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HIT Project Management: Managing HIT Projects in Rural Settings

Agency for Healthcare Research & Quality’s 2005 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. Goals for Today’s Discussion. Outline what ‘rural’ means

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HIT Project Management: Managing HIT Projects in Rural Settings

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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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