The College of Health Information Management Executives has released a case study on how Chadron Community Hospital and Health Services, a critical access hospital in Chadron, Neb., implemented its electronic health record system.

Chadron Community went live with its records system in July 2011, but preparations for the change started many months prior. “A great deal of work went into the planning,” said Cheryl Cassiday, Director of Nursing for Chadron Community Hospital. “We did a lot to prepare and teach staff, physicians and other providers.”

While communication and cross-function teamwork were easier at a smaller organization, other challenges existed. “We were using our regular full-time staff to work on this, not someone who could dedicate 100 percent of his or her time,” Cassiday said. “Still, it was a plus to have the people who are actually doing the job designing the system. They could see it from the staff perspective.”

The 25-bed CAH provides medical and surgical care, obstetrics and newborn care, emergency care, and rehabilitation services to the population of the Nebraska panhandle and surrounding communities.

Critical access hospitals like Chadron Community Hospital represent roughly 30 percent of hospitals nationwide, often providing critical healthcare services in underserved rural areas of the country. As of last year, 89 percent of CAHs had an EHR in place and 62 percent of CAHs with an EHR had a fully electronic health record system, while 27 percent had a health record system that was part electronic and part paper.

However, critical access hospitals are struggling with EHR implementations.  As of late 2013, they were less likely than other hospitals to have demonstrated meaningful use in the EHR incentive program. In addition, determining payments for participating in the Medicare and Medicaid EHR Incentive Program is not as straightforward for CAHs as it is for other types of acute care hospitals

The CHIME case study on Chadron Community Hospital is available here.

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