rural health IT

Rural Health IT


Rural hospitals and providers are having a difficult time keeping up with all the changes being driven by healthcare reform. However, it is possible for rural healthcare not only to survive – but thrive – in this ever changing environment. We sat down recently with Joe Wivoda, our Senior Director of Healthcare at Analysts, to talk about the impact of today’s healthcare climate on rural hospitals and providers. Andabout how Health IT can help.

A Conversation with Healthcare Practice Leader Joe Wivoda

I often say that “rural is not small-urban,” and I believe that has never been more true than it is today. Many rural challenges are very different than those experienced in urban areas. Reimbursement is often very different, for example, and rural also has incredible challenges with workforce. Many rural hospitals and clinics have very small IT staffs, if they have any at all. With all of the changes being driven by healthcare reform, rural hospitals in particular are having a difficult time keeping up.

Yes, and they can even thrive while remaining independent! One of the best things that a rural hospital or clinic can do is become part of a network. Networks that focus on their referral patterns can be particularly effective, and they can capitalize on these relationships by moving quickly into alternate payment models and implementing technologies that enable exchange of health information. By working together and finding their unique strengths, they can remain independent while providing better care to their community.

Again, it is critical that healthcare providers understand and focus on their referral network, and the needs of their patients. We have a tendency to focus on the “big gorilla” and try to get exchange working with the large hospitals, when the vast majority of referrals are with smaller, local providers. We often forget about long-term care, primary care clinics, homecare, hospice, and behavioral health providers. It is frustrating for patients that their health information is not as easily transferred as they would hope.

There are a few areas I always like to consider when looking at an EHR. The first is how the system can improve patient care processes. Many EHRs take the traditional paper-based process and replicate it in electronic form. That is not always the best way to do things. Then, I want to understand how the system can exchange health information with other systems, and how easy it is for external information to be incorporated into the EHR. Interoperability is so important for coordinating care and improving the patient experience. Lastly, I want to know how easy it is to get data out of the system. Standardized reports are fine, but a well-managed hospital or clinic will seek to improve by measuring outcomes that may not be available in standardized reports. There are other areas – such as support and corporate upgrade strategy – thatare worth investigating as well, but these three are most important today.

As healthcare moves from “pay for volume” to “pay for value,” we believe that it will be more and more important for patients to stay at their rural hospitals, rather than being transferred to more expensive urban hospitals. Rural hospitals – andall healthcare providers really – needto look at how they can increase their efficiency and improve quality. Health IT systems are essential for these efforts;and in my experience, most hospitals have what they need, but are not making full use of their technology. “Staying the course” is not a good plan; improving your current implementation while retooling for value-based payment is a much better plan.

It can be very difficult to find and retain HIT staff in rural areas. When looking at HIT needs in rural, you can divide it up into a few jobs: Daily IT support, Health IT expertise, Data Analysis, and so on. It is much easier to find someone who can perform the duties of daily IT support than to find someone who has deep expertise in HIT. HIT expertise and data analytics is not necessarily needed on a daily basis in a rural healthcare organization, and can most effectively be performed by a trusted consultant or a shared resource in a network. Finding that trusted resource who has the skill set you need is very important.

With the meaningful use incentives all gone, and with electronic systems that were often slammed in without enough internal process improvement, now is the time to improve what we have. Make patient care workflows more efficient, improve the methods we use to communicate with other providers and patients, and seek ways to use our existing technology to improve safety and save lives. That is what we are here for, and we can make a difference in our communities with technology!

How Analyst can help

Implemented properly, Health IT (HIT) is a core enabler of care processes, care coordination, reimbursement, and safety. Our Healthcare team can help. We offer comprehensive services targeted at rural hospitals, networks, clinics, and state and national HIT programs.

  • EHR Readiness Assessments
  • HIT Network Readiness Assessments
  • HIT Strategic Planning
  • Management and Leadership
  • HIE Readiness and Interoperability Planning
  • Care Coordination HIT Strategic Planning and Project Leadership
  • EHR Go-Live Support
  • Project Management
  • Vendor Selection
  • Plan and Implement Electronic Clinical Quality Measures
  • Total Cost of Ownership of HIT
  • Support and Business Strategy for HIT Vendors
  • Rural Healthcare IT Education
  • HIPAA Risk Assessments
  • Interface Engineering and Management

See also: Our industry-leading EIM practice also provides healthcare solutions, including expertise integrating existing technologies with FHIR-compliant data. Learn more here.

Health IT in Rural America

Living in rural America has its advantages and its challenges. One of these challenges is access to healthcare professionals. Despite the fact that 20% of the nation’s population reside in rural areas, only 11% of our physicians work there. Rural workforce challenges also exist in healthcare professions such as nursing and lab. And finding expertise in Health IT (HIT) can be seemingly impossible.

With the aging of rural populations and the move toward value-based payment, now is the time for rural hospitals, clinics, home care, behavioral health, and other providers to focus on utilizing Health IT in meaningful ways. This includes telehealth, interoperability, and mobile health solutions.


Joe Wivoda

Joe Wivoda is our Senior Director of Healthcare at Analysts. He leads our healthcare IT practice, with a particular focus on rural health. A nationally recognized expert in Health IT (HIT), Joe has worked for more than 20 years advising rural healthcare organizations, most recently as the CIO of The National Rural Health Resource Center. Today, Joe and his team at Analysts are helping our clients achieve true EHR interoperability across the care continuum, realize an ROI from electronic health systems, analyze and report on clinical data, and use HIT to improve patient outcomes, workforce retention, and financial stability.

Joe received his BS and MS degrees in Physics from the University of Minnesota Duluth, and has completed the coursework for a PhD in Business Administration from Northcentral University. Equally comfortable conversing in technical and business strategy, Joe is a sought-after speaker at HIMSS, NCHN, NRHA, and state rural health conferences.