Dr. Karen Joynt, the lead author of a recent report that found critical access hospitals (CAHs) in rural areas lagging behind in health IT adoption, said she applauds the initiative. In an interview with InformationWeek Healthcare, Joynt said that, while CAHs have limited resources to adopt technology, they are being asked to meet the same requirements under the Medicare and Medicaid electronic health record (EHR) incentive programs that other hospitals with more capital and skilled IT personnel must meet.
"Certainly more money and more resources and being able to get access to the technology is a tremendous start because CAHs have a completely different and more challenging set of circumstances," Joynt said. "A lot of these hospitals face greater challenges than other hospitals in trying to recruit the people that they need to get these systems up and running and to maintain them."
To help these efforts along, the Obama administration announced that it will increase rural access to healthcare workers and technology. The new initiatives are based on the recommendations of the White House Rural Council, which has made suggestions on how to grow the economy and create jobs in rural America. With regard to healthcare, the federal government issued a statement outlining its plans which include:
-- Expanding health IT in rural America: The U.S. Department of Agriculture (USDA) and the Department of Health and Human Services (HHS) will sign an agreement linking rural hospitals and clinicians to existing capital loan programs that enable them to purchase software and hardware needed to implement health IT. Under current conditions, rural healthcare providers face challenges in harnessing the benefits of health IT due to limited access to capital and workforce challenges. Rural hospitals tend to have lower financial operating margins and limited capital to make the investments needed to purchase hardware, software, and other equipment.
-- Increasing physician recruitment at CAHs: HHS will issue guidance to expand eligibility for the National Health Service Corps loan repayment program so that CAHs (those with 25 beds or fewer) can use these loans to recruit new physicians. This program will help more than 1,300 CAHs across the country recruit needed staff. The addition of one primary care physician in a rural community generates approximately $1.5 million in annual revenue and creates 23 jobs annually. The average CAH creates 107 jobs and generates $4.8 million in payroll annually.
Joynt's recent report, Quality of Care and Patient Outcomes in Critical Access Rural Hospitals, found that CAHs in rural locations lagged behind in the adoption of electronic medical record systems, computerized physician order entry (CPOE) systems for medication orders, and other technology when compared to non-CAHs. For example, the report found that only 66% of CAHs have electronic viewing of laboratory test results, compared with 91.3% of non-CAHs, and only 22% of CAHs use electronic clinical reminders, compared with 44% of non-CAHs.
One of the recommendations of the report was that CAHs would benefit from telemedicine services and clinical data exchange, which has the potential to improve the quality of care at these hospitals.
According to Joynt, advancements in hospital connectivity and telemedicine technology offer a tremendous opportunity to make some inroads on improving the linkage between rural health and the larger hospital centers.
"If we can harness the technology then we can bring to these hospitals a lot of resources remotely, and making the capital available to build these technology platforms to be able to use telemedicine is a great first step," Joynt said.
Find out how health IT leaders are dealing with the industry's pain points, from allowing unfettered patient data access to sharing electronic records. Also in the new, all-digital issue of InformationWeek Healthcare: There needs to be better e-communication between technologists and clinicians. Download the issue now. (Free registration required.)