Dive Brief:
- Critical access hospitals still face significant challenges in adopting electronic health records (EHRs), according to a new study in Health Affairs' July issue.
- Barriers arise from high EHR implementation costs, a chronic lack of adequate staffing and poor access to quality high-speed broadband internet, said the Office of the National Coordinator for Health Information Technology.
- The survey of nearly 800 critical access hospitals found that CAHs owned by larger hospital systems were much more likely to have adopted advanced technologies than hospitals going it alone, as were CAHs that banded together for pooled purchasing arrangements. Overall, 60% of CAHs reported major financial challenges to EHR adoption, 30% had technical challenges and 20% cited privacy and security issues.
Dive Insight:
Despite federal health IT efforts, CAHs remain less likely than other healthcare organizations to adopt and use advanced capabilities such as adopting EHRs, participating in health information exchanges and offering patient portal access. But reaching rural areas is considered critical in efforts to transform U.S. healthcare delivery.
Nearly eight in 10 CAHs were getting advice or financial assistance from the ONC's network of regional extension centers as of last December. But federal subsidies and technical assistance have been insufficient to close the health IT adoption gap.
Requirements for Medicare-certified CAHs include having no more than 25 inpatient beds; offering 24-hour, 7-day-a-week emergency care; and generally being located in a rural area at least a 35-mile drive from any other hospital. The idea is to encourage CAHs to handle common conditions and outpatient care, referring other problems to larger hospitals; and CAHs get cost-based reimbursement instead of standard fixed payment rates with the aim of reducing small, rural hospital closures.
How simple is it for CAHs to share electronic records? It likely means finding at least a million dollars upfront, which is tough when the average rural hospital operates at a financial loss of about 8% a year, Kaiser Health News reported in April. ONC's website offers tools to rural hospitals for EHR adoption and insists challenges can be overcome. But will CAHs increasingly need to give up their independence and join healthcare systems to meet federal standards and stay in their communities?
Read more on Healthcare Dive about rural health
Despite an ongoing rural health crisis that has resulted in closures across the nation, rural hospitals are on average less expensive and more efficient than their urban counterparts. Healthcare Dive took a trip to an isolated town in the mountains of eastern Tennessee to find out why.