Rural Healthcare CFO Shares EHR Implementation & Strategic Planning Advice

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By CereCore | Jun 7, 2024

5 minute read EHR/EMR| Blog| Client Perspectives| IT Strategy

If you have a strategic plan for your healthcare organization, do you also have healthcare operations data that can help you make decisions? How does a healthcare chief financial officer (CFO) view a large IT investment like an EHR replacement? Alma Alexander is the chief financial officer (CFO) at Cuero Regional Hospital, and she shared her perspective on what it’s like serving as a CFO in rural health during a recent interview on The CereCore Podcast.  

From guiding conversations with hospital boards to preparing for multi-year, complex EHR implementation projects, Alma has seen her approach to using strategic plans work well when it comes to encouraging collaboration across the leadership team and being ready for technology change.

Stream the episode and hear Alma’s conversation with host Phil Sobol, Vice President of Business Development at CereCore, about how to maintain leadership alignment around operational goals, budget and plan for modernization efforts, and ways technology makes a huge difference to patent care in rural settings.  

Communication between CIOs and CFOs 

CIOs are paying attention to new and emerging technology like AI, automation, consumer-facing technologies like portals and EHRs. They are looking for ways to modernize infrastructure by moving to the cloud and ward off technical debt. And, top of everyone’s mind is cybersecurity. The list goes on and on.  

What healthcare technology topics catch the eye of a healthcare CFO? 

Alma recounts ways that technology helps provide and support patient care, especially in a rural area. Inpatient cardiology, psychiatry and stroke in their ER are a few areas that take advantage of telemedicine. Their patients can receive bedside care even though the specialist or cardiologist practices in another city.  

While larger health systems need data, too, rural health benefits tremendously from better data and possibly AI for certain business processes, and Almas has started to think about future plans. 

"Right now, we are going through changing our EHR to a newer system that should bring us more efficiency,” said Alma. “It is hard to pull information out of our systems. Those older systems are not as easy to track stats and things that can help us make decisions for our future. If we have a strategic plan, how do we know what to look at if we do not have great data?” 

CFO’s take on financial readiness for technology investments 

Often the list of needed (or wanted) technology investments needed can be quite long.  

What does a hospital or health system CFO look for from a CIO when it comes to an investment request?   

Alma explained that several years ago their CIO joined the team, and they started planning what they needed to do to update the EHR system and then implement a new EHR. “Having a conversation with her included things like: what are the needs? How far behind are we? And what do we need to do to get there?”  

As a part of their organization’s strategic planning process, they established a regular cadence of planning, reviewing and updating their plan to remain aligned and focused.  

"By using that strategic plan, we were able to make sure that we were financially ready for it. Working with our CIO, she helped us know what we needed, what needed to be updated, what type of rules that we need around it, cybersecurity, things that we needed to do to make sure that we were taking care of our system and keeping it safe. Also, what is the return on investment, how do we come up with showing how it is going to assist our organization? We rely on her and her expertise to guide us through what we need to be done in the organization,” said Alma. 

Managing strategic alignment from board of directors to front line care team members   

Embarking on an EHR upgrade and modernization program and keeping an organization informed of strategic plans and rallying around common goals can be a challenge across leaders, stakeholders and especially busy care providers.   

Have there been tough decisions, critical conversations or pivotal moments along the way? of the hospital, the board, or any pivotal moments yet?   

Several years ago, Alma and the leadership team took on the effort to determine what EHR system they were going to move forward with. From pulling together the budget to present to the hospital board of directors to being prepared to answer their questions and educating them on how it all works was one of the first pivotal moments. 

“Especially now with all the changes in the way that you book equipment, software service, and all those types of things. All of that came into play,” said Alma.  

Alma pointed out that they included contingent cost in the budget and made sure their board was aware should they need additional services, equipment, processes, or software as a service partner because the new system could have different requirements. 

“The pivotal thing now is we have a team that is ready and willing to do the work, but we still do not have enough hours. So, those are some of the things that we will have to plan on stepping out and getting additional help on.” 

During testing, they included directors, care providers and those on the front lines and Alma shared, "It is great to see that our team is really engaged and that they want to do the work...So, those types of things that we have been able to do are the pivotal moments to me.”   

EHR Success for a Healthcare CFO 

From your perspective as the CFO, what will success look like for the Expanse implementation?  

"First of all, I do want to say that patient safety is my number one concern,” said Alma. “I want to make sure our patients are safe when they walk in that door.” 

“Having this newer system and being able to get all the information that is needed, being able to trace it from our clinics, all the way through the hospital service, and just to be all on the same platform is great for us. And then, ultimately, as the CFO, I am going to go back to — are we dropping all of our claims and getting all our revenue in?” said Alma. 

Key Takeaways 

  1. Financial readiness: Alma emphasized the importance of keeping up with revenue, controlling costs and planning for technology investments for the long-term sustainability of the facility. 
  2. Staffing: Alma stressed the significance of having a well-thought-out staffing plan to help ensure the organization has the right people in place to deliver quality patient care and take on all the pre-planning and implementation work associated with a new EHR system. 
  3. Equipment: Alma discussed the need to plan for equipment that will be needed to update the EHR, stay current with technological advancements and enhance operational efficiency. 

Related Resources 

Download more podcast episodes

Hear perspectives from other healthcare leaders on The CereCore Podcast:

When Healthcare's Toughest Problems Need an Outsider's Perspective

Kim Waters, Principal Consultant of Revenue Cycle at CereCore


Why EHR Optimization Is Worth The Effort And Budget

Bob Gronberg, Assistant Vice President of MEDITECH Professional Services; John Walsh, Manager of MEDITECH Professional Services; and Stephanie Murray, Senior Director of Epic Services at CereCore


Rolling Out EHRs in the Rural Setting: An Expert Guide

Ismelda Garza, CIO at Cuero Regional Hospital and Senior Consultant at CereCore


Rural Healthcare: A CEO's Take on Advocacy, Tech and More

Lynn Falcone, Chief Executive Officer at Cuero Regional Hospital


A CEO's Experience: What an EHR Technology Change Really Needs for Success

Anne Hargrave-Thomas, Chief Executive Officer at OakLeaf Surgical Hospital and Vice President of Operations at Surgery Partners


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