Among its several IT initiatives, the hospital worked with INHS to implement a barcode medication verification system.

"We've really driven down our medication error rate just through scanning. We're running maybe one medication error for every 6,000 medications dispensed," says Geller. "Medication errors are probably the most common errors that occur in hospitals and through using IT, we've really been able to see significant improvements in that area."


If this particular IT solution is so effective, does the government require hospitals to have it?

"Absolutely, except for not really," says Smyly. "You don't have to have the barcode medication verification system to meet meaningful use, but if you don't, I don't know how you would meet meaningful use, meaning that the system works by driving the best practice and it's by far the best way to do it," he says.

Despite their value, critical access hospitals are bound to face some problems in working to achieve the new IT standards. For rural facilities that often have strained budgets, meeting the requirements may be a costly process.

"A lot of critical access hospitals are simply fighting for survival. It's very difficult to find the financial resources to implement IT because it's not cheap," says Geller. "You can get systems that aren't very good that are cheap, but it just isn't going to equate to what meaningful use means in health reform, which means to really enhance patient outcomes."

Another problem with IT adoption is culture. It takes a lot to make sure the staff is comfortable and willing to undergo the necessary changes for using the new technology, says Geller. In addition, the rural location of critical access hospitals makes it difficult to attract the professionals needed to effectively implement the new technology.

"You need some really sophisticated IT health care expertise to run these systems for you," says Geller. "There are a lot of computer experts now in the country, but very few of those people are experts in the health care arena, who can effectively communicate with doctors and nurses and understand what they're looking for in electronic medical records," he says.

Rollins Brook Hospital launched its EMR system a few years ago. Currently, the hospital is working on implementing computerized physician order entry (CPOE), says Villanueva.

This summer, Mammoth Hospital will begin using the barcode medication verification system and plans to implement CPOE in a couple of years.

"The key to this is getting physician involvement," says Boyd. "We're actually having a vendor fair next month for the physicians to come and look at the products that we're considering for CPOE and an ambulatory electronic health record system, so we can get their input and they can get their hands on it."

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