The implementation of a RHIO requires obtaining the necessary resources, both in terms of infrastructure and skills.  Facilitating health information exchange necessitates access to networking technology.  However, in rural communities, broadband costs may be higher thus this needs to be considered during the business planning phase.

In addition, skilled IT expertise may also be more difficult to acquire in a rural setting.  Recruiting both technical and management staff with experience in health information exchange can pose a significant barrier.  Vendor or consultant support may be available, but can be more expensive due to additional travel costs.  Rural RHIOs may seek to utilize staff from participating stakeholders.  Leadership may consider extending membership in the RHIO to larger tertiary care centers that often receive referrals from the community providers.  These larger entities may provide additional resources and expertise, including staffing and funding.   Another possibility may be to share staff with other local and regional RHIOs.  This may also facilitate more interaction with other RHIOs.

Rural RHIOs may also face a challenge in securing necessary legal counsel to draft documents and receive appropriate guidance with regard to issues, such as privacy and security.  Again, working with other similarly placed RHIOs and with member stakeholder organizations may also provide access to legal professionals with experience in health information exchange-related matters at reduced costs.  

Resources:

• Rural Healthcare Information Technology Adoption Project - Arizona GITA
• Health Information Exchange (HIE) Toolkit