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Small Hospitals Take on Big Projects


By Beckie Kelly Schuerenberg, Senior Editor March 2006
Small hospitals may outnumber their larger peers, but they have a lot of catching up to do in terms of information technology.

More than 70% of registered U.S. hospitals have fewer than 200 beds, according to the Chicago-based American Hospital Association. But despite their numbers, small hospitals haven't gotten much attention from health care I.T. software vendors, says James Griffith, senior vice president at Affiliated Computer Services Inc., a Dallas-based consulting, software development and outsourcing firm.

"They've largely been ignored by the vendor community," Griffith says. "Small hospitals don't have the financial clout of large and medium-size hospitals, and many vendors follow the dollars and cater to large facilities."

While some I.T. vendors do focus on the small hospital market, their product menus often aren't as extensive as those of larger vendors, he adds.

A dearth of software options combined with a lack of staff and capital resources to implement and maintain enterprise applications puts many small hospitals at a distinct I.T. disadvantage.

However, adversity has bred innovation at many smaller facilities that have installed high-end technology on shoestring budgets. They've managed to do so using various strategies, including aggressively looking for software discounts, gambling on emerging technologies and being creative with vendor service contracts.

"Smaller hospitals don't have the same choices as larger facilities, but by keeping things simple and implementing systems that give them the best productivity, I would put some small hospitals up against larger organizations to compare which is getting the biggest bang for their buck," Griffith says.

Jackson Community Memorial Hospital is a case in point-the hospital needed a wireless bang, but was pretty short on bucks.

Executives at the 103-bed hospital in Altus, Okla., felt compelled to buy mobile software in mid-2004 after physicians began complaining about not being able to get to a personal computer during rounds to access patient information from various clinical systems from Medical Information Technology Inc., Westwood, Mass.

Jackson Community, however, had not budgeted for the purchase. So executives went looking for the most affordable mobile system they could find.

No money, no problem

David Parker, director of I.T., found that MercuryMD, Research Triangle Park, N.C., was offering members of VHA Inc., an Irving, Texas-based hospital network, preferred rates on mobile software. Jackson Community was able to get the deal as a member of VHA.

Further, the vendor was offering additional discounts to the first and second hospitals in each state to implement their mobile software. Jackson Community also qualified for this discount, which brought its purchase price down to just over $200,000, Parker says. The hospital implemented the system in August 2004.

"We looked at several mobile systems and they all seemed to offer the same functions," Parker says. "But none of the other vendors offered special pricing."

Jackson Community physicians now use the MercuryMD software on PDAs to access patient data from anywhere within the hospital's Wi-Fi network, from Enterasys, Andover, Mass. Nurses use the system to document patient data; physicians use it to access results, such as labs, radiology reports and admission/discharge/transfer information.

Jackson Community was able to fulfill its clinicians' desires without blowing its shoestring budget.

Johnson Health Network, struggling with the same financial constraints, decided to place a bet on an emerging technology to keep its shoestring from unraveling.

The 80-bed, Stafford Springs, Conn.-based delivery system needed to replace a three-year-old fiber channel storage area network that had run out of space.

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