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Community Hospitals and Stimulus IT

It seems to me that the real impact of the IT funds available under the Stimulus Package will be felt at the community hospital level: those hospitals that for a variety of reasons are not as far along in clinical documentation as they want to be.  I asked Tom Stephenson, President and CEO of Healthcare Management Systems, Inc., which has 600 community hospital clients, how they see the law playing out.

“The high-level view is that for people who have been trying to get there, you now have a path, a timeline and a monetary picture to actually move,” Stephenson says.

Tom Stephenson, CEO of HMS

But how to move is going to keep IT vendors and consultants busy for years to come. “There are still some cloudiness around what you have to do, but the basic principles are there around the big picture functionality the hospital has to have in place and the framework to receive incentives. The folks we have been talking to over the last few weeks understand that their organizations have to get serious about rolling out some of these advanced clinical functions within the hospital.”

The key phrase of law that is subject to all the speculation right now is what is meant by “meaningful user of an EHR.” There is still not much to go on from HHS, but “there are a lot of assumptions going around that the HIMSS EHR model will be in play there,” he says. “Everyone is basing it on the assumptions that certainly you need to have your nursing documentation, CPOE, basic functionality like that in play in the hospital.”

For many community hospitals, two big obstacles may be time and infrastructure. Time, because, as he says, “only 10-15% of hospitals in this country have CPOE, and that is a lot of change to occur in roughly a year and a half.” And infrastructure because they may not have the servers, or even things like carts on wheels, to move forward.

Another unique challenge–which Stephenson is quick to add is not a negative but a fact–is that much of the certification process is driven by large academic medical centers. “They do not fully understand what it is like to go to a 50-bed hospital in the middle of nowhere.”