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New regulations, flowing from federal health care reform, require hospitals and clinics to convert from paper to electronic medical records by 2015 or face fines from Medicare. The task is especially daunting for small, rural hospitals, since they operate on very narrow margins. Implementing electronic records can cost millions of dollars.

In rural Minnesota--where medical services can be scarce and communities worry that financially-strapped hospitals and clinics could fold under additional pressure--a group of hospitals is facing the requirement together, as a co-op called SISU.

, which one fan says is "Finnish for chutzpah," offers its members technical equipment and support and saves money through group purchasing and volume discounts.

"A lot of pricing is based on bed size or revenue," says Jodi Nelson, SISU's chief operating officer. "These rural hospitals pay more. This was a means for us to pull together users for purchasing power and licensing agreements and to leverage the numbers."

SISU's technical staff comes in handy in rural areas, which are often short on IT professionals. Says Nelson, "Some of our members would say, even if I had the funds, I can't get the types of people, the breadth of knowledge I would need, [in my town]."

Informally started in 1982, SISU became official in 1997. Its 22 full and associate members range from Regina Medical Center in Hastings to Cook County North Shore Hospital & Care Center in Grand Marais. The organization, which operates as a non-profit, embraces system hospitals and independents alike.

It's all but impossible for a hospital to go it alone on electronic medical records, explains Nelson. "It's about cost and resources.  Partnering with other organizations allows them to pool together and make more headway. The savings are incredible."

Minnesota News

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SISU in Duluth gives rural hospitals technical support and buying power.

Rural Hospitals Use Co-op Approach to Meet Tech Requirements

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