Wheat fields and open prairie dominate the majority of
Syringa Hospital's 7,500-mile service area in Idaho's
frontier region, where only 16,000 residents reside. Yet,
Hospitals and Health Networks has twice recognized
this Critical Access Hospital (CAH), which has only 16
beds, as one of the nation's Most Wired Hospitals.
Health Forum, an American Hospital Association
information company, coordinates the Most Wired data and
develops benchmarks for measuring information technology
(IT) adoption for operational, financial and clinical
performance in health care delivery systems. According to
CEO Joe Cladouhos, Syringa was one of the first CAHs to
receive the Most Wired distinction in Idaho and the first
Idaho hospital to achieve HIMSS (Healthcare Information
and Management Systems Society) Analytics
Stage 6 status. The three-year process has been
accomplished internally using hospital employees with
little or no IT background. Cladouhos said it would have
been too expensive and too complicated to bring in
out-of-state industry experts.
"We decided early on if we couldn't find the
professional resources we needed to do this, we would
figure it out for ourselves," he stated.
"This process has been a learn-as-you-go for
all our staff. Fortunately, we have quick learners and a
supportive medical staff. We like to think we are the
little hospital that could when even a lot of big
hospitals haven't yet accomplished what we
Hospital and Clinics, with one clinic attached to the
hospital in Grangeville and a second clinic 24 miles away
in Kooskia, went live with its first step in electronic
conversion in early 2011. Hospitals nationwide are
mandated by 2015 to implement
electronic health records (EHRs). After 2015,
penalties will be implemented for hospitals without EHRs.
Before proceeding, Syringa's community-owned hospital
board of directors had the formidable task of convincing
voters to pass a $1.5 million loan for upfront funding.
Idaho law at the time required voter approval. Choosing
the right model and system was the hardest decision, said
Darla Anglen-Whitley, Syringa's
"Go-Live" implementation manager.
Getting staff buy-in and teaching staff to use the system
required ongoing education throughout every department
over a six-month period.
"This whole project was like a big puzzle where
you analyze your operation and look at everything like
workloads, procedures, etc. With every step, you ask why
you have been doing it the way you do,"
Anglen-Whitley said. "It's been a challenge all
over the country for physicians to deal with
Meaningful Use mandates for things they were never
responsible for in the past. Our staff did struggle with
that at first. But now they are quite satisfied with how
well it all works."
In fact, Syringa's staff of 10 physicians and midlevel
practitioners has even gone paperless, using iPads for
examinations and charting. Anglen-Whitley said staff
appreciates the EHR system's numerous safety provisions.
For instance, built-in alerts notify staff of possible
problems such as patient medication interactions and
"This system has eliminated a lot of telephone
tag too," Anglen-Whitley commented.
"It helps immensely between the hospital and
clinic staffs that they no longer have to search to find
out who saw this patient last or what happened at that
visit. Any provider can easily access every medication,
every note made about this patient, every order that has
been given relative to that patient. Patient scheduling
is easier and duplicative tests have been
Improved patient safety is the biggest benefit, Cladouhos
stressed. "EHR has transformed us as an
organization," Anglen-Whitley added.
"It's exciting to be helping make and drive our
As Broadband penetration improves throughout their
frontier region, more patients will be able to access
their records from home using the mySyringaChart patient
portal, Cladouhos said. Meanwhile, Syringa staff
continues to move forward with the goal of achieving the
final HIMSS level, Stage 7, by 2015.