By - A lack of a robust health information exchange (HIE) is a significant barrier for rural hospital telehealth adoption, according to a study published in The Journal of Rural Health.
Rural hospitals and providers do not possess the same spending power as larger hospitals. As a result, rural hospitals do not have strong telehealth adoption, health IT, and interoperability. Additionally, rural areas of the country have a higher number of health disparities, a higher percentage of older adults, and experience more natural disasters, according to the researchers.
While telehealth could help rural hospitals deliver and improve care to their community, several barriers disrupt telehealth adoption, such as high implementation cost, health IT concerns, and concerns about telehealth technology.
However, a strong health IT system can ease telehealth integration and provide a number of different integration options.
Using the 2018 American Hospital Association (AHA) Annual Survey and IT Supplement Survey, researchers found significant variances when comparing telehealth adoption among rural, micropolitan, and metropolitan areas.
Rural hospitals were about 65 percent less likely to adopt the top eight telehealth services compared to metro areas. Furthermore, rural hospitals adopted 55 percent fewer telehealth services and rural hospitals saw 43 to 49 percent more telehealth barriers than urban hospitals.
Rural hospitals were also less likely to access patient data from external providers and were less likely to query patient information from an outside provider. As a result, rural hospitals were less likely to exchange patient data from outside providers than their metro counterparts.
HIEs are crucial for connecting communities and ensuring patient medical records are available at all times. However, for rural hospitals and providers, participating in an HIE is not always a reality.
According to the most recent ONC data brief in late 2018, small and rural hospitals were about half as likely to share records than their larger counterparts. In total, only 62 percent of small hospitals shared this information.
Additionally, urban hospitals were more likely to have telehealth platforms with patient engagement capabilities to view health information, request prescription refills, schedule appointments, and send patient data to providers.
Researchers said COVID-19 should trigger user-friendly telehealth platform integration in rural areas that could help boost patient engagement. But both providers and patients would have to undergo training to improve this area.
Although micropolitan hospitals faced challenges, their results were also greater than rural hospitals.
“HIE requires an interoperable infrastructure to enable communication and information‐sharing between health care providers across multiple settings, and among community partners from health or social services sectors,” explained the study authors. “Such systems can promote more efficient data exchange, tracking, and integration. Our results support the urgent need to build and strengthen existing integrated data systems in rural areas.”
These differences were not surprising to the study authors. The difference in hospital bed size and geographic factors, such as natural disasters, will always place rural providers at a disadvantage for patient data exchange and telehealth adoption.
However, to promote interoperability and remove cost barriers, funding from the government or organizations allows rural hospitals to access the same benefits as the larger hospitals.
“Results provide baseline data upon which to examine the importance of promoting data communication, exchange, and sharing among multiple sectors, and to advocate for policy design to encourage telehealth capacity building to improve rural health,” concluded the study authors.
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November 18, 2020 at 12:28AM
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Rural Hospital Health Information Exchange Stunts Telehealth Adoption - EHRIntelligence.com
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