Most hospitals have implemented a basic EHR system, but costs have discouraged them from purchasing the advanced capabilities called for by the federal health-reform law that allow them interact with other systems to share and analyze data and use clinical data warehousing, population health management and quality benchmarking. Not having these advanced capabilities may hurt these small hospitals in the long run, Bresnick reports.
“The larger hospitals are doing well,” Lorren Pettit, vice president of market research for HIMSS Analytics, told Bresnick. “But we have seen that where the applications are behind the curve tends to be in the smaller hospitals. There really is a correlation between hospital size and the breadth and depth of their applications—how advanced their infrastructure is.”
Pettit said he is concerned about critical access hospitals, those that limit their beds and procedures in return for slightly larger Medicare and Medicaid reimbursements. Kentucky has 29 such hospitals. He fears they are getting too far behind the larger hospitals in implementing the advanced capabilities of the electronic health records, creating a situation where there is a difference in the quality of care between urban and rural areas.
Pettit said the most successful critical area hospitals are those that are part of a larger system that helps them with their technology. He told Bresnick, “Being an independent, small hospital . . . there’s just too much at stake and too much investment, and it’s going to impede a lot of these hospitals from moving forward.”