Before Michael Coyle joined Coteau des Prairies Health Care System in South Dakota as CEO, he knew he'd have to address a few issues.

The 25-bed acute care system in Sisseton, a rural town 160 miles north of Sioux Falls, had limited staff, burdensome administrative tasks and low satisfaction among providers and patients. Coyle, who particularly enjoys the challenge of turning around struggling small-town hospitals, started by bringing on a new leadership team and looking at various departments for answers.

“We just started peeling apart the onion to see what some of the problems were,” Coyle says.

His team asked staff and one another a number of questions: Are there standard operational procedures? Did patients trust the staff? What was the culture like at Coteau des Prairies? And did everyone in the system smile?

During their review, Coyle and his team heard concerns again and again about the electronic health record system in place. One member of the staff went as far as to describe it as a “rock pile,” Coyle said. He discovered that the EHR wasn’t set up correctly and wasn’t being used by any providers, and that the data didn't exist.

Many physicians used a hybrid of manual notes and EHR entry because they didn’t trust the system, or couldn’t get the information they needed, Coyle recalls.

Within six months, Coteau des Prairies had a new EHR in place.

Coteau des Prairies now has 100 percent physician usage of its EHR, a percentage that Coyle says he has not achieved in any system he's worked at before. Provider trust has also improved. Many of the clinicians travel to multiple clinics, and the new system allows for records to be readily accessed across locations.

The data collected by the new EHR have created a picture of the health needs of the population served by Coteau des Prairies. If any condition is 30 percent higher than the system’s average, Coyle and his team re-evaluate how they're allocating physician hours across the system.

Data from the electronic records are analyzed to keep providers aware of the top five or six reasons for patient visits. And the patient information allows Coteau des Prairies to decide whom to recruit, which pieces of equipment are needed and where processes can be streamlined, Coyle says.

Spending less time with the EHR and more time with patients and family has made staff at the system happier than ever. The time staff no longer spends wrestling with the EHR is now spent with their own families, says Coyle.