Phew! Suzanna's interview with Russ Branzell lays out a number of critical IT issues facing hospital executives. As Russ points out, the situation is magnified in rural settings where CIOs wear multiple hats and staffing is at a premium.

It's been an eventful week here in Phoenix. While I'm happy to get home to my family, I'll miss the 70-degree temperatures and sunshine. I'll also miss the conversations with the executives and trustees in attendance. They are an enthusiastic group of leaders who are committed to improving care for their communities. That was even evident in this extremely awkward lunch conversation I had:

Me: How are things going at your hospital these days?
Joan (not her real name, which she didn't want to use): It's been challenging. We are a critical access hospital and we've been bankrupt for a while. I've been trying to keep things afloat until we could find a partner, which we did recently. That's helped shore things up.
Me: How is that transition going?
Joan: Well, I'm not totally sure. They terminated my contract.
Me: Oh….
Joan: I guess they didn't feel like they needed two CEOs.
Me: Oh…um….
Joan: But it's good for the community because we were able to keep those valuable services in the community.
Me: Huh…how about this weather…

To be sure, Joan isn't happy with her current circumstances. A nurse by training who still helped out in the ED from time to time, she'd like to be back at the helm of the hospital. The bitterness, though, is overtaken by a deep concern for her small Arizona community. Maintaining critical health care services was paramount. 

While Joan's personal story is the outlier among executives who attended this week's meeting, her hospital's tale isn't. As I reported on Tuesday, rural hospitals are exploring a variety of survival options.

Speaking in even more blunt terms during his plenary session, governance consultant James Orlikoff said, “You must make yourself relevant. If not, you'll be rendered irrelevant.”

Let's put some context around Orlikoff's comments. He had spent several minutes describing how the market — not necessarily the government — is rapidly pushing to value-driven care.

Whether it is narrow networks or employers such as Walmart striking deals with centers of excellence, market forces are disrupting the traditional relationship between communities and their hospitals. Consumers have more choices and more flexibility, he pointed out.

He implored the executives to “get aggressive” about addressing cost and quality. And to the trustees, he said, “You must engage in disruptive governance.”

This wraps up our coverage from the Rural Health Care Leadership Conference.