Achieving Interoperability in Rural Communities

November 20, 2014

Today is National Rural Health Day, a day where we highlight health care in rural communities across the United States but also discuss the healthcare challenges that Americans living in rural areas are dealing with on a daily basis.  Rural communities face issues that city dwellers usually don’t even think about, they include accessibility issues, limited selection of healthcare providers, an aging population suffering from chronic conditions, and larger percentages of un- and underinsured citizens.

In order to help enable connectivity and accessibility in these communities, Surescripts is working with Inofile on an initiative that enables rural community care providers to achieve interoperability and ultimately remove fax entirely from healthcare operations.  We had a conversation with Inofile’s President and Chief Technology Officer, Therasa Bell to discuss the healthcare challenges and opportunities in rural communities.  Read below to learn more.

Though we’ve come a long way as an industry, what are the biggest challenges that rural providers are facing in terms of achieving health IT connectivity?

Rural providers face many of the same challenges faced by almost all healthcare providers across the spectrum... cost reductions, speed of technology change, risk management, and of course legislation mandates.  However, challenges are magnified significantly within a rural setting.  Cost of healthcare delivery with reduced reimbursements, disproportionate mix of Medicare patients, attracting clinical, administrative, and IT talent to rural areas, limited healthcare IT vendor options, cost of technology deployment, and coordinating care across a large geography, just to name a few.   Specifically for connectivity, realistic IT solutions that are available, affordable and usable by all healthcare providers in a rural area simply have not been available.  Technology adoption drops off dramatically 50-100 miles from an urban epicenter, which is another challenge facing rural healthcare providers.  This combination of events creates a very difficult set of circumstances to overcome.  Conversely, rural areas also have an advantage due to the known and limited audience that needs to be connected, versus a highly populated area.

What do you see as the number one priority that rural providers must have on their enterprise IT agendas in 2015 to increase interoperability?

I believe it will land in the area of MU2 requirements for creating and sharing C-CDA documentation using Direct messaging as a simple and easy method for care coordination.  Although definitely not the end-all for interoperability and exchange, Direct and structured content make significant strides towards sharing information in an efficient, secure and affordable manner versus the methods used today, primarily fax.  Rural providers are in a unique position to connect their entire geography quickly, with the right technology solution.

How is Inofile’s work with Surescripts helping to make the seamless sharing of patient information a reality?

The combination of the entire technology offering in conjunction with Surescripts as the largest national health information network is the first and only solution of its kind in healthcare and is truly disruptive to the healthcare environment in a very positive way. Kno2 is the first internet-based clinical document exchange platform targeted at getting fax out of every type of communication where clinical documents are involved.  For instance, Kno2 has patented technology that is being embedded in mainstream multi-function devices as well as fax and scanning devices that convert traditional fax and scan workflows to Direct messaging from the touchscreen of a device.  Also, through an invitation platform within the application, a user can encourage trading partners to sign up and continue to remove fax from their organization.  The low monthly subscription cost removes any of the financial barriers that are so common in healthcare.

How are rural providers working (with vendors) to meet meaningful use objectives? 

Rural providers are actually struggling to get the attention and resources they need to meet MU objectives.  For the few that have or are in the process of attesting, the traditional approach to meeting MU is to provide solutions that achieve 10% and nothing more.  Thus, the solution becomes an additive workflow and expense, instead of bringing efficiency and cost reduction through technology.  In many cases, creating connectivity between providers that are part of different organizations is not easily accomplished.

What steps should solutions providers be taking to help advance health information exchange in rural communities?  How can/should rural providers reach out to and work with solutions providers for guidance and assistance?

Bluntly providers should develop solutions that work and solve real problems.  Start servicing the customer the way they deserve.  Our approach is to attack the connectivity problem from the ground up, instead of discreet use cases that don't change habits or change business.  That's what will change healthcare in our country.  For any technology initiative to be disruptive a global change in behavior has to occur.   Discreet use cases do not change behavior. 


Feel free to share your thoughts and opinions in the comments below, or connect with us on Twitter @Surescripts.

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