Sunday, October 4, 2009

HIT Success in Rural Areas

HHS releases “New Success Story Report: Health Information Technology Strengthens Care in Rural Communities” a new report emphasizing how health information technology can improve healthcare in rural areas. Approximately 65 million Americans live in communities with shortages of primary care providers and nearly 50 million of those Americans live in rural areas.

The report examines how the Columbia Basin Health Association (CBHA) in Othello Washington operates. CBHA provides 25,000 patients in Central Washington with access to a variety of medical, dental, prescription, and other services. CBHA was one of the first health centers in the U.S. to fully transition from paper-based charts to an electronic health record system.

Diabetes is more common among rural residents than urban residents and also the percentage of diabetes patients who received all three recommended exams for diabetes is lower for patients in rural areas than in metropolitan areas.

CBHA reports that in January 2008, only 31 percent of patients had received a foot exam and only 37 percent had received an eye exam during the previous year. By June 2008, 86 percent of patients had received a foot exam and 63 percent had received an eye exam over the previous year.

CBHA used their EHR system to track 1, 302 diabetic patients and then monitored whether these patients received recommended exams. Feedback was provided back to the healthcare providers on their performance.

By using practice management software, CBHA has decreased no-shows for dental patient appointments by about 50 percent and has filled 200 percent of available appointment slots. This allows clinicians to see more patients and to provide timely care. CBHA now ranks above the 95th percentile nationally in total medical and dental team productivity as reported in the Bureau of Primary Health Care Uniform Data System. In addition, CBHA has partnered with the nearby Othello Community Hospital so that both organizations now have HIPAA compliant access to each other’s EHR systems.

The report addresses health insurance reform and the need for HIT to help especially in rural areas. For example, a recent study found that physicians spends an average of three hours a week dealing with health insurance bureaucracy and this is impacted even more in rural areas by the shortage of doctors. Health insurance reform plus the use of electronic health records would improve efficiency, quality, and access in underserved areas.

According to the report, health insurance reform would make significant investments in developing and reporting on quality issues, but to be effective, HIT is needed to collect, analyze, and report information on the quality of care measures across the healthcare delivery system. In addition, health insurance reform needs to invest in telehealth technologies as part of a continuum of health information technology to enable residents to have better access to the range of services that are accessible to them.

The report along with other reports is available at