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Rural Hospital Hinging Future on Federal Incentive
Many rural hospitals have been hesitant to do away with handwritten records because of the budget-busting costs of electronic systems and a shortage of staff with technical expertise.
Associated Press/AP Online
August 05, 2009
OSCEOLA, Mo. – Electronic medical records are a life-or-death issue at Sac-Osage Hospital – not necessarily just for the patients, but for the hospital itself.
Facing a budget shortfall, the 47-bed hospital in rural western Missouri is borrowing nearly $1 million to pitch its paper medical charts and purchase a state-of-the-art electronic health records system. The hospital is hinging its survival on what it hopes will be a $3 million windfall of federal incentives for hospitals that go digital.
“If that doesn’t happen, we’re shutting it down,” Sac-Osage CEO Jeff Speaks said. “We’re rolling the dice.”
It’s the final gamble for a hospital that already has laid off staff, is operating on a $370,000 deficit and is warning of dozens of deaths if local voters on Tuesday don’t also approve a property tax to keep its emergency room open and ambulances running.
The stimulus act signed by President Barack Obama directs $17 billion to doctors and hospitals, beginning in 2011, that make “meaningful use” of electronic medical records. In 2015, health care providers could face financial penalties if they haven’t made the switch.
Electronic records are a key part of Obama’s plan to remake the nation’s health care system by expanding coverage and improving treatments for millions of Americans. Advocates say digitizing the nation’s health care records will allow critical information to follow a patient through the medical system, speeding through red tape and reducing the chance for errors.
But some paper-dependent hospitals are in a predicament. To qualify for the technology incentives, they must act soon to purchase the equipment and train their staff. Yet they won’t know until later how the federal government defines the criteria to qualify.
Across the country, many small, rural hospitals have been hesitant to do away with their clipboards of handwritten nurses’ notes and doctors’ orders because of the budget-busting costs of electronic systems and a shortage of staff with the technical expertise to oversee them.
Hospitals with fewer than 100 beds and those in rural areas rank consistently lower than their larger and urban counterparts in their use of electronic records, according to quarterly reports of the Healthcare Information and Management Systems Society, or HIMSS. The lowest of all are in a central U.S. region comprised of Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota.
“The No. 1 barrier traditionally is the cost of the systems,” said Rod Piechowski, senior associate director of policy for the American Hospital Association.
Sac-Osage is one of a couple thousand hospitals nationwide that still rely primarily on paper records. On a scale of 0-7, HIMSS rates Sac-Osage a mere .065, due partly to the fact that the hospital failed to note on a survey that it already uses electronic records in its laboratory, radiology and pharmacy units.
