1. Rural HIT Challenges and The Importance of a Foundation to Success Roger L. Holloway Co-Director

2. Typically Three scenarios: Free Standing non-owned or affiliated Affiliated with larger organization Owned/Operated by larger organization

3. 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

4. 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

5. 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

6. Clinical Needs Replace non-HL7 lab systems with HL7-compliant one Replace Radiology equipment Replace outdated telemetry equipment Replace outdated nurse call HIM coding software need and training of coder

7. General Needs HR and Payroll software upgrade needs Phone System Upgrade Upgrade email management systems (such as Windows Exchange Client)

8. 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)

9. 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