Background
Health Information Advances better known as ‘health IT’ hold immense promises for assisting minute and rural communities prevail over challenges in the provision of personnel shortages and distance in healthcare. Despite clinical health information technologies progress in recent years, rates in adoption seemingly remain low in areas like computerized provider entry (CPOE), electronic health records (EHRs) and the electronic medication administration record (RMAR). A report published in May 2006 from the Flex Monitoring Team which is an association of rural health research centers from North Carolina and Minnesota universities show that although 95% of critical access hospitals (CAHs) have automated their administrative functions such as billing, patient registration, claim submission, payroll and accounting and that only a small fraction of about 21% use the HER system (Adsit, 2011, p. 171).
Various rural and small providers point to lack of fiscal resources as the main cause of poor adoption rates. Certain health IT implementation such as EHRs could be quite expensive undertakings. Aside software, many costs is linked with
- Acquiring an IT system which includes: peripherals, network expenditures and hardware,
- Maintenance &
- Implementation such as initial lower productivity and staff time.
Areas of Current Investigation
Arguably, the main reason for stumpy adoption of clinical health systems in the small and rural communities majorly revolve around the lack of resources in regards to IT staff and funds.
- Financing:
Providers of health care in the small and rural communities frequently need to request loans and grants from State and Federal agencies in order to finance an information technology execution. The Agency for Healthcare Research and Quality in 2004 earmarked $139 million purposely for enhancing rural health IT. Close to that, the Office of Rural Health Policy which is within the Health Services and Resources Administration has also funded opportunities for small and rural providers which also include the area of telehealth. In addition to that, the Rural Health Care Program of the Universal Service Fund is providing discounts to health care providers for monthly internet services and telecommunication services. Health offices of the State can also lead providers to resources like the foundation based funding and other State programs. The American Recovery and Reinvestment Act of 2009 that was recently passed has various provisions which impact the entire financing of small and rural health provider’s health IT. For instance, non-hospital-based providers who are enrolled in the Medicare program who report and implement the evocative use of EHRs can receive total payments amounting to $44,000 and incentive payments amounting to $18,000. Seemingly, providers in shortage areas in rural health professional will in the near future be eligible for a 10% increase in the above payment amounts. Under the Medicaid program, incentive payment programs will be available to rural health clinics as well as other non hospital-based providers. Providers who are dully eligible will only have the benefit of taking advantage of under Medicaid or Medicare. Nonetheless, acute care hospitals and the CAHs are entitled to incentive payment programs under both the Medicaid and Medicare programs (Klugman, 2008, p. 14).
- Workforce
It is quite challenging overcoming limited numbers of available staff in the IT department in small and rural communities. Though no model is found to fit all, every provider is expected to determine ways to retain and recruit staff that are talented in order to implement and maintain IT systems. Providing opportunities for selected training in health IT is a significant approach for rural organizations to increase existing clinical staff expertise through providing other opportunities in health IT training. Additionally, seeking new staff to live within the community and provide them with the necessary support for education in IT is another option to be considered. Also included in the ARRA are significant funding opportunities for programs in health IT. These opportunities include grants to academic institutions aimed at expanding programs in medical informatics and also to integrate IT into clinical program's curriculum whose goal is to increase the workers who have a background in health IT.
References
Adsit, T. L. (2011). Small schools, education, and the importance of community: Pathways to improvement and a sustainable future. Lanham, Md: Rowman & Littlefield Education.
Lohmann, N., & Lohmann, R. A. (2008). Rural social work practice. New York: Columbia University Press.
Klugman, C. M., & Dalinis, P. M. (2008). Ethical issues in rural health care. Baltimore: Johns Hopkins University Press.
