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Small Missouri Town an HIT Front-Runner

By Rick Hellman, HCF/KHI News Service, April 13, 2011

LEXINGTON, Mo. – With just 25 acute-care beds, Lafayette Regional Health Center is a small, rural hospital. But as part of the for-profit HCA Midwest Health System, and as both a supporting member and a beneficiary of the non-profit Health Care Coalition of Lafayette County, the hospital is a national leader in the adoption of health information technology.

The promotion of health information technology – known by the acronym HIT -- has been one of the top priorities of the Health Care Coalition of Lafayette County since its formation in 2006.

Convened by the Lafayette County Health Department and funded primarily by the federal Health Resources and Services Administration and the Health Care Foundation of Greater Kansas City, the coalition’s purpose is to advocate for the well being of county residents and employers.

After first assessing health-related needs in the county, it has done this in a variety of ways, from helping low-income residents pay for transportation to doctor’s visits to organizing the Rural Missouri Health Co-op, which was designed to help cut insurance costs for employers. The coalition’s total operating budget for 2010 was $327,000.

Coalition Executive Director Toniann Richard said the group’s efforts have led to the adoption of HIT programs – specifically those for electronic prescribing (ERx) and electronic medical records (EMR) -- by more than half of Lafayette County’s health-care providers. Among other things, the coalition provided $400-per-institution grants for the purchase of computers.

“We have gone from zero to 15 users of ERx programs, and from zero to 10 users of EMR programs,” Richard said.

The coalition also provided a subsidy to Lafayette Regional Health Center to institute an Emergency Room Information System, or ERIS, two years ago.

Darrel W. Box, the hospital’s vice president for operations, said he was glad to have the coalition’s help. Apart from the inherent benefits of electronic records over paper when it comes to patient care – e.g., speed, accuracy and automatic cross checking of various databases – the system has benefited the hospital’s bottom line, too, he said.

The sooner the hospital meets the federal standard for “meaningful use” of electronic records, the sooner it qualifies for federal incentive payments in the form of higher Medicare and Medicaid reimbursements.

“In 2014, that carrot turns into a stick,” Box noted, “and they start docking you.”

Not that the adoption of HIT has been free of problems.

For example, Box said the hospital had to solve an interoperability issue that is keeping communication between the newer ERIS and the older, inpatient EMR system flowing in just one direction instead of both ways.

He said he was glad to have “the corporate behemoth” HCA, with its legal and information-technology departments, standing behind him and the Health Care Coalition at his side as the hospital navigates the frontier of health information technology.

“Lafayette Regional Health Center is ahead of the curve, especially in terms of rural services,” Richard said.

“The sooner you get in the game, the better off you are,” Box said. “Ultimately, we want all the doctors in the place to do it. The ER has been the test case. We’ll start by urging and ultimately require our docs to use it. Forty years ago in medical school, you learned medical Latin. Today you learn computer-speak.”

Health News


  • USA Today, August 19, 2011
  • Pew Charitable Trust, August 5, 2011
  • Kansas City Star, August 16, 2011


  • Grandview News, August 16, 2011
  • Fox 4 News, August 17, 2011
  • Kansas City Star, August 16, 2011