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Managing HIT Projects in Rural Settings: Overcoming Challenges and Maximizing Impact

This conference discusses the approaches to managing HIT projects in rural settings, including the challenges and solutions for implementing healthcare technology in areas with limited resources and access to healthcare.

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Managing HIT Projects in Rural Settings: Overcoming Challenges and Maximizing Impact

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  1. Agency for Healthcare Research & Quality’s2005 Patient Safety & HIT Grantee Conference HIT Project Management: Managing HIT Projects in Rural Settings June 9, 2005 Washington, D.C. Michael P. Rodriguez HIT Projects Director

  2. Goals for Today’s Discussion • Outline what ‘rural’ means • Discuss approaches to rural HIT projects • Answer questions

  3. What’s Rural? • Limited healthcare access options • Healthcare is ‘old fashioned’ • Information is inconsistent • Public transportation not the norm • Chronic healthcare conditions abound

  4. The Case of Wyoming • 500,000 people living in 97,818 sq. miles • More than 90% of land is considered “frontier” • 48th among the 50 states in physicians per 100,000 population • Nearly half its 23 counties qualify as Health Professional Shortage Areas • No passenger trains in state, no point-to-point air links; limited taxis and buses in smaller towns

  5. Interoperability Framework Full Integration Networked Systems Stand Alone Electronic Systems Paper Medical Records

  6. Cascading Method of Evaluation • Cultural Barriers • Financial Constraints • Systemic Barriers • Technological Considerations • HIT Solutions

  7. Cultural Barriers • Fiercely independent • Desire for local control • Limited history of collaboration • Fear of unknown – technology • Resistance to change in workflows

  8. Financial Constraints • Cost • Hardware/software • Implementation time and effort/productivity • Sustainability/maintenance/upgrades • Limited capital sources • Uncertain return on investment for most constituencies

  9. Systemic Barriers • Majority of physician practices are small (1-2 providers) and single specialty • Majority of hospitals under 100 beds • Relative physician shortage • High out-migration for care • Market considerations for HIT vendors • HIT training and education gap

  10. Technological Considerations • Low penetration of HIT in physician practices • Limited electronic capture of health information • Broadband more limited/expensive • Provider education around HIT is a key

  11. Take Away Messages • Start with ‘healthcare issues’ not HIT approaches • Moving toward collaboration will facilitate HIT options -- focus on building trust • Be willing to change directions when new ideas come along • Don’t forget about the patients

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