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Small Rural Hospitals Coping with Meaningful Use Challenges

From central Appalachia to the Great Plains, healthcare organizations in rural America face their own set of challenges.

Qualified workers continue to be scarce and aging facilities need upgrading, while chronic illness continues to be rampant. And despite impending Meaningful Use deadlines, rural hospitals are lagging behind urban hospitals in adopting electronic medical records (EMRs).


One study shows that while more than 80% of urban hospitals are using computers to collect basic clinical information, only between 30% and 40% of rural hospitals are digitizing their paper records.

In an effort to get a 1,000 federally designated “critical access hospitals” and small rural hospitals onboard with Health Information Technology (HIT), the Office of the National Coordinator (ONC) has challenged these remote outposts to accelerate their progress before Medicare penalties for noncompliance kick-in two years from now.

The U.S. government is funneling as much as $30 million through its Regional Extension Center (REC), which could help the majority of those already in the federal Small Rural Hospital Improvement Program (SHIP). This program helps small rural hospitals with fewer than 50 beds meet the stipulated requirements in the Patient Protection and Affordable Care Act (PPACA) by helping to purchase equipment or training.

In a recent blog post, Mat Kendall, director of the Office of Provider Support in ONC and Leila Samy, Rural Health IT coordinator, acknowledged that the path to Meaningful Use is not easy for small rural hospitals and Critical Access hospitals.

It requires coordination, said Kendall and Samy: “We need everyone rowing in sync, including leadership and staff in every critical access and rural hospital, EHR vendors, hospital associations and state offices of rural health in every state, Rural Health IT Network Development grantees, ONC grantees, and many more public and private, Federal and local partners.”

But it is very possible for small rural hospitals to meaningfully use EHR technology, as demonstrated by Yuma District Hospital, a 12-bed critical access hospital serving 7,000 people in Yuma County, Colorado. After 30 years in operation, the hospital had accumulated millions of paper records – file boxes were stored in offices, hallways, and piled to the ceiling in storerooms. The hospital decided to implement an Enterprise Content Management System (ECM) made by Digitech Systems that would integrate easily with NextGen, their medical records software.

Multiple levels of encryption, security, and electronic backup systems were put in place to fortify protection of records. Today, instead of taking two hours to find some records, retrieval time can be under five minutes, and claims processing has been accelerated.

And Yuma is not the only rural hospital making changes. According to Kendall and Samy, so far, more than 1,220 Critical Access Hospitals and rural hospitals across the nation—as well as over 5,644 clinicians that work in these hospitals and provide inpatient and outpatient services—have enrolled with a Regional Extension Center for assistance on their way to Meaningful Use.

“This is great news because it provides data supporting the anecdotal evidence that Critical Access Hospitals and rural hospitals along with the clinicians working in these hospitals recognize the value of health IT and want to offer their communities health care services powered by the benefits of meaningfully using certified EHRs,” said the ONC coordinators.


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