As more legacy systems reach their end of life, Rural Community Hospitals are searching for replacements comparable to those used in the larger metropolitan medical center. If you view the map of population density across the U.S. it is plain to see that there are wide gaps between population centers, which is not normally served by large Health Information Systems vendors. These vendors tend to focus on clients with deeper pockets and large Academic Centers that can feed the Vendor’s “who’s who” reference list. But what about the clients in geographically dispersed areas? What about those patients?
The need for patients to have access to the same integrated care solutions as the metro areas is something that most Information System vendors overlook. What are we talking about in terms of an integrated solution? Acute, Ambulatory, Clinical, Financial, Account-GL, Ancillary, reporting, Pop Health, and Materials Management integrated system. It’s a package because they cannot continue to support disparate systems, interface engines and the associated overhead. It needs to be cloud-based and the implementation effort needs to be condensed. The Cost model is different. Many vendors have become accustomed to Large Medical Center pricing. The model needs to change to provide an ROI for both the vendor and the smaller clients.
Cerner CommunityWorks is one of the major players in this market. It does not offer a scaled down version of their product, it offers the product as a shared-domain experience. This new emergence of Community Based Cloud services from a major player in the market could mean the turning point for Community Based care. The Shared Domain needs to be at a data center that is not owned by a client but is supplied by the vendor.
Vendors can talk about giving back all they want, until they incentivize sales and actually empower them to do so. Even getting to some of the clients may involve a 2-hour drive after flying for 3 hours to get to a major airport Hub. Sales staff may not be “hungry enough” to make that commitment for a smaller commission opportunity. The vendor needs to provide added incentives to the Sales staff to do so.
Smaller communities mean that consulting dollars are slim to none. Being able to lean on a 3rd party to provide client Project Management resources or expect the client to have a fully baked PMO program is not realistic. The vendor needs to augment project resources in areas that they normally have client resources. Smaller staff means more vendor involvement. From an implementation stand-point, the vendor also has to have a fully locked-down implementation methodology. You cannot afford hiccups during go-live, since cash reserves are not there.
On the other hand, the ROI for a Cloud Based-shared environment is the reduced maintenance and support of Servers, Disaster Recovery (DR) and security. For many community hospitals this offers them the opportunity to reduce their server hardware footprint, while improving their DR and system security. It also allows them to reduce the multiple maintenance and support costs of all the smaller systems that they have implemented to keep pace with clinical requirements.
The reality is that the larger Information System vendors have to come to terms over the saturation of metropolitan markets. Unless they are willing to go into support mode and give up net new sales, the next frontier is truly in Rural Care.