“Who else can provide healthcare in rural Mississippi besides these small rural hospitals? With so much responsibility and so few resources, they need all the help they can get,” said Jim Rice, RN, MBA, Health IT and Electronic Health Record Consultant at the Mississippi Health IT Regional Extension Center.
We traveled to Mississippi recently to launch a pilot project between White House Rural Council partners from the Departments of Health and Human Services, Agriculture, and Education to expand access to information and federal funding to support health information technology (HealthIT) infrastructure and workforce needs for Critical Access Hospitals (CAH) and other small rural hospitals The Mississippi pilot is part of a larger pilot initiative across five states.
Critical access and small, rural hospitals are often the foundations of their communities’ health care systems. They extend local access to care where it would not otherwise be available. Rural community hospitals also are typically the largest or second-largest employers in the community and often stand alone in their ability to offer highly skilled jobs.
Rural Health IT Challenges and Opportunities, Job Opportunities
The national transition to digital healthcare from a paper-based system comes with challenges for rural communities. This is particularly true for rural safety-net providers serving persistent poverty county in rural Mississippi according to Jim Rice who said: “I’m glad our Health IT Regional Extension Center has been able to help select, implement, and meaningfully use their Health IT to continue to give our rural residents the excellent and affordable health care they deserve.”
With new technology come new questions about funding infrastructure and training needs. In advance of the our two-day workshop, the ONC funded Health IT Regional Extension Center in Mississippi, conducted in-person surveys of 42 CAHs and small, rural hospitals in Mississippi to identify specific funding needs necessary for these hospitals to successfully achieve Stage I and Stage II of Meaningful Use of health IT. For example, over 60 percent of these rural safety net hospitals reported a need for improved access to more robust broadband connectivity to support reliable administrative operations and clinical services (e.g., telehealth).
With the challenges come new opportunities. And, rural communities are uniquely positioned to benefit from the adoption and use of health IT, including electronic health record technology (EHR) and telehealth. For example, the field of health IT presents new opportunities for career advancement for rural residents who want to stay in their communities and not move to urban areas.
The Mississippi Rural Health IT Pilot
The Mississippi pilot was designed to develop best practices to enable rural, persistent poverty communities to leverage the full suite of currently available resources made available by both public and private sector partners. Importantly, this pilot seeks to leverage both the field level expertise of USDA Rural Development in supporting rural economic development projects with the situational awareness offered by the HHS ONC funded Health IT Regional Extension Center that providers local, boots on-the-ground technical assistance to Mississippi CAHs and rural hospitals working to adopt health IT and transform health care delivery.
On July 30 and 31, the in-person workshop drew 23 critical access and rural hospitals as well as 31 Rural Health Clinics. During the workshop, each rural provider, CAH and rural hospital identified top priority funding needs. Then, USDA Rural Development representatives, ONC, the other private sector funders, as well as the rural health care providers in the room worked together to identify and come to agreement on the programs most suited to meeting each need. In doing so, our goal was to make it easier for these rural safety-net providers to navigate the often complex process of applying for grants and loans.
During the workshop, HHS and USDA offered resources to CAHs and rural hospitals to help them coordinate funding and financing opportunities to support the adoption of certified electronic health record (EHR) technology, associated system and facility improvements. New content and HealthIT resources for rural communities are also available online at http://www.healthit.gov/ruralhealth
Jimmy Graves, administrator at Jefferson Davis General Hospital, a Critical Access Hospital said: “Rural Hospitals have limited resources and limited access to funding the IT needs of providing quality care to our community. The MS Rural Health IT Workshop was very informative on ways to utilize USDA programs to help fund the IT needs of Rural Hospitals with the ultimate goal being to improve quality care to our patients.”
Key partners at the workshop included the Mississippi Hospital Association, Foundation for the Mid-South, Mississippi State Office of Rural Health. We are all committed to following up on and tracking the progress of each CAH and rural hospital participating in the pilot projects.
Health IT Workforce Development in Rural Communities
At the same time our nation’s healthcare providers are using technology to improve the delivery and quality of care, there is a need for more skilled professionals to sustain these new systems. Small rural hospitals are in urgent need of IT skills and are a place where Health IT professionals often serve multiple roles, gain comprehensive experience, and move up quickly in their careers. With federal, state and local support, highly skilled in-demand career pathways can be developed from secondary to postsecondary education into HealthIT and other in-demand jobs.
To support this work, the President Obama proposed to double funding for career and technical education (CTE) in the Fiscal Year 2014 budget for education. The Administration’s plan to strengthen CTE also proposes higher standards and more public-private collaboration. Health Science and Information Technology are two of 16 career clusters recognized by the U.S. Department of Education.
In 2010, HHS ONC awarded almost $118 million in funding toward the development of a suite of Health IT Workforce Development programs. The goal of these programs was to train a new workforce of skilled health IT professionals, as well as support the development of curricula and instructional materials to enhance health IT workforce training programs at community college nationwide. As of June 2013, over 18,000 professionals and additional 1,200 professionals have been trained through the Community College Consortia Program and the University-Based Training Program, respectively. The HHS ONC funded teaching institutes are ready to provide technical assistance to other institutions of higher education interested in offering health IT training.
At 9:00 AM ET today, one of HHS ONC’s grantees, Pitt Community College, hosted a free 30-minute webinar for rural and community health stakeholders on opportunities available for health IT training. Because of the high demand, this workshop will be replicated at least one more time. The next webinar is Thursday, August 8, 2010 at 9AM ET. Registration is required and available online.
Because funding can be a barrier to hiring and implementation of HealthIT systems, the U.S. Department of Agriculture’s Rural Development team can be a key partner for critical access and rural hospitals in every state. The HHS Regional Extension Centers, funded by the Office of the National Coordination for Health Information Technology, offer unbiased Electronic Health Records adoption support throughout the implementation process and serve as two-way pipelines to local and federal resources. The Mississippi State Office of Rural Health, funded by the HHS Office of Rural Health Policy also works to build productive health care systems in rural communities by administering a range of grants and engaging in activities, such as, helping CAHs and rural hospitals recruit and retained much needed health care workforce.
For more information on funding opportunities for rural health care providers see: http://www.healthit.gov/providers-professionals/implementation-support-critical-access-hospitals-and-other-small-rural.
John White is Deputy Assistant Secretary for Rural Outreach at the U.S. Department of Education; Leila Samy is the Rural Health IT Coordinator in the HHS Office of the National Coordinator for Health IT,).