulations and interruptions, and organizations continue to consolidate and separate, community hospitals must rely on innovative technologies and information exchange networks just to stay afloat.
Why did you decide to upgrade your hospital’s technology? How has it impacted your day-to-day?
For more than 30 years, we sat on top of outdated, cumbersome software that required different departments to log the same data; it was timely and caused us to be error-prone. When our old vendor began charging us ever-greater fees for ongoing services, upgrades, and new applications—many just to meet regulations for Meaningful Use—we knew we had to find an adaptable and more transparent solution. We just needed more out of an EHR: A collection of modules can allow you to meet Meaningful Use requirements, but it doesn’t help you practice better business or deliver better care.
We made the jump to athenahealth in February 2017, and it’s been a difference of night and day. Rather than struggling to align across our melting pot of former software, the entire hospital now thrives on one cloud-based system. Everyone has access to the same patient records across the house. Not only has this saved us immeasurable time and labor, we’ve also been able to deliver a 110-minute average time for patients to visit the ER door-to-door and boast a 90 percent patient satisfaction rate.
And the implementation process allowed us to hit the ground running. Due to the outstanding preparation of our staff, and support from our new partner, we were able to go live in one day. That’s not something hospitals who switch entire systems are often able to say.
What were the keys to success for Ellenville in 2017?
By connecting to a network of 106,000 providers and 102 million patients, we’ve become much nimbler when it comes to quality reporting. Our technology takes on the brunt of learning and preparing for federal and state requirements, allowing us to submit claims cleanly and achieve incentive payments.
The network has also enabled us to extend beyond our four walls and establish relationships with local stakeholders: Once patients transition from our care, we’re able to communicate with specialists and non-clinical organizations to ensure they remain fully supported.
What role do you see EHRs playing in the new world of value-based care?
Short answer: Cultivating collaboration.
Long answer: As the industry moves into its new landscape, it’s critical—now more than ever—that our EHRs move with us and become more interoperable and collaborative. We need patient records to be accessible and actionable in order to ensure doctors and care teams have what they need to provide the most accurate care for their patients.
I’d also like to see more EHRs involving healthcare teams in the design of their systems: As one of athena’s development partners, we can put our fingerprints on our own piece of the platform by testing prototype features and offering suggestions. Having this deep visibility into the mechanics of our workflows has allowed us to better see and streamline care across our system and the network.
What advice do you have for other community hospitals eager to thrive in 2018 and beyond?
At Ellenville, we’ve discovered we thrive best and brightest on technology that’s future-proof and elastic—able to bend with mounting federal programs, financially-difficult months, flowing patient information, and the market’s unknown future. We’ve seen payoff of our tech investment reflected in our ability to scale care and support population health initiatives. We’ve seen it lift the burden of administrative work off the shoulders of providers and staff. And we’ve seen it increase the amount of facetime providers have with their patients and the quality of care provided.
With that being said: My piece of advice for a community hospital looking for something new, necessary, exciting? Join a network that you can grow with and that will grow with you, too. Invest in technology that dares you to push boundaries, but can also keep up with your day-to-day challenges, many workflows, and patient population. In 2018, I urge you to find a partner that connects you with larger organizations in the local area and across the nation alike while also stabilizing and embracing your independence.
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