Overcoming rural hospital challenges through community engagement at Comanche County

July 30, 2019 |  Productivity, Patient Engagement, Social Determinants

Doctor leading a medical team at the hospital

According to a new report from Navigant, 21% of rural hospitals in the U.S. are at a high risk of closing. Lack of liquidity, outdated technology, and knowledge gaps with minimal financial resources to fill them are just a few of the challenges rural hospitals are struggling to overcome. Despite these alarming statistics and obstacles, there are steps organizations can take to be successful and address socioeconomic drivers for their communities

Overcoming rural hospital challenges

At Comanche County Medical Center (a 25 bed critical access facility in Comanche, TX), we were on cruise control despite facing the common rural health struggles. After evaluating our care setting capabilities, the staff and medical board made it our mission to better leverage our organization’s operational capacity. We provided a vision to the board of what the future could be for us and how we could fulfill our potential. 

A big part of achieving this vision has been MEDITECH’s EHR. It has helped us to correct internal processes and train our staff the right way so everyone is moving forward together. As a result, we’ve reduced clinical variation and eliminated inefficiencies that caused higher operating costs. Other positive outcomes have included enhancements in population health, reduced diabetic conditions for those who are predisposed, and improved internal communication. But the real impact of our improvements is showcased through the support of our surrounding community. 

Supporting your local community

At Comanche, we take great pride in partnering with companies and delivering benefits for employees and their families. With no restrictions of industry or municipalities, we are consistently working to remove healthcare barriers and become a preferred provider. This outreach has allowed us to offer pre-employment screening for large-area employers, such as Kohler, which typically leads to new patient sign-ups. 

By operating as an all-inclusive regional health care system that puts patients first, regardless of their social or financial status, the community supports us. Because of this, we are being approached by individual providers, such as dermatologists and health/nutrition coaches, who are interested in working at our facility. With a steady influx of patients coming into an enriched care environment powered by the latest EHR technology, our cash flow and bottom line continues to increase. Our patient census is running two to three times greater than previous years during the same time period, an astounding number for a critical access hospital and the type of volume we knew we could achieve. 

These results and the dynamic aspects of our organization are all fueled by a culture built on the principles of consideration and respect, and commitment to community trust. With rural hospitals suffering from a lack of capital, it’s vital to stick together and share ways of empowering other rural health organizations so they can invest in quality care initiatives and, thereby, the community. From supporting local events to hosting a free food truck every month, sponsored by the state for families in need, our journey shows that little things can make a difference. 

The intuitive nature of MEDITECH Expanse will help us isolate issues, such as pain management, and put more resources into new areas, especially analytics. By not staying stuck in the past and taking a novel approach to care, we hope to keep building a tangible blueprint for critical access hospitals. Small, rural hospitals can thrive and make a powerful impact by engaging with their communities and doing whatever it takes to serve them. 


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Written by Dr. Larry Troxell, CEO, Comanche County Medical Center

Dr. Larry Troxell is the CEO of Comanche County Medical Center in Comanche, Texas. Dr. Troxell has held roles as Chief Operating Officer and Chief Executive Officer in both Critical Access Hospitals and Surgical Hospitals in Oklahoma and Texas. He has over 30 years experience in hospital operations and management and has implemented plans improving quality, efficiencies and overall hospital performance.