1. The Value of an Interoperable EHR for Small & Medium Size Hospitals

2. EHR systems designed for small hospitals have as much a requirement for interoperability as those designed for large integrated delivery networks both to improve patient care and to protect record security. Standards-based interoperability for all is indispensable in unifying world-wide healthcare. The Value of an Interoperable EHR for Small & Medium Size Hospitals

3. There has always been a constant quest to ensure, that regardless of where one physically resides, they have access to as high quality healthcare as anyone living in a large metropolitan area. The delivery mechanism may differ, but no one should have less opportunities than another Equality of Healthcare Services

4. Historic delivery mechanisms of high quality healthcare services to rural areas Small and mid-sized hospitals have always provided excellent leadership by continuing to add services previously only available at larger regional medical centers Regional medical centers have provided outsourced and outreach programs to smaller communities

5. Examples of advanced technology enablers of high quality healthcare services to rural areas Internet Smart Phones Collaboration Teleconferencing Telemedicine IHE Interoperability

6. Emergency Room Scenario Patient present in the emergency room Limited or no history at the rural facility States they have a long history of their ailment or cannot speak at all Access to prior medical history is crucial

7. Patient presents for treatment with multiple providers in a region Requires or requests controlled substance Access to prior medical history is crucial Substance Abuse Scenario

8. Emergency Room Physician Office Pharmacy Podiatrist Ophthalmologist Hospital Outpatient Lab Diabetic Scenario Dietary Nutritionist Diabetic Ed. Program ADA Support Group Local Fitness Center Home Healthcare Long Term Care

9. Government services and healthcare services overlap and boundaries blur Requirement for cross agency access to vital records Portsmouth NHS Trust, U.K. Children Services (7) Agencies Social Services Scenario

10. Recruitment to Rural Areas Access to technology expected only in available in large metropolitan areas is essential to physician and other care giver recruitment and retention. Productivity demands of all types of healthcare providers continue to increase.

11. Financial Survival Financial “productivity” continues to be a requirement for not only the ability to survive but the ability to thrive in rural areas. Reduction of unnecessary tests, length of stay, medication errors, etc. all effected by adequate access to patient histories.

12. Aging & Mobile Population Shift The average American moves residence once every 5 years Health records becoming increasing dispersed “Snow-birds” Baby boomer population coming of age Children often need to track parent health over long distances

13. Community trust and confidence in quality of local healthcare delivery Patient Satisfaction Physician Satisfaction Employee Satisfaction Financial performance Competitive Positioning

14. Clustered mini-RHIO’s Beginning of regional and state-wide exchange of patient data Multiple connection of these “building block networks” will eventually evolve into RHIOs Role of the IDN’s, For-profit & Non-profit groups

15. World-wide Connectivity Compliant vendors continue to expand into global markets bringing technology with them Both personal and business travel continue to increase World-wide health initiatives require global connectivity (AIDS)