What implementation issues are unique to rural settings and how do we best manage them?
An obvious implementation barrier, particularly for rural providers, is the prohibitive cost of many health IT systems. Other barriers to implementation in rural settings include: access to information on various health IT vendors, suitability of vendors' products for rural settings, interoperability requirements and problems in obtaining ongoing health IT support to aid users as they learn to interact with the new system. Additionally, there may be unique connectivity issues and greater difficulty collaborating and forming partnerships in rural settings.
IT workforce issues are often of great concern in rural parts of the country. Staff with expertise sufficient to support users and ongoing maintenance of health IT systems may be in short supply. In many small institutions, one staff person dons several hats or multiple people share IT-related responsibilities. One factor contributing to this problem is that rural institutions often find it difficult to compete with the salary and benefits their urban counterparts offer. With less overall revenue, paying the going rate for these types of services and attracting qualified staff to a rural community may be next to impossible for small institutions. However, rural providers also risk losing business and revenue if they do not have the same level of technological sophistication as other institutions. Competition from neighboring hospitals or clinics can draw business away if patients perceive that quality of care might be greater at these other organizations. Therefore, coming up with a solution to address these barriers is important for survival.
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