Access to health care services is critical to good health, yet rural people often face barriers to health care that limit their ability to receive care. that they need.
Similarly, service providers in rural areas also Face unique challenges. Consider that about 20% of Americans live in rural areas, but only 1 in 10 physicians practice there — and there will be a projected shortage of 20,000 primary care physicians in rural areas by 2025.
Furthermore, many rural areas also lack the support of specialists, hospital doctors or emergency physicians.
Adding to the challenges, rural hospitals are are also struggling financially as COVID-19 benefits expire and reimbursements decline: Half of rural hospitals lost money last year, up from 43% the year before and 418 Rural hospitals are considered vulnerable to closure.
We interviewed Dr. Jay Anders, chief medical officer at Medicomp Systems, who also hosts a show on HealthcareNOW Radio, to discuss why he believes rural hospitals are the frontier forgotten and in need of advocates for a better model.
Q. Why do you think rural hospitals are the forgotten frontier? Who do you see as the best advocates who need to step up?
ONE. Rural hospitals are often forgotten because they are small-budget operations that lack the resources to attract attention and invest in infrastructure, IT and recruiting. Despite caring for the majority of the US population, rural hospitals remain part of the “flyover area” that is overlooked unless a major event occurs. Sixty million Americans live in rural areas – that’s one-fifth of the country’s population.
Because rural populations tend to be older, many people have health problems, which means the majority of America’s health care needs are concentrated in this population. Care at these smaller, independent hospitals tends to be more individualized and patient-oriented.
The problem is that rural hospitals lack strong advocates. Competent physicians can make efforts, but professional associations and hospital associations do not support them effectively. However, As interoperability advances, rural hospitals will have more visibility because they will need to share patient data with larger health systems. This could make them part of the broader healthcare conversation.
If any group is positioned to be the best advocate, it may be the federal government through organizations like ONC that are promoting widespread health data exchange and interoperability. It is difficult for typical health care organizations to take on that advocacy role for rural hospitals.
Q. Please discuss the “better model” you feel is needed to create change in rural hospitals.
ONE. A better model for rural hospitals involves leveraging newer, cloud-based technologies to access specialized care and augmentation services, even with limited budgets. With family close by, rural hospitals can focus on getting patients well enough to return home, which benefits patient psychology and outcomes. Telehealth capabilities developed during the pandemic could be especially valuable in rural areas.
These hospitals are increasingly being integrated into larger health systems. And when that happens, specialized care starts to become harder to access because those patients will be transferred to the mother ship for treatment. What does that do?
Well, if you have a small hospital and a general surgeon wants to practice medicine at that smaller hospital, they won’t be able to because the patient volume will be too low because the patients are transferred to another facility. .
So as system consolidation took place, rural hospitals began to disappear because they were converted into triage stations where patients came in, stayed for two days and then were transferred elsewhere. to be taken care of.
Rural hospitals face staffing challenges, especially nurses. They have difficulty hiring and keeping nursing staff due to competition from high-paying travel nursing companies. Rural facilities also have limited budgets for health IT, affecting the functionality and innovation they can access.
While some EHR vendors focus on the small and medium-sized hospital market, their R&D activities are limited compared to the investments of larger companies like Epic.
Rural hospitals often rely on access to scaled-down versions of systems like Epic from larger health systems. However, this comes with reduced functionality and little customization to suit their specific needs.
Most of their minimum IT budget goes to staffing instead of strong health IT capabilities. To help address this problem, government funding programs, similar to Meaningful Use incentives, could be developed to make interoperability and other technologies more accessible. more accessible and affordable for rural organizations.
Can technology help? Yes, in some ways. If interoperability was now accessible in all these rural areas, they would have a complete picture of medical records. Additionally, telehealth is not just from provider to patient, it can be from provider to specialist.
So, technology can be applied in rural areas to enable access to that expertise. There is also technology to monitor critically ill patients remotely.
Ask. You support initiatives that make health IT more available and affordable for rural hospitals. Please explain.
ONE. While EHR adoption is saturated, rural hospitals need ways to operate more efficiently with limited resources. Adding functionality to existing systems to directly improve efficiency can deliver high ROI and benefit them.
For example, if a hospital implements technology that can help reduce ICU nurses’ workload by 50%, it will allow nurses to spend more time providing quality patient care. quantity.
It is important that rural hospitals have access to these technologies at an affordable cost. It is not feasible to decouple and replace systems, but adding functionality to improve efficiency and enhance care delivery by providing quality data for decision making is a practical approach. The technologies stack on top of existing technologies EHR helps streamline workflows and deliver key insights that can make a meaningful difference.
Ask. On a related note, you think it is important to provide clinicians with technology that is easy to use, deploy and train, while also giving doctors and nurses more time to provide high quality patient care. How can rural hospital IT leaders ensure this happens?
ONE. Rural hospitals often rely on manual versions of complex EHR systems designed for large medical centers. These systems are difficult to use, deploy, and train, especially without a dedicated support team like larger organizations. Workflows are not optimized for rural environments, leading to inefficiencies.
To solve this problem, IT leaders at rural hospitals need to speak up and push EHR vendors, both large and small, to provide technology that is easy to use and improves efficiency. They need to clearly identify ineffective work processes and demand better solutions. Rural hospitals are being overlooked and exploited from an IT perspective.
Emerging technologies like ambient listening and AI tools can help, but they come with rising costs that rural hospitals can hardly afford, especially if they don’t improve. Significantly effective at the point of care. Unless new technology saves clinicians’ time, it risks making the problem worse.
Ultimately, end users and hospital leaders need to protect themselves, ask IT to support their unique needs, and call in when systems go down. Technology has the potential to change the game, but it won’t happen if rural hospitals remain the alternative. They deserve IT that helps them thrive and provide the best possible care to their communities.
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Healthcare IT News is a publication of HIMSS Media.
