Community hospitals, which have traditionally lagged behind in automating their clinical data, picked up the pace in 2010 with 52% reporting they contracted with a clinical information system (CIS) vendor to install systems where none existed, a recently published KLAS study revealed.

The KLAS report, Community Hospitals Accelerating CIS Adoption: Community Hospital Clinical Market Share Report 2011, also noted that an additional 36% of respondents said they are purchasing a system from a different vendor after retiring their legacy system.

"Cerner is seeing a lot of critical access and community hospitals go to market for a new healthcare IT partner," observed Eric Geis, managing director of CommunityWorks for Cerner.

Geis told InformationWeek Healthcare that many clients aren't happy with their current systems' clinical adoption or support, and they see Meaningful Use as an opportunity to fund the necessary changes that will help them keep pace with a modern national health IT infrastructure.

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The study suggests that more community hospitals than ever are implementing CIS systems as they adopt more advanced electronic medical records (EMRs). CIS systems consist of tools such as clinical data repository (CDR) systems, along with physician and nurse documentation systems.

"To get to a full electronic medical record, obviously that becomes much more difficult," Paul Pitcher, the report's author, told InformationWeek Healthcare. "This study did not measure the adoption of EMRs in the community hospital space; it examines the steps that these hospitals are taking to advance in that direction."

KLAS researchers found a nearly saturated EMR market at larger hospitals. By comparison, community hospitals have delayed purchasing EMRs because they have a hard time justifying the technology investment due to resource constraints.

However federal incentive programs have spurred health IT adoption at many community hospitals, the report said, through financial reimbursements, and through regulations that penalize hospitals if their health IT systems do not show improvements in the quality of patient care.

"Now motivated by Meaningful Use (MU) and its associated financial incentives, community hospitals have awakened to the reality that clinical information technology is not only within their reach but may be fundamental to their sustainability," the report stated.

Combining previous research with additional interviews, KLAS contacted officials at 694 community hospitals for the report. Based on its research, the group estimated that approximately 300 to 500 community hospitals had yet to commit to a CIS vendor at the beginning of 2011.

"The challenge for community hospitals is to get to Meaningful Use and that comes in stages," Pitcher said. "Once they get past the first stage of Meaningful Use they can't rest on their laurels, they have to go onto the next stage, so it's going to be an aggressive pace over the next couple of years and that's what community hospitals are working toward."

According to KLAS, EPIC Systems is the community hospital IT market leader, and has won nearly triple the number of hospitals compared to any other vendor. The report noted that the majority of EPIC's customers belong to integrated delivery networks, or hospital systems that have a minimum of two hospitals with at least one of them being an acute care hospital with 200 beds or fewer.

Cerner holds second place; it has the greatest CIS market share in children's hospitals under 200 beds. The study found that the majority of Cerner's community hospital clientele have chosen a hosted platform to defray the costs of buying hardware and software to operate and manage clinical data systems internally.

The study went on to say that KLAS estimates that, of those hospitals that don't have a CIS system, approximately 70% are organizations with 50 beds or fewer. This market will present a plethora of opportunity for vendors, the study concluded.

"Making the change to a fully integrated and automated healthcare environment is a big change and not all organizations have the internal expertise to make it happen," Cerner's Geis said. "Clients are looking for a strategic partner to provide the solutions, services, and experience to get them through the new era of regulatory compliance and competition."

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