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Rural Electronic Records

Rural Electronic Records. Fact or Fiction?. Renee’ Rowell, MS, RHIA 7.04 Rural Electronic Records 10/23/04. And…. Where in the world is Tecumseh, Nebraska ?. Do they even use computers?. Johnson County Hospital. 18 bed Critical Access Swing Bed Unit OB Unit ICU / ER

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Rural Electronic Records

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  1. Rural Electronic Records Fact or Fiction? Renee’ Rowell, MS, RHIA 7.04 Rural Electronic Records 10/23/04

  2. And….. Where in the world is Tecumseh, Nebraska ? Do they even use computers?

  3. Johnson County Hospital • 18 bed • Critical Access • Swing Bed Unit • OB Unit • ICU / ER • 10 Outpatient Clinics • 78 total staff • 4 physicians, 2PA, 1NP • 1 hr SW of Omaha • population 2,000 • 1 blinking stoplight • Only hospital in county

  4. Rural Midwest = Greater geographic distances, isolation New York = Socio-economic status

  5. Fiction • Fiction is the term used to describe works of information created from the imagination • This is in contrast to non-fiction, which makes factual claims about reality.

  6. Myths • Universal physician resistance • Small facilities play no role • Same culture, same agenda • It won’t take long, once we decide • Rural is smaller so it’s less complex

  7. Double edged sword? In one sense it’s easier to implement and control because we’re smaller…..but at the same time it’s harder because it’s so large of a project that something may be overlooked.

  8. Depopulation of Great Plains • Youth are leaving • Professionals in other career fields • Culture is changing

  9. Rural Patient Facts • Elderly • Poor, high rate of poverty • Economically dependent • Risk of leaving is a barrier • Hope for growth

  10. Rural Facts • Financial burden • Fear of change • Lack of qualified professionals, specialists • Baby steps, technology lacking • Access to care • Shortage of services

  11. Positive Note • Alliances • Networks • Dedicated & Committed • Grants

  12. Partnership • Heartland Health Alliance • Nebraska Hospital Assn • COMS – Clinical Outcomes • Management System

  13. COMS • Flex program – Office of Rural Health • COMS uniform discharge reporting system • Peer comparison, statewide • Grants fund pay 1/2

  14. UNMC Medication Errors Project

  15. Benchmarking Project Quality Montana Michigan Nebraska Kansas

  16. Digital Link • Nebraska Public Service Commission • $900,000 calendar year • Currently 31 • Opportunity for 48/85 hospitals • Secure broadband intranet • Subsidize monthly connection fees

  17. Radiology - Telemedicine

  18. Trauma • Lifeflight • Regional Trauma Centers • Better Communication

  19. Educational Opportunities • Video Conferencing • Nursing Inservices • Workshops • Professional CEU’s

  20. Mental Health • Services not readily available • Counseling • Emergency Admit

  21. Bioterrorism / Security

  22. Geographic Terrain


  24. Benefits of EMR • Immediate access • No lost charts • Standardization of patient care • Organized data, easy analysis • Reduction of errors • Coding efficiency • Data availability for QI, risk, utilization

  25. How will this be accomplished? • National level to oversee • Statewide agencies, similar to QIO’s • Coordinated to ensure consistency • Training and education

  26. Strategies • Incentives • Reduce the risk of investment • Promote implementation in rural and underserved areas

  27. HIM Professionals Technical Operational Bridging the gap……….

  28. Incubation phase • Incubation depends on the maturity of the infrastructure needed to support the technology. • 50 years for stethoscope

  29. “in this room” • You have made a choice to listen • You have expressed an interest • Will become advocate or adversary • Critical stakeholder • Rural needs a voice in Washington, DC

  30. Thank you for sharing your time  Have a safe trip home…

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