Some critics say that the government's timeline for EMR implementation is unrealistic, as many facilities don't have enough resources to meet the standards in time to avoid the penalties.

"For us, it took seven years to get there. It can't be done in two or three years like the health reform calls for," says Geller. "There aren't enough computer experts out there to do all the installations in 6,000 American hospitals to get up to meaningful use. It's a great goal, but it's too rapid of a pace," he says.


Smyly says INHS works to speed along the process of bringing hospitals up to meaningful use standards by working in a packaged, box-like approach. The organization tells the hospital staff exactly what needs to be done in terms of IT to be eligible for the incentives. INHS strives to address the necessary changes in a streamlined and straightforward route.

"It's not a discussion about philosophy of care, it's, 'You need to capture this element in this point in the process,'" says Smyly.

Despite the challenges, the government's commitment to IT is bringing EMR to the forefront of hospital budgets. Smyly says INHS has been working on such initiatives for years and believes it's a step forward in the quality of care.

"Lots of visionary folks are seeing this and if they're not, the best thing the government's done is put a big stick and a big carrot out there, so now it's not our team talking people into it and trying to prove to them that this is the right thing to do, this is the law," says Smyly. "It's beautiful because it's just moving it up the priority chain."

Other solutions for community hospitals

In addition to physician shortages and IT implementation, rural hospitals face a number of other challenges. Whether it's replacing parts on a piece of equipment or securing a source of funding for a major infrastructure project, several companies provide customized services for rural hospitals.

Tracey Wischmeyer, a sales and marketing associate with TriMedx, describes critical access hospitals as her "bread and butter." The company provides medical equipment management services for community hospitals (large hospitals make up approximately 75 percent of the company's business).

"Because most of our hospitals are so small, they cannot afford a full-time employee on staff to be on call whenever a piece of equipment goes down," says Wischmeyer. "TriMedx specializes in repairing, doing maintenance and preventative service on biomedical equipment."

In addition to biomedical equipment, TriMedx also services radiology and laboratory equipment.

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