Rural HIT Challenges and The Importance of a

Foundation to Success

Roger L. Holloway

Co-Director

Typically Three scenarios:

• Free Standing non-owned or affiliated • Affiliated with larger organization• Owned/Operated by larger

organization

Top Needs• Replace/upgrade/additional workstations

– Most running Windows XP; need Windows 7 or higher

• Server room upgrades– More space, cooling, locks

• Security Risk Analysis – Required for MU, not purchased with the EHR

software

Top Needs (Cont.)• Better internet access

– More bandwidth, less expense• Personnel:

– Lack of dedicated IT and informatics staff– Current staff lack adequate training

• Hardware– Additional and/or upgraded servers/server host– Router/wireless upgrades: too slow, additional area

coverage, allow for portable devices

Needs for Stage 2 MU• Purchase EHR patient portal and related expenses• Operating system upgrades• Ongoing submission of public health data requires

either– Interfaces– Or Health Information Exchange (HIE)

• Upgrades to HL7-compliant lab and radiology systems

Clinical Needs• Replace non-HL7 lab systems with

HL7-compliant one • Replace Radiology equipment • Replace outdated telemetry equipment • Replace outdated nurse call • HIM coding software need and training of

coder

General Needs

• HR and Payroll software upgrade needs • Phone System Upgrade • Upgrade email management systems (such

as Windows Exchange Client)

Structural/Building Needs• SERVER ROOM ADDITIONS

• NEW FACILITY (35 BED, 40,000 SQ FT)

• FACILITY IMPROVEMENTS: ROOM RENOVATIONS (25 ROOMS)

• FACILITY IMPROVEMENTS: COMMON AREAS (FLOORS, HALLS, WALLS)

• 500 SQ FT ADDITION TO HOSPITAL FOR O/P SERVICES (currently operating from ER space)

Personnel/Training

• Physician EMR training/retraining• IT and clinical informatics staff

– Most are internal transfers, not outside hires– Designated staff must be:

• Trained• Original FTEE replaced and trained