Imagine you’re a small town’s hospital CIO with a batch of technical problems to solve for your clinicians and administrative staff.
It’s 1 AM when the telephone rings at your bedside. You answer.
On the phone is the overnight ER discharge nurse with a problem. An elderly patient needs a ride home and the town’s only taxi driver is a patient in the hospital, too.
If you think that’s not a CIOs job, you’d be wrong.
We spoke recently with a community hospital CIO in northwest Ohio about the challenges he faces. At the time we spoke, he was serving in multiple roles: CIO, CAO and CFO, all while the organization was recruiting people for those positions.
This is a common situation in community care settings. With all of that to deal with, a hospital’s information system shouldn’t add to the complexity.
Independent culture
Community hospitals face much different operational challenges than their larger counterparts. Those challenges make their strong desire to remain independent increasingly difficult.
According to the American Hospital Association (AHA), nearly 20% of Americans live in rural areas. In nearly all cases, the hospital is the backbone of the community. The local hospital is often the largest employer and delivers key contributions to community services such as fire, law enforcement and public education.
What’s more evident than the financial input from these organizations, however, is the impact to community culture. These hospitals help to cultivate a sense of family, pride and belonging.
In rural communities, people aspire to grow up and work at the local hospital. And when you spend time in a rural or small-town hospital, you quickly understand how deeply the spirit of community is engrained. This great sense of community contrasts with the increasingly difficult challenges rural hospitals face.
Among the most pressing challenges:
- Lower patient volumes and higher Medicare/Medicaid payer mix
- Aging infrastructure
- Geographic isolation far from populated areas with associated limits on resources and transportation access to timely, quality care
As a result of these challenges, many rural hospitals have decided to merge or affiliate with larger health systems in order to stay viable. The AHA cites 380 rural hospital mergers between 2005 and 2016, with some of those hospitals being acquired multiple times.
Unfortunately, the notion of a merger or affiliation often contradicts to the small hospital’s mission to provide comprehensive care to the community while serving as an economic engine.
Here’s what our rural hospital CIO told us recently: “To lose the independence is to lose the culture. They (the acquiring health system) usually take away key service lines that aren’t profitable (obstetrics is number one), reduce or remove leadership roles, and outsource things that aren’t core competencies, like information technology or nutrition and food services. The result is that community members lose their jobs and patients have to travel out of the community to receive their care.”
What is more unsettling than a community hospital being acquired is the possibility of it closing due to the continued financial challenges it faces. The Government Accountability Office reports that more than twice the number of hospitals closed between 2013 and 2017 than in the previous five-year period, indicating a worsening trend.
HIT support
So, given the unique challenges of this market – and its steadfast commitment to culture and community – how can healthcare information technology help?
HIT can help best by supporting rural hospitals and communities with cost-effective innovations that reduce clinical and operational burdens, increase access for patients, and improve quality metrics leading to better patient throughput and care.
Below are just three ways to help the community hospital remain independent and thrive:
- A specifically designed set of solutions. Rural and community hospitals need fully integrated solutions for clinical as well as financial/administrative workflows at a price point that makes sense. With the savings, a rural hospital can invest in what matters most: Staffing and resources needed to provide the quality care and the community culture patients deserve.
- Tackling Social Determinants of Health and patient engagement: It’s critical to make it easy for patients to stay connected by removing social barriers that discourage interaction. As well, an integrated and fully mobile approach to patient engagement, such as Allscripts FollowMyHealth, ensures patients and care teams are in sync.
- Removing geographic barriers: An integrated ride-sharing app, such as Allscripts Go, ensures patients get to their appointments regularly, which supports improved clinical and satisfaction outcomes in addition to shorter wait times and higher throughput for the hospital
Small hospitals need fully supported IT solutions that deliver the clinical, financial and operational results they need at a price point they can afford.
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