Electronic Health Records


How can rural healthcare providers afford EHR?

By Kyle Murphy, PhD

- On Wednesday, the Department of Health and Human Services (HHS) announced the awarding of $10.4 million to improve healthcare services in rural communities across the US. HHS selected 70 grantees, each receiving $450,000 over three years to provide healthcare to these communities, many of which comprise low-income families, elderly, and individuals with serious medical needs.

As we reported in our interview with Todd Searls, Director of Wide River Technology Extension (TEC), many rural clinics are unable to receive payments from the Centers for Medicare & Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Programs because of oversight in federal legislation. So what impact will this latest grant through Health Resources and Services Administration (HRSA), the HHS division charged with awarding and distributing these grants, have on EHR implementation?

As it turns out: none. But that’s not to say that HRSA and its Community-Based Division have likewise ignored helping rural clinics and providers benefit from the implementation of EHR systems. As Nisha Patel, Director for the Community-Based Division in the Office of Rural Health Policy, explains, this latest award is just one of many grants offered through HRSA: “There’s something new that comes out on a regular basis that rural communities can tap in to that really addresses those challenges, which is really important.”

The award announced on May 2 is part of a grant program dating back to 1987 that focuses directly on providing medical services to rural communities. Ever since the launch of President Obama’s Improving Rural Health Care Initiative, HRSA has increased its efforts to make EHR and HIT a meaningful part of rural healthcare.

We developed a new program in FY 2011, and that was in response to the President’s Rural Healthcare Initiative, which came out in 2009. We made 40 awards to rural communities and so they’re focusing in on implementing EHR as we speak so that they’re able to achieve Meaningful Use Stage 1.

HHS grants represent yet another way eligible professionals (EPs) and hospitals, albeit a much more limited group, can offset the costs of adopting and going live with an EHR or other HIT system. “A lot of what the grantees right now are focusing in on is HIT. They’re in the process of implementing EHR across multiple counties that they serve so that they can improve the quality of care,” says Patel.

For rural communities, they must find creative solutions to challenges unique to their patient population and communities. “Over time, you really see a lot of the same challenges,” Patel continues, “The primary challenges that constantly remain are around recruitment and retention, workforce, transportation, reimbursement, lack of providers, etc. A lot of the challenges stay the same.”

In the next fiscal year, rural healthcare providers will have access to government grants that can assist them in EHR implementation, namely the Delta State Rural Health Development Program and the Small Rural Quality Program. The former “focuses in on infrastructure development and service delivery in the Delta region.” While the latter does not deal with EHR specifically, it looks to HIT to improve the care of patient populations: “The program requires the grantees to implement an electronic patient registry system. It’s population-focused: They’re collecting certain health indicators around diabetes, cardiovascular disease, and obesity. And a lot of that will actually interface with EHR.”

While much of the focus on EHR systems and incentives is on the billions of dollars made available through CMS, still other financial resources made available through HHS and its other divisions warrant attention.

Related Articles:

• Why can’t rural health clinics receive EHR Medicare incentives?
• Wide River TEC reaches REC milestone
• Getting CAHs to attest to meaningful use
• Part I: The go-to resource for meaningful use in NH
• Part II: The go-to resource for meaningful use in NH

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