GMH details fragmented EHR and a $25M IT infrastructure ask; RCM outsourcing seen as revenue lever

Guam Memorial Hospital executives told the Committee on Health and Veterans Affairs they are running multiple, noninteroperable electronic health systems that create ‘‘dead zones’’ at the bedside and impede registration, charting and revenue collection.

IT and EHR condition: Hospital staff said patients are registered in a sunsetted system while clinical documentation occurs in a separate EHR; scanned documents and disconnected modules force clinical staff to open several systems for a single patient. The hospital described large sections of the facility with limited wireless coverage that hamper bedside documentation and barcode‑based inventory tracking.

Funding and projects: GMH identified an IT network and infrastructure upgrade totaling $25 million (five‑year plan) to power the building and address coverage gaps; it separately listed an estimated $25 million for a full EHR replacement, currently listed as an unfunded project. Hospital leaders said cyber‑security improvements are included in the infrastructure work.

Revenue cycle and outsourcing: GMH described active efforts to outsource revenue cycle management (RCM) and other services (environmental, dietary, security) to achieve efficiency and revenue gains. Management estimated improved RCM processes could generate roughly $12 million per year through faster claim processing, denial management and automation. The hospital plans phased outsourcing and said vendor proposals should include staff‑absorption plans to limit involuntary layoffs.

Why it matters: A modern, interoperable EHR and an effective RCM materially affect patient safety, billing accuracy and cash flow. GMH told lawmakers the current setup contributes to manual processes, denials and revenue loss.

Next steps: GMH said it is pursuing financing options for a consolidated EHR and has begun IT infrastructure upgrades; the Legislature, hospital and governor’s office may need to coordinate funding and procurement steps. The committee asked for clearer timelines and milestones for IT infrastructure, EHR replacement planning and expected RCM contract outcomes.

Attributions: Interim CEO Jolene Ugen and IT administrator Manny Gabriel described the technical gaps; CFO Yuka Heninova discussed the budgetary posture and the RCM revenue estimate.