This article was originally published on healthsystemCIO

A 130-bed independent hospital in Amsterdam, New York, earned a Leapfrog B safety grade by tackling one of the most daunting challenges in clinical IT: getting medication alerts right. St. Mary’s Healthcare, a rural safety net hospital where roughly 70% of patients are covered by Medicare or Medicaid, had long delivered strong clinical care, but its Leapfrog score told a different story. Because the hospital had not participated in the Leapfrog survey between 2020 and 2024, its grade was based entirely on publicly available data and did not reflect the quality of care the staff was providing. When leadership decided to take control of that narrative by submitting its own data, the organization turned to its CPOE system and set out to maximize every point it could earn.

Julie Demaree, VP and Chief Technology and Digital Innovation Officer at St. Mary’s Healthcare, said the hospital already had a medication alerting tool in place, but the organization had been cautious about expanding its use. Concerns about alert fatigue, physician disruption, and the governance required to manage changes had slowed adoption. “Safety isn’t about size,” she said. “It’s about discipline and culture and being committed to patient care.”

The Leapfrog initiative gave the team a clear reason to accelerate: Demaree and her colleagues formed a cross-functional committee with the chief medical officer, the director of pharmacy, and the informatics team to determine which alerts to activate and in what order. The Leapfrog Hospital Safety Grade is one of the few national ratings that evaluates hospitals exclusively on their ability to prevent errors, injuries, and infections. Hospitals are scored whether they submit data or not; those that don’t participate have their grades calculated entirely from public sources.

Getting the Alerts Right

The CPOE component of the Leapfrog score requires two things: proof that prescribers enter their own orders and evidence that the hospital’s system can flag more than 60% of serious medication errors. The first criterion was easy; St. Mary’s quickly got over 92% compliance by identifying the few outliers who weren’t entering their own orders. The second criterion required expanding the alert categories the system monitored, including drug interactions, drug-allergy conflicts, dosing errors, drug-lab levels, and drug-age warnings. The hospital had a solid alerting foundation in place; the Leapfrog standard called for broadening it. The challenge was doing so without creating alert fatigue among physicians who would encounter notifications dozens of times a day.The governance model made the difference. The committee recruited volunteer physicians from both inpatient and outpatient settings to pilot the new alerts before a broader rollout. The feedback was immediate and specific. A GI physician assistant reported that every bowel prep order triggered a dangerous-dose alert; the team suppressed it before the systemwide launch. Physicians also flagged the lack of appropriate override options: the only choices available forced them to acknowledge a dangerous situation and proceed anyway. The committee added options such as “this is a home medication” and “these medications have a synergistic effect,” giving clinicians a way to document sound clinical reasoning when dismissing an alert.

A dedicated physician trainer rounded daily during the rollout, asking clinicians what was popping up and what felt unnecessary. That in-person presence proved more effective than any help desk ticket system. Physicians don’t call the help desk, Demaree noted; they’re too busy, and many have concluded that IT can’t help them. Having someone physically at their side, capturing frustrations in real time, created a feedback loop the organization had never had. “If we are living in a world where we think no one complaining means things are going well, we are fooling ourselves,” Demaree said. When a clinician flagged an alert as unnecessary, the team evaluated the data, made a decision, and communicated the rationale. That transparency built trust and sustained momentum.

Rebounding from a Sub-Optimal EMR Go-Live

The Leapfrog journey built on years of EMR optimization work. Demaree joined St. Mary’s nearly three years ago after spending 23 years at Saratoga Hospital, where she evolved from a physician assistant into an informatics and operational transformation leader. The hospital had implemented a new Meditech Expanse system in 2022 under challenging circumstances: it had divested from a national health system in 2020, lost significant IT resources, and completed the build during COVID with consultants cycling in and out. Some legacy workflows and data from the old Meditech Magic system carried over into the new platform, creating optimization opportunities.

Demaree’s initial mandate was to bridge clinical leaders and technical teams, fine-tuning the EMR and driving adoption of structured data. She credits the clinical informatics team already in place with having done significant post-go-live work before she arrived. Through reorganization, her role expanded to encompass IT strategy, clinical innovation, and biomedical engineering.

The culture she found surprised her. At a hospital where many employees have worked for 30 or 40 years, she expected resistance to change. She found the opposite. OR nurses who once documented on paper, physicians who trained before gloves were standard: these staff members had already absorbed enormous change over their careers. They asked questions and wanted to understand risks, but they were not rigid. Demaree credits the hospital’s deep ties to its community for that resilience. St. Mary’s, founded in 1903 by the Sisters of St. Joseph of Carondelet, is the only hospital for miles. Closing would leave 400,000 patients a year without a local provider. That urgency shapes every technology decision the organization makes.

AI, Payer Denials, and the Fight to Stay Open

St. Mary’s uses AI primarily through vendor-embedded tools: ambient documentation, payment posting automation that frees billers for higher-value denial management, and features baked into the Meditech Expanse platform. Vendors are now integrating AI directly into their products, which is exactly what smaller organizations need. Demaree is also collaborating with vendors on a project she considers high-impact. “I think AI has a real potential to aggregate and reconcile medication data across disparate sources, which is a huge opportunity right now,” she said. Patients frequently arrive at the emergency department with incomplete or inaccurate medication lists, and unintentional omissions during transitions of care are a persistent concern.

The financial pressures on rural hospitals are intensifying. Payers have deployed AI-driven algorithms to process and deny claims at a scale and speed that small billing departments cannot match. Even if payers deny 10% of claims and half go uncontested, the savings for insurers are enormous; the losses for rural hospitals are existential. Demaree’s billers must now spend their time working denials and rebuilding claims, a labor-intensive process that pulls staff away from other critical revenue cycle functions.

That pressure extends to every corner of the organization: vendor contracts are negotiated with extreme precision, technology investments are evaluated for their ability to attract surgeons and generate downstream revenue, and infrastructure upgrades compete for scarce capital. Vendors who stayed engaged after a major grant application was denied in December 2025 earned Demaree’s loyalty. Those who walked away did not.

Take it Away

• Leapfrog scores hospitals whether they participate or not; submitting your own data ensures your grade reflects actual performance.
• Form a cross-functional committee with clinical, pharmacy, and informatics leadership before activating new medication alerts.
• Provide clinically appropriate override options so physicians can dismiss alerts with documented reasoning.
• Round in person during rollouts; silence from physicians does not indicate satisfaction.
• Respond to feedback transparently, even when changes take weeks to propagate through governance cycles.
• Rural hospitals should expect AI to arrive through vendor products; focus vendor partnerships on collaboration and long-term value.

For Demaree, every budget line and every technology decision at St. Mary’s connects back to a single reality. “We are here because we love this community,” she said. “And we know that nobody else is rushing in to build a hospital here.”

You have probably heard how it takes a village to raise a child. But you might not know it takes a village, a community, to keep a hospital healthy and strong.

Gilli Hachey sure knows this is true. As Executive Director of the Foundation of St. Mary’s Healthcare, she sees this dynamic in action day in and day out.

“It’s a collective commitment — among all our staff  members, the volunteers, our corporate and individual donors, civic leaders — that’s what allows us to keep this excellent healthcare we have both local and independent.”

And there’s probably never been a time when making this collective effort has been more critical. Many community hospitals around the country have closed or are at risk of closing due to rising costs, low  reimbursement rates, and dwindling inpatient volumes. They also face severe workforce shortages,  cybersecurity threats, and the list goes on. While St. Mary’s is not immune to these forces and continues to face many of these same challenges, we have made progress in stabilizing our community hospital. Despite limited resources, strategic and deliberate investments in programs,  services, and our workforce have paid dividends as we work to ensure that care remains local.

That’s what makes the current portrait of St. Mary’s so inspiring for all of us living and working in the Fulton and Montgomery region. People are stepping up to meet the moment. In this past year, the hospital’s Annual Gala event saw record breaking attendance and raised $105,000 to help support urgent care and emergency services. This was a 94% percent increase from the previous year. Its Annual Golf Classic was sold out, and thanks to the generosity of its sponsors, donors, and  golfers, it raised more than $65,000 to support the education, training, and professional development of hospital employees. This was a 75% increase  from the previous year. The recent end-of- year giving campaign successfully brought together both internal and community support, generating  more than $67,250 in gifts and pledges — a 33% increase from the previous year.

“This is about people wanting to make a difference and being supportive on behalf of their families, friends and neighbors,” Gilli says. “It shows me that they see the tremendous importance of  having quality healthcare just minutes away.”

Gilli believes the generosity of people and businesses around the region also speaks to the confidence building that St. Mary’s is on the right track. “Our leadership team has vision and sound strategic thinking, and that’s becoming more and more evident to people,” she says. “The community’s participation in our fundraising events speaks for itself. Something meaningful is happening here — people want to be a part of it, and their support is essential to the future of St. Mary’s.” she says.

This confidence has also received validation as St. Mary’s has been named  a 2025 Times Union Top Workplace — the  first acute care hospital in the Capital Region to earn the distinction
since the program was launched 14 years ago. There’s also that the Daily Gazette named St. Mary’s “Best of the Best” hospital, and its Emergency Department has the lowest wait times in the Capital Region—beating state and national averages — even as demand continues to grow.

“We are building positive momentum,” Gilli says. “I know we face significant challenges, and the road ahead won’t be easy, but with the dedicated leadership we have, and the strong community support we have, I see a bright future for St. Mary’s.”

How Foundation gifts make a different at St. Mary’s Healthcare

• Investing in new equipment, materials, and supplies to enhance comfort, care, and the overall patient experience
• Assisting patients with pharmaceutical co-pays, medical transportation, and other health and safety measures
• Providing support for cancer patients receiving treatment or undergoing testing
• Funding professional development grants to help associates enhance their skills and advance their careers
• Awarding nursing scholarships to St. Mary’s registered nurses pursuing advanced degrees in nursing and nursing leadership
• Offering financial assistance for associates facing hardship to help with housing, transportation, and utilities

. . . and more!

Donate today and invest in St. Mary’s and keep quality healthcare location for generations.

Q: What are the most important things I can do to reduce my cancer risk?

A: About 30-50%of cancers are linked to modifiable lifestyle factors, meaning you have significant power to reduce your risk through everyday choices. Research shows people who follow healthy lifestyle recommendations have a 10-20% lower risk of developing cancer and a 24-30% lower risk of dying from cancer.

Here are the most impactful steps you can take:

• Maintain a healthy weight throughout life.
  • Excess body weight increases your risk for multiple cancers including breast (after menopause), colorectal, endometrial, kidney, esophageal, and pancreatic cancers. Even modest

    

    weight loss can make a difference.

• Stay physically active.
  • Aim for 150-300 minutes of moderate-intensity activity per week (like brisk walking) or 75-150 minutes of vigorous activity (like running). Physical activity reduces cancer risk both directly and by helping maintain a healthy weight. Even replacing 30 minutes of sitting with light activity can lower your cancer mortality risk by 8%.
• Follow a healthy eating pattern.
  • Focus on whole grains, vegetables, legumes (beans and peas), and fruits. Limit or avoid red meat and processed meats, which are linked to colorectal cancer. Reduce sugar-sweetened beverages and highly processed foods.
• Avoid or limit alcohol.
  • It’s best not to drink alcohol at all. Alcohol is associated with liver, upper digestive tract, breast, and colorectal cancers. If you choose to drink, limit consumption to no more than one drink per day.
• Don’t smoke, and if you do, quit.
  • Smoking is one of the most significant cancer risk factors. Long-term smoking increases risk for lung cancer and many other cancers, and quitting at any age provides benefits.

**Studies show that adopting these healthy behaviors together has a powerful cumulative effect. People with the healthiest lifestyles have up to 48-52% lower cancer mortality compared to those with the least healthy habits.

To learn more about our Oncology team and the services we provide, please click here.

Q: What’s the best way to manage menopause?

A: There’s no one-size-fits-all remedy for managing menopause. But, one of the mainstays of treatment is estrogen therapy. Based on your symptoms and medical
history, other hormones may be added as well, such as progesterone and testosterone. Since hormone therapy is available in tablets, creams, gels, and skin patches, there are many options to choose from.

However, there are reasons why some women cannot use hormone therapy, and if that is the case, there are non-hormonal options available. You should keep in mind that menopause therapy is not the same as hormonal birth control. So, even if you have been told you cannot take a birth control pill, you still could be a candidate for hormone therapy.

Management is individualized to a woman’s health status, her medical history, symptoms and personal goals. The treatment approach should be a shared decision between you and your provider. The goal of therapy ultimately is to improve your quality of life and optimize your health, all while minimizing any risks of treatment. If you are struggling with symptoms, or feeling like your symptoms are being dismissed, please seek care from a certified menopause provider.

Learn more about our OBGYN team and locations here.

On Monday, January 26 we will delay opening our physician practices (primary care and specialty care), including urgent care centers, outpatient addictions clinic, Community Pharmacy and the Rao Outpatient Pavilion. These locations will open at 9AM.

Patients with scheduled appointments will be contacted by our team to reschedule if their appointment is impacted.

If at any time you or a loved one needs immediate medical attention, our Emergency Department is always open, and our team is ready to help.

The safety of our patients and associates is always a top priority. Thank you for your understanding. Please take care and stay safe!

Dear Friends and Neighbors,

When we launched our strategic turnaround plan for St. Mary’s Healthcare in 2023, we made a commitment to
strengthen and enhance our community’s local, independent hospital.

We pledged to grow and add much needed services; focus on quality, safety, and the patient experience; and build a supportive work culture. We also promised to be transparent about our progress and our challenges.

In return, we asked you to do your part by choosing St. Mary’s as your preferred healthcare provider—and you most certainly have. Thank you!

The results of our combined efforts get more impressive every year. In 2025, with your support, St. Mary’s:

• Increased patient visits across almost every service line.
• Was recognized as one of the Capital Region’s safest hospitals.
• Reduced our ER wait time to the lowest in the Capital Region—even as more patients turned to us for emergency care.
• Continued to invest in our people, programs, and technology.
• Remained true to our core value of caring for those who are underserved.
• Became the first Capital Region acute-care hospital to be named a Times Union Top Workplace.
• Was voted “Best of the Best” hospital in The Daily Gazette People’s Choice awards.
• Reopened our Charlton office for primary and specialty care and lab services.
• Recruited 36 providers in 14 specialties.
• Set records for attendance at our golf outing and summer gala.

We still have much more to do, including stabilizing our finances to ensure St. Mary’s remains viable for this community for years to come. So once again, I’m asking for your help. Please continue to turn to us first for healthcare—and to keep coming back. Tell your family, friends, and neighbors about the transformation underway at St. Mary’s. Let us know when we meet or exceed your expectations and when we can do better.

For us, there is no higher calling than to provide the care our community deserves. On behalf of our Board of Trustees, leadership team, and all our associates, thank you for the privilege of serving you, for choosing St. Mary’s, and for playing a key role in our continued success.

With best wishes for a happy, healthy 2026,
Jeff Methven, President & CEO
St. Mary’s Healthcare

Q: How do I make the most of my annual visit with my primary care provider?

A: Your annual visit is a time to do a comprehensive overview of your health. We often ask a series of questions about your health status, concerns, changes in family or social history. It’s also a good time to update your provider on recent hospital or ER visits, or visits with other specialists.

It is very helpful if you have an updated list of all the medications you
take — both prescribed and over the counter medications, including herbal supplements.

Your provider may have ordered lab work prior to your visit and may review the results with you in detail. Your visit will usually involve a physical exam. You may discuss recommended immunizations based on your age and health status.

The end of the visit is typically working on a plan for the coming year together-setting some goals or scheduling preventive care (mammogram, colonoscopy, dental visits, etc). The annual visit is not the best time to come in with a long list of concerns-if you have many concerns, these are often best addressed at a separate, problem-focused visit. Your provider may have you
schedule follow up appointment(s) based on your health needs.

And remember-you can always call the office if you have questions.

Learn more about our primary care team and locations here.

AMSTERDAM, N.Y., Dec. 9, 2025—Two more providers—Dr. Dhaval Swaminarayan and women’s health nurse practitioner Sara Gorham—have joined the OB/GYN Health Center at St. Mary’s Healthcare. Both were recruited as part of the hospital’s commitment to ensure convenient, local access to key healthcare services.

Dr. Swaminarayan has 23 years of experience in academic and clinical settings, most recently as a physician with Capital Region OB/GYN in Latham. Gorham has been providing women’s healthcare for more than two decades, including nine years with Saratoga OB/GYN and Midwifery Services.

“With Dr. Swaminarayan and Sara, we add two experienced providers who share St. Mary’s dedication to excellence and compassion,” said Dr. James Charland, chair of obstetrics and gynecology at St. Mary’s. “As members of our OB/GYN team, they will be instrumental in expanding access and enhancing care for women in our community at every stage of their life.”

Dr. Swaminarayan earned his medical degree from NHL Medical College, Gujarat University in Ahmedabad, India and completed OB/GYN residencies at BJ Medical College in India and Rutgers New Jersey Medical School. He is board certified by the American Board of Obstetrics and Gynecology and a member of the American College of Obstetrics and Gynecology and the American Medical Association.

St. Mary’s Expands Access to Sexual Assault Care

Technology connects St. Mary’s providers to New York’s most experienced forensic examiners, ensuring 24/7 expert, trauma-informed care

AMSTERDAM, N.Y., Nov. 25, 2025—Patients who experience sexual assault now have 24/7 access to trauma-informed care within their own community, at St. Mary’s Healthcare.

The local independent hospital has taken significant steps to ensure that those who are sexually assaulted receive immediate, expert, compassionate care:

• Partnered with TeleSAFE. The statewide program of St. Peter’s Crime Victim Services provides remote support at the St. Mary’s bedside so patients can receive clinical forensic exams without having to transfer to a larger hospital.
• Trained 13 St. Mary’s providers to conduct these highly detailed exams and collect evidence with the utmost sensitivity.
• Continued to nurture relationships with local social services, patient advocacy and other organizations that provide additional, essential patient support.

“Patients deserve access to expert, trauma-informed care regardless of where they live,” said Kristina Thomas, MS, RN, NE-BC, director of emergency and urgent care services at St. Mary’s. “They’re coming to us for a difficult exam after a devastating ordeal. They should not have to endure the additional distress of being transferred to an unfamiliar facility, far from their community.”

Thomas has high praise for TeleSAFE and its network of expert Sexual Assault Forensic Examiners. TeleSAFE’s team comprises some of the most seasoned and recognized forensic examiners in the state and across the nation. “These cases are extremely complex, and no two are the same,” Thomas said. “The SAFE-certified providers have extensive experience and are available around the clock to answer questions, guide us through the exams and provide care and support to patients of any age.”

St. Mary’s officially launched its program Nov. 17 but has been working with TeleSAFE for several months, collaborating on documentation, policies and procedures. During that time, St. Mary’s has conducted numerous exams for adult and pediatric patients. Thomas expects that number to increase once people and organizations realize that this care is available locally.

Sexual assault occurs every 68 seconds in the U.S. In addition to physical, legal and emotional burdens, many survivors have difficulty obtaining follow-up care.

“With TeleSAFE, we can make sure survivors receive the care they need, no matter when they arrive at St. Mary’s,” Thomas said, “and we can connect them to critical support services close to home.”

***

About St. Mary’s Healthcare, Amsterdam: St. Mary’s Healthcare has been providing high-quality, compassionate healthcare to the people of Montgomery and Fulton counties since 1903. At St. Mary’s Hospital, the Rao Outpatient Pavilion and other locations, the local, independent healthcare organization offers the comprehensive, critical services its community needs and deserves. For more information: (518) 842-1900, www.smha.org or www.facebook.com/smha.org.

About TeleSAFE: TeleSAFE is a free, hospital-based clinical service established in 2018 through funding from the New York Office of Victim Services, the New York Department of Health, and in conjunction with St. Peter’s Health Partners. TeleSAFE provides a remote solution to hospitals to ensure that survivors of sexual assault receive the comprehensive, compassionate care they need. TeleSAFE’s clinicians are all certified SAFEs who can provide support ranging from basic questions to guiding a full exam and evidence collection process remotely and are available 24 hours a day. For more information on TeleSAFE, visit: https://telesafe.org/.

Contact:

Kristin Mosher
Director, Marketing and Communications
St. Mary’s Healthcare, Amsterdam
(518) 770-7505
kristin.mosher@nysmha.org