Planning the Implementation of HIT in a Rural Setting

The goal of this planning project was to prepare for the implementation of a health information technologies (health IT) infrastructure that will eventually weld together as a "virtual organization" all of the disparate health care organizations and providers in Deer Lodge, Granite, and Powell Counties in Montana. The project was conducted by a partnership including six initial members: the Community Hospital of Anaconda, Inc. (CHA), the Deer Lodge County Public Health Department, the Mt. Powell Medical Society, Anaconda Internal Medicine, PC, David Kidder, DO and the Health Services Center, Anaconda Jobs Corps of the USDA Forrest Service. The planning effort included nine areas of activity: hospital management and financial software systems; hospital-based clinical operations; ambulatory care EHR; Continuity of Care Record (CCR); technology; partnership extension and model exportability; HIPPA and Regulatory Compliance; capitalization and economic sustainability of the health IT effort; and research. As a result of the planning effort, pre-project hospital management and financial software systems will be retained and expanded; a single source solution was chosen for hospital-based clinical operations; a provider collaborative for ambulatory care EHRs was initiated to obtain benefits of more robust products; the Continuity of Care Record (CCR) developed within this project was suspended, as commercial solutions have become available; rural high-speed VPN internet connectivity was investigated and established by a variety of mechanisms, including satellite connection with satisfactory speed using SSL security; the original partnership membership has been extended with emphasis on shared systems, particularly ambulatory care EHR, with project results represented at state-wide conferences; and HIPAA and Regulatory Compliance was noted to be increasingly addressed by vendor standards and certifications. Both capitalization and economic sustainability of the health IT effort, and other research, are pending.