Kristy Boldt

Leveraging HIT at Rural Hospitals: Challenges, Benefits & What to Look for in a Critical Access Hospital EHR Solution

April 2, 2021

EHR, Rural Healthcare 7 Minute Read

As a cornerstone of the communities they serve, rural and critical access hospitals hold a special place similar to local mom and pop businesses. However, these hospitals play a more significant role than most people realize. Not only do they provide much needed medical care to the almost 20 percent of Americans (60 million) residing in rural areas, rural hospitals also power the economies of the towns where they are located, often serving as the largest employer.

What Rural Hospitals Are Facing Today

Despite the intrinsic value to their communities, many rural and critical access hospitals are facing a grim prognosis. After struggling financially for years, then facing sizeable revenue loss during the pandemic, hospital closures are climbing. It is estimated that 25 percent of rural hospitals across the U.S. are facing closure right now unless their financial situations improve.

It is important to understand the impact these closures have. When a rural hospital closes, it doesn’t just mean the town’s residents have farther to travel for care. The impact is far greater. According to a recent working paper from the National Bureau of Economic Research, rural hospital closures increase mortality rates by almost 6 percent overall. Additionally, the community as a whole is severely impacted from an economic standpoint, driving higher unemployment rates and decreasing per capita income for the community.

Beyond the financial struggles, rural hospitals face many other immense challenges. A report recently published by the American Hospital Association highlights in detail the persistent, recent, and emerging hurdles facing rural communities (minus the newest one: COVID-19).

This eye-opening graphic illustrates these challenges.

Rural Health challenges

The Role of Health Information Technology in Rural Healthcare

Although not directly listed in the graphic above, many providers view health information technology, and particularly electronic health records (EHRs), as a significant chain of interrelated challenges for small, rural, and critical access hospitals. It is a challenge to deal with the manual processes caused by antiquated and disparate systems. It’s also challenging for many hospitals to find the money for modern healthcare IT systems, provide proper training, find and retain IT staff, and keep up with changing regulatory demands (Promoting Interoperability Program, formerly Meaningful Use or EHR Incentive Programs).

However, in looking at the larger scope, if rural hospitals had access to better, more affordable, and interoperable systems, many of these challenges wouldn’t be an issue. Healthcare IT, rather than being the problem, can instead be the solution.

Rural hospitals

Ways HIT/EHRs Can Benefit Rural and Critical Access Hospitals

The benefits of electronic health records in rural healthcare settings can be tremendous for patients and providers alike. This technology improves the safety, productivity, communication, delivery, and quality of healthcare in a variety of ways:

  • Provides accurate, up-to-date, comprehensive patient records for more timely decision-making at the point of care
  • Allows better coordination of care across departments and other healthcare organizations
  • Extends and improves patient care through the ability to easily connect and refer rural patients to specialists outside their remote area (since access to specialists is limited)
  • Uses decision support systems to provide clinicians with best practices and treatment options that improve care quality
  • Reduces medication, transcription, and order handling errors typical of paper documents and systems for better patient safety
  • Improves population and public health through more advanced reporting and disease surveillance
  • Streamlines workflows for increased productivity and efficiency
  • Improves the accuracy of and ability to process charges, thereby improving financial performance
  • Enables the use of remote clinicians, pharmacists, and staff, since many rural communities lack resources

Now that we’ve covered how rural hospitals can benefit from EHRs, we are going to take a look at what to look for in a rural hospital EHR.

critical access hospitals

Checklist: Top Things to Look for in a Rural and Critical Access Hospital EHR

Since rural and critical access hospitals are vastly different from urban facilities, so are their EHR requirements. Here are the top seven things they deem important.

  1. Affordability. Rural hospitals simply can’t afford to overspend on big brand vendors. Instead, they must seek out vendor solutions that fulfill their functional needs and their budgetary requirements. Many times, the rural hospital is also looking for a solid, integrated financial system in addition to the EHR, so that must also be taken into account. Another important consideration is whether the vendor offers subscription model pricing, which helps hospitals avoid unexpected expenses.
  2. Ease of Use. EHR adoption depends on the ease of use of the system. If clinicians don’t find it easy to use, they won’t use it. A simple, intuitive, automated system that satisfies users is required since the staff in rural hospitals is perpetually stretched thin and often turns over frequently.
  3. Interoperability. Rural hospitals typically lag behind urban hospitals with regard to interoperability and access to external electronic health data. Being able to share data with other healthcare providers in order to see a comprehensive picture of the patient’s medical history impacts the quality of care. It goes without saying that vendors should have proven interoperability and integration with other systems, including pharmacy, lab, and radiology.
  4. Customization. Every facility is different and has different needs. Some of the larger EHR vendors have been able to expand their offering into rural hospitals by only providing very limited customizations. High configurability out of the box allows for a tailored workflow and higher clinician satisfaction and adoption.
  5. Flexible Architecture. Some hospitals still prefer on-premise or client-server EHR systems. However, most ruralhospitals can’t afford the upfront costs of an on-premise solution and likely don’t have well-staffed IT departments to accommodate them. Enter cloud-based options. Not only do they eliminate the high upfront costs of new hardware and in-house data/storage centers, they also typically include free updates.
  6. Strong Support and Services. Quality support is paramount to the success of an EHR implementation and long-term EHR goals, so it’s important not to make the mistake of choosing an EHR vendor before understanding their support system. One question to ask yourself in the evaluation process: Do you feel the vendor will provide a high level of attention and service if you aren’t a big hospital or health system?
  7. Experience Working with Similar Hospitals. Most EHR vendors work with larger hospitals, but how well do they work with rural hospitals to truly understand their needs? Take a detailed look at a vendor’s client references to see what their experience is working with similar types of hospitals.
Rural hospital EHR

Is a New EHR the Logical Next Step for Your Rural Hospital?

The right EHR system can truly transform how rural health organizations store, retrieve and transfer patient data to improve care quality, safety, and delivery. Rural and critical access hospitals shouldn’t be prohibited from obtaining an advanced, integrated EHR system tailored to each facility’s unique needs.

If your organization is considering a new EHR, we invite you to take a look at Medsphere’s CareVue EHR.

About Medsphere and CareVue EHR

Not familiar with Medsphere or the CareVue EHR? Just like you, we may not be a big name in healthcare technology even though we’ve been around for decades. However, we have dedicated ourselves to helping rural and critical access hospitals meet their healthcare IT needs and goals with reliable, affordable, and interoperable healthcare IT solutions and services.

We continue to expand our capabilities and modernize our CareVue EHR platform, which is used in rural communities across the nation. Our extensive ability to customize our EHR solution is a huge advantage for rural environments versus some of the larger EHR vendors that offer limited customizations and virtually no affordability.


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