Regulations, health IT, and rural health care
Geoff Caplea, MD, MBA
Every year, health care organizations (HCOs) across the country feel the impact of evolving legislative and regulatory mandates and the changing technologies that accompany them. In many cases, rural health care organizations feel that impact most acutely. Government regulations such as the Quality Payment Program and Inpatient Prospective Payment System might affect the financial health of rural HCOs, add administrative burden, and increase clinician burnout—all of which can cause quality of care to suffer.
If carefully managed and executed, the following critical priorities can help rural health care providers stay on course. These priorities will help rural organizations succeed not only in the industry’s evolving regulatory and technological landscapes, but also in ensuring patient and clinician experiences are elevated and the cost of care lowered.
Helping rural HCOs succeed with ACOs
Delivery system reform has created a national priority for safe, high-quality, cost-effective health care. Accountable care organizations (ACOs) are one example of a delivery system reform that provide a highly visible example of an administrative program intended to improve health outcomes while lowering costs. The road to success is particularly difficult for rural HCOs due to economic factors, remote location, workforce shortages, limited access to quality health care services, and the impact of public health epidemics, such as obesity, diabetes, and opioid abuse.
To succeed with ACOs, HCOs must take a holistic approach that considers people, process, organizational structure, and technology. Health IT vendors have a responsibility to provide innovative tools—EHRs, clinical decision support, patient engagement strategies, telehealth, analytics resources—that will position rural HCOs for success. By understanding rural HCOs and the communities they serve, health IT vendors can help organizations achieve the best possible outcomes, manage more risk, and earn more rewards.
Using telehealth to reach remote patients
Telehealth adoption is rapidly accelerating, and payers both public and private are reimbursing more for telehealth services. Beyond financial advantages, telehealth provides tremendous clinical benefits by increasing access to health care services, improving patient experiences, and increasing patient engagement.
Telehealth is especially valuable for rural HCOs because it helps address some of the unique challenges of providing care in rural communities. By incorporating video conferencing for remote visits and consultations, rural HCOs can provide patients with access to high-quality services and specialists that would have been previously unavailable. Remote patient monitoring is another form of telehealth that can be used by critical access hospitals and rural health clinics to manage many aspects of patient care.
As with any innovation, it is important to leverage telehealth as a complement to an organization's existing investments in people and IT systems. Through thoughtful use of telehealth solutions, rural HCOs will not only address existing challenges facing care delivery but also improve their patients' experiences and health.
Opioid crisis: How we can alleviate the epidemic
According to NRHA’s Jessica Seigel, the opioid epidemic has affected a “disproportionate number of rural communities” and the rate of opioid-related overdose deaths in non-metro areas is significantly higher than in metro areas. The opioid crisis is a public health emergency that needs serious attention. But what can be done? And how can health IT help address the crisis?
The Center for Disease Control and Prevention has a thorough set of guidelines on opioid prescribing for chronic pain, and many of the recommendations are facilitated with intuitive health IT solutions. For instance, clinicians can leverage medical and prescribing histories within an EHR to better understand a patient's chronic pain and evaluate the appropriate prescription and non-prescription interventions.
Additionally, clinical decision support solutions leveraging EHRs, community data, and prescription drug monitoring program databases provide physicians with insights into which patients are at highest risk for addiction and overdose. Clinical decision support also provides guidance on which personalized treatment options are best suited for an individual patient.
Taking the next steps
The health IT playing field is different now, and that is especially true for rural communities. It’s imperative for HCOs to partner with health IT vendors to address the challenges faced by rural hospitals with solutions that keep costs down while delivering personalized care to improve the health of every patient.
NRHA commissioned the above piece from Allscripts, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog