HIT Implementation in Critical Access Hospitals: Extent of Implementation and Business Strategies Supporting IT Use
- First Online:
Small rural hospitals face considerable financial and personnel resource shortages which hinder their efforts to implement complex health information technology (HIT) systems. A survey on the use of HIT was completed by 85% of Iowa’s 82 Critical Access Hospitals (CAH). Analyses indicate that low IT staffing in CAHs is a barrier to implementing HIT solutions. CAHs with fewer staff tend to employ alternative business strategies. There is a clear relationship between having IT staff at a CAH and the types of technologies used. Many CAHs report having difficulty expanding upon HIT functionalities due to the challenges of finding IT staff with healthcare expertise. Most CAHs are in the transition point of planning for or beginning implementation of complex clinical information systems. Strategies for addressing these challenges will need to evolve as the HIT investments by rural hospitals race to keep pace with the goals for the nation.
KeywordsCritical Access Hospitals Rural Hospitals Health Information Technology Electronic Medical Records
- 1.American Hospital Association. Continued progress—hospital use of information technology. http://www.aha.org/aha/content/2007/pdf/070227-continuedprogress.pdf. Accessed October 25, 2008.
- 2.Li, P., Bahensky, J. A., Jaana, M., and Ward, M. M., Role of multihospital system membership in electronic medical record adoption. Health Care Manage. Rev. 33 (2)1–9, 2008.Google Scholar
- 3.American Hospital Association, Forward momentum: hospital use of information technology. American Hospital Association, Chicago, 2005.Google Scholar
- 6.Wang, B. B., Wan, T. T., Burke, D. E., Bazzoli, G. J., and Lin, B. Y., Factors influencing health information system adoption in American hospitals. Health Care Manage. Rev. 30(1):44–51, 2005.Google Scholar
- 8.Medicare Payment Advisory Commission, Report to the Congress: issues in a modernized Medicare program. MedPAC, Washington (DC), 2005.Google Scholar
- 9.Medicare Payment Advisory Commission, Report to the Congress: Medicare in rural America. MedPAC, Washington (DC), 2001.Google Scholar
- 10.Li, P., Schneider, J. S., and Ward, M. M. Effects of critical access hospital conversion on the financial performance of rural hospitals, Inquiry, 2009, in press.Google Scholar
- 12.Bahensky, J. A., Frieden, R., Moreau, B., and Ward, M. M., Critical access hospital informatics. How two rural Iowa hospitals overcame challenges to achieve IT excellence. J. Healthc. Inf. Manag. 22(2):16–22, 2008.Google Scholar
- 14.Flex Monitoring Team. The current status of health information technology use in CAHs. Flex Monitoring Team Briefing Paper No. 11; May 2006. http://www.flexmonitoring.org/documents/BriefingPaper11_HIT.pdf. Accessed October 25, 2008.
- 15.Houser, S. H., and Johnson, L. A., Perceptions regarding electronic health record implementation among health information management professionals in Alabama: a statewide survey and analysis. Perspectives in Health Information Management. 5:6, 2008.Google Scholar
- 16.Iowa Hospital Association. Profiles; Section VI: Hospital and Health System Specific Data. 2005, http://www.ihaonline.org/publications/profileserv/profileserv.shtml. Accessed October 25, 2008.
- 17.Biddle, B. Assessing high-speed internet access in the state of Iowa: Fifth Assessment. A Report of the Iowa Utilities Board. May 2006.Google Scholar
- 18.HIMSS. 17th Annual 2006 HIMSS Leadership Survey. Health Information Management Systems Society. February 13 2006. http://www.himss.org/2006Survey/healthcareCIO_home.asp. Accessed October 25, 2008.
- 20.Garets, D., and Davis, M. Electronic medical records vs. electronic health records: Yes, there is a difference. HIMSS Analytics. January 26, 2006. http://www.himssanalytics.org/docs/WP_EMR_EHR.pdf. Accessed October 25, 2008.
- 21.United States Department of Health and Human Services. Office of the National Coordinator for Health Information Technology (ONC): Goals of strategic framework. December 10, 2004. http://www.hhs.gov/healthit/goals/html. Accessed November 6, 2008.
- 22.Robert Half Technology. Competing for top IT talent in a tight market. Infrastructure Insite. April/May/June: 20–23, 2007.Google Scholar
- 23.Lee, K. S. Business acumen: the new must-have skill. Infrastructure Insite. April/May/June: 25–27, 2007.Google Scholar
- 24.Lanzalotta, J. High-impact tech talent in high demand. ComputerWorld. March 1, 2007. http://www.computerworld.com/action/article.do?command=printArticleBasic&articleId=284494. Accessed October 25, 2008.
- 25.Fenton, S. H., Amatayakul, M., and Work, M., The HIM impact on EHRs: newly released study links HIM professionals and successful EHR implementations. J. AHIMA. 77(9):36–40, 2006.Google Scholar