How Gulf coast storms spurred EHR adoption

"How Gulf coast storms spurred EHR adoption" is third in a four-part series on healthcare IT and EHR adoption in rural regions.)

Louisiana is almost entirely rural with just 27% of its people living outside major metropolitan areas. But no state faced greater challenges in bringing electronic health records to its rural areas in the past decade.

“The IT push for us all got started after hurricanes Katrina and Rita,” says Linda Deville, CEO of Bunkie (La.) General Hospital, an 18-bed critical-access hospital with an eight-bed psychiatric unit. Refugees from New Orleans and Baton Rouge fled north and west from Katrina in August 2005, and north and east from Lake Charles from Rita a month later. The human waves of patients without medical records crashed on Bunkie, a town of about 4,100 people.

“We're in central Louisiana, so we were the first stop,” Deville says.

The one-two punch of Katrina and Rita raised health IT consciousness all along the Gulf Coast. The Louisiana Legislature allocated $15 million to start a health information exchange and offered $1 million grants to the first seven healthcare organizations to purchase health information technology, Deville recalls.

Bunkie won a grant, and then rushed to get its new EHR up and running by the state deadline. The installation started in January 2008 and “had to be substantially complete by June 30, when state funding ended,” Deville says. The thinking was, “We may never have another $1 million to do this. It was rip the Band-Aid off. We were the first critical-access hospital (in Louisiana) to go fully electronic.”

Bunkie also was the first of the state's 29 CAHs to join the information exchange, run by the Louisiana Health Care Quality Forum, based in Baton Rogue. The link went live in September 2012. So far, 130 Louisiana hospitals, 35 in rural areas, including 20 CAHs, are connected to the information exchange, says spokeswoman Linda Morgan.

“It's just the very beginning of this, so there's not a whole lot of healthcare information in the network as we speak,” Deville says. Bunkie also recently launched a clinical and psychiatric telehealth program in conjunction with the LSU Health Sciences Center in Shreveport. The program loads a number of telehealth tools on a rolling cart.

“We call it our computer on wheels,” she says. Aboard the cart are a stethoscope, skin camera and other tools. “They have a doctor in Shreveport and you talk to him. The doctor has a headset and a nurse (at the clinic) has a headset. He can hear the heartbeat in real time and tell the nurse to move it left and right. The skin camera can take snapshots and put it in the electronic health record and magnify it.”

In calmer times, the hospital and its two outpatient clinics draw nearly 20,000 patients. “It is harder for a small hospital,” Deville says, but on the other hand, “you don't have all the politics. It's 'this is what we have, let's work with it.' ”

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