Workflow, Training Key to Critical Access Hospital’s EHR Adoption

September 23, 2014 in News

A critical access hospital in Nebraska had success transitioning to an electronic health record system by focusing on workflow processes prior to vendor selection, according to a case study released by the College of Healthcare Information Management Executives, FierceEMR reports (Hall, FierceEMR, 9/18).


Data show that critical access hospitals are struggling with EHR implementation and in 2013 were less likely than other types of hospitals to have demonstrated meaningful use of EHRs, according to Health Data Management. For example, data show 89% of critical access hospitals in 2013 had an EHR system, with just 62% having a fully electronic system (Goth, Health Data Management, 9/19).

Under the 2009 economic stimulus package, providers who demonstrate meaningful use of certified EHRs can qualify for Medicaid and Medicare incentive payments.

Case Study Findings

The case study involved the 25-bed Chadron Community Hospital and Health Services in rural Nebraska, which had been entirely paper-based prior to implementing an EHR system in 2011 (Bresnick, EHR Intelligence, 9/19).

The case study found that Chadron took several steps prior to selecting an EHR vendor, including:

  • Conducting a year-long study of each of its workflow areas;
  • Leveraging its full-time employees to assist with the transition (FierceEMR, 9/18); and
  • Designating “super-users” from each department to be the primary respondents to department staff questions or issues (EHR Intelligence, 9/19).

According to FierceEMR, the hospital gave itself six months for staff training and implementation after it selected an EHR vendor (FierceEMR, 9/18).

During that time Chadron:

  • Held extensive training for staff members, including classes in using computers and productivity software;
    Implemented upgrades to its health IT infrastructure; and
  • Used email to familiarize staffers with communicating electronically (EHR Intelligence, 9/19).

In addition, the case study highlighted the challenges Chadron faced, such as not having a dedicated transition team (Health Data Management, 9/19).

Although Chadron was able to attest to Stage 1 of the meaningful use program, officials noted difficulties attesting to Stage 2 of the program, implementing system upgrades and transitioning to ICD-10.

Anna Turman, Chadron’s CIO and COO, said that attesting to Stage 2 “has been a tough haul,” adding, “We are making progress, but could use some breathing room to celebrate our successes” (EHR Intelligence, 9/19).

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