Overcoming Integration Challenges for Rural Health Organizations

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Friday, 22 May 2015 00:06

CoreTech Revolution’s Michelle Burton will be presenting at next month’s Indiana Rural Health Association (IRHA) Spring Conference on the topic of “Understanding True Electronic Health Record (EHR) Integration for Healthcare.” As a supplement to that presentation, we’ll outline in this article the current state of the rural health community, as well as how organizations can work together toward EHR integration and interoperability for the benefit of all.

Rural Health Defined:

According to Wikipedia, “rural health or rural medicine is the interdisciplinary study of health and health care delivery in rural environments.” When we think of the word ‘rural,’ we often think of a remote or distant location without access to health care. However, many cities and towns throughout the state have a large population of patients, and may have access to hospitals and facilities in the larger hospital networks, but may not have the same resources as the urban area. An example of this includes Hendricks Regional Health, a rural health organization in Hendricks County, Indiana with a medical staff of more than 250 physicians located in six rural communities. However, rural health would also include regional locations of larger health organizations such as St.Vincent Hospital and IU Health, with dozens of hospitals and facilities and thousands of physicians throughout Indiana.

Providers and patients in each of these rural areas face different challenges than those in urban areas. According to the National Rural Health Association (NRHA), some of these obstacles include economic and educational limitations, lack of recognition by legislators, and geographic isolation. Some of the goals of the rural health community include:

With disparate needs, goals and complexities at every type of rural health facility – from funding to decision-making -- every rural health organization must coordinate efforts to create a truly integrated health community. One of the keys to delivering on this promise is to work toward interoperability between rural and urban health systems through the use of technology --- particularly via electronic health records and healthcare information exchanges (HIEs).

Current state of the EHR system in Rural America

After the enactment of the American Recovery and Reinvestment Act, which required the adoption of Electronic Medical Records (EMRs) by 2014 for 70 percent of primary care providers, most rural health organizations have begun implementing some form of electronic health record (EHR) systems. In addition, Centers for Medicare & Medicaid Services (CMS) offered reimbursement incentives for providers meaningfully using EHRs starting in 2011, and expects full adoption, before they begin subjecting providers with financial penalties for non-compliance.

Slow adoption rates, lack of meaningful use and other issues have prevented the rural health community from fully using EMRs or HIEs. In order for rural health care providers to improve operational efficiencies through health IT and EHRs, they first must be aware of the issues unique to the rural healthcare setting. Some of these issues include:

Steps to a Successful EHR Integration:

In general, here are the basic steps required for setting up an EHR or HIE integration within a rural health community:

Rural health organizations are slightly behind urban health organizations in the implementation of health IT. However, despite limitations in resources, rural institutions have the capability to develop fully-integrated health IT systems that can begin to create efficiencies, enhance connectivity and improve overall patient care.