The Board of Trustees of Phelps County Regional Medical Center approved a measure on Wednesday that mandated hospital physicians to regularly utilize the computerized physician order-entry system no later than Jan. 1.

Already ahead of the curve to implement an overall system of electronic medical record-keeping, having received the “Stage 6” designation from the Healthcare Information Management Systems Society earlier this year, trustees and administrators were gratified to hear the hospital is but one of the few in the nation to have attained such a high ranking for its paperless system. Only 1 percent of hospitals nationwide presently have the Stage 6 designation, according to a representative of HIMSS.

As prelude to the monthly trustee’s board meeting, HIMSS Vice President John P. Hoyt congratulated the trustees and administrators for their strategic planning and commitment to improving patient care and safety.

“You are really out in front, in terms of information technology,” Hoyt said, referencing the 23,000 hospitals worldwide that belong to the HIMSS organization.

With federal Stimulus funds waiting to be distributed in 2011 with an initial reimbursement of $2 million for each compliant hospital, Hoyt said hospitals and physicians stand to benefit the most the earlier a paperless environment is adopted.

To be considered Stage 6, Hoyt explained, a hospital needs to have adopted electronic physician documentation, closed-loop medication administration, pictorial-archiving computerized medical-imaging records and electronic records for the laboratory, radiology and pharmacy. Only one higher designation is possible — Stage 7 — which includes the criteria of a fully-electronic medical record and data warehousing.

PCRMC Vice President and Chief Financial Officer Jerry Paule said the hospital first began the conversion to electronic medical records as early as 2001.

“This project started with a vision,” Paule said. “And that was to create a central repository of clinical and financial information that is reliable, timely, consistent and can be conveniently accessed. By creating the repository, we hoped to provide operational efficiencies, increase patient safety and increase the likelihood of better decisions and outcomes.”

David Dawdy, PCRMC’s chief information officer, said, “Everyone at PCRMC, from the executive team, to nurses and clinicians, to administrative support, has worked together to help get us to Stage 6. We have had such a positive experience implementing technology into our organization, because all of our staff has been on-board since Day One with our goals.”

Chairman of the Board of Trustees Jim Marcellus commented on the board’s decision to set a deadline for computerized physician order-entry.

“Even though there will be a learning curve for changing the way they do their documentation, our physicians recognize how important this is for patient safety,” Marcellus said.

The special meeting also was attended by numerous members of several PCRMC committees presently assisting with the ongoing development of electronic medical record-keeping, including the Physician Advisory Committee, the Information Technology Steering Committee and the group, Senior Leadership of PCRMC.

Other actions taken by the PCRMC Board of Trustees at Wednesday’s meeting included the following items:

• The board approved the July financial statements submitted by the Finance Committee. Although July revenues were not as “robust” as the first six months of the year, with net patient revenues of $13.58 million coming in under budget by $338,000, year-to-date net patient revenues of $100.74 million still exceeded budget by $5.68 million.

Hospital expenses also came in under budget at $14.07 million, or $358,000 less than expected.

Moreover, nonoperating revenue gained $886,000 in July and exceeded budget by $655,000 because of “outstanding market conditions.”

The total cash and investments of the hospital stood at $77.55 million on July 31, which increased by $3.25 million since June 30.

The total debt owed by the hospital at the end of July was $53.99 million, which decreased by $81,000 from the end of June.

• In preparation for planning the next five-year, capital-asset budget, which encompasses 2010 through 2014, Paule recommended the board maintain a conservative stance. He presented a model income statement, balance sheet and cash-flow projections based upon the following assumptions: A 5-percent growth in revenues and expenses; 10 percent of net operating revenues paid for bad debts; no new indebtedness; a capital budget of approximately $13.4 million a year; and not spending any investment or related income on capital expenditures.

“There are no critical capital projects that can’t wait,” Paule told the board.

One possible exception might be the patient tower project, which would privatize patient rooms and add an additional 90 rooms, Paule said.

With an estimated $40-to-$50 million price tag, Paule said the present cost of borrowing money for the project is too high. Should borrowing-costs decrease, the hospital may have to reconsider the improvement plan.

However, should the board adopt the proposed model, Paule forecast a reduction in overall debt of $30 million dollars by the end of 2014.

• Linde Merrow, administrative director of PCRMC’s Clinical Quality and Measurement, reported the latest Integrated Quality Assessment Committee findings to the board, which approved the report.

The second-quarter patient satisfaction reports indicated the following results: Outpatient satisfaction results stood at 93.5 percent; ambulatory surgery at 92.7 percent; inpatient results were 84.2 percent; and emergency department results were 82.7 percent.

Merrow said the campaign to heighten awareness of good hand hygiene is under way and is especially needed with the “flu season around the corner.”