Health Informatics/ IT

When it comes to community and its health, one of the critical topics is the uptake of IT in rural communities. Health IT has the potential to save lives in such communities by improving health care delivery through the provision of quality and effective health services. Additionally, health IT can aid health care providers in managing the health of the population. Health IT includes such tools as patients’ electronic records, telehealth, the transmission of medical results electronically, the communication of health care providers and their patients electronically, and electronic prescriptions among others. However, the implementation, maintenance, and optimization of health IT can become a challenge for the health care facilities in rural communities, especially due to inadequate resources and limited expertise in technology. Therefore, despite the advances in health information holding, such a promise to the improvement of health care delivery and challenges that have caused the uptake should be addressed to ensure the uptake of health information technology in various health facilities in rural areas. This essay discusses health IT in small and rural areas.

Rural areas face similar problems that eventually lead to ineffective health care delivery. Some of these issues include distance and the shortage of resources such as health care personnel. Despite the tremendous advances made in the health care sector related to technology, the uptake of health information technology has been low in rural areas. A research by the Flex Monitoring Team (2006) from University of Minnesota, South Maine, and North Carolina has showed that most health care facilities in rural areas do not use the health care information technology tools that are available to them. The report suggests that although close to 95% of critical access hospitals have integrated IT into their administrative functions, only about 20% of them use some form of electronic health records (Flex Monitoring Team, 2006). Therefore, it is evident that despite having the tools to ease the health care delivery process in rural communities, most health care facilities do not use the available tools.

Several reasons have been attributed to this slow uptake of health information technology. The major hurdle, as seen in most of the health care facilities, has been the lack of financial resources. The adoption of heath IT tools, such as Electronic Health Records, can be a very expensive venture. The adoption is hindered with various setbacks, including the cost of acquiring the software and acquiring the prerequisites of this software use such as hardware, peripherals, and networking equipment. Additionally, the cost associated with the implementation of the system, including the initial low productivity of the system, the time required to train the staff to use the equipment, and the expenditure required to maintain the whole system also proves to be a challenge. Apart from the above issues, the implementation of health IT also requires that hospitals provide space, from which the system can be operated. Such a space comes with additional expenditure for health care facilities. Consequently, small and rural health care centers are also hesitant to commit their resources in terms of capital in a sector that is hardly standardized and where advancements are constantly made. Health facilities also need the appropriate staff to operate and implement the system. However, in the health care facilities of rural areas, it sometimes becomes difficult to hire and retain experts to implement the system. Once an expert is found, he/she takes up many roles and responsibilities in regards to health IT system, and it becomes hard to replace such an important individual whenever the need arises. These are among some of the issues faced by rural health care facilities when it comes to the uptake of technology.

In contrast to the belief that the reason why uptake of technology in rural areas is caused by lack of IT staff, the main reason is that such areas have a shortage of staff due to the competition from larger and better financed urban providers. These providers compete with rural hospitals in terms of physicians and other members of staff as well as patients. Therefore, rural hospitals continue to use their scarce resource to train medical staff in the unfavorable conditions of competition with these big hospitals, and as a result, they lack the required resources to integrate technology into their work. In extreme conditions, this factor even leads to the closure of some hospitals. However, certain forms of IT are used in critical access hospitals and other rural health facilities to provide health care services. Such tools include telehealth systems that provide health care services to the patients by connecting physicians with patients. Thus, the research by the Flex Monitoring Team (2006) has found out that 80% of all the critical access hospitals use teleradiology – technology that offers support for diagnostic imaging interpretation. Additionally, 24% of critical access hospitals use Tele-pharmacy to ensure that any medication orders are remotely checked before they are administered to patients (Flex Monitoring Team, 2006). Such IT tools have greatly improved the service delivery in the health care sector in rural communities. However, much needs to be done to enable the uptake of other critical IT tools and infrastructure by the health care facilities found in the rural areas.

To ensure that there is a higher uptake rate of health IT in rural communities as compared to the issues revolving around the lack of resources, their funding and IT staffing should be addressed. To solve the issue of financing, the health care facilities in rural areas often seek for loans and grants from the State and federal institutions. Any financing received is used to implement IT in these health facilities. The state and federal agencies set up a kitty to help health care providers. For example, in 2004, the Agency for Healthcare Research and Quality set aside $139 million for the advancement of health IT in rural areas (AHRQ, 2016). The Office of Rural Health Policy also has a grant kitty for the rural health providers to implement such services as telehealth. Additionally, the American Recovery and Reinvestment Act of 2009 has several clauses that will drastically transform the funding of health IT for small and rural health care facilities (AHRQ, 2016). Any non-medical providers already in the Medicare program, who document critical usage of electronic health records, receive startup incentive of up to $18,000 and total pay up to $44,000 (AHRQ, 2016). Apart from the federal government, State rural health offices can also offer direction in form of funding at a state level to these health care providers.

To address the issue of IT staffing, each health provider should devise their own model that serves them best to recruit and retain IT professionals. A model that can work for all health providers is to train local clinical staff interested in health IT. These health providers can also look for individuals with appropriate expertise and those who are likely to stay within the community. Lastly, the health institutions can also seek for academic grants to diversify their health informatics training programs as well as incorporating IT with their medical curriculums. All these models work to increase the number of staffing in health IT.

In conclusion, information technology is an important integration step that should be made in health care. With the use of health IT, better services can be delivered by health care providers in an efficient manner. The uptake of health IT in rural health facilities has been challenging due to the issues related to limited resources. Financing of health IT has been the main hurdle that has prevented health providers in rural areas from integrating IT into their day-to-day activities. Additionally, IT staffing has also been an issue in these areas where the providers have not devised ways to overcome hiring and retaining IT staff to implement the system. To overcome these challenges, the health care institutions in these areas can seek for loans and grants to implement the systems. Additionally, they can also create models, by which to train and retain staff in their community.