How technology can solve efficiency, quality challenges in rural healthcare

From resource strain to workflow enhancement, tailored technology solutions can help rural health systems overcome current barriers.

How a rural health system approaches the buying decision on technology platforms can vary greatly depending on the size of the group, the resources that will be using the systems, reimbursement and funding mechanisms, and security.

In choosing a solution, there is typically an emphasis on the clinical aspect, and the CEO or CFO consults closely with the head of nursing (CNO) to select a platform that meets their criteria, which usually center on ease of use and cost.

While the inherent needs of clinicians and billers are the same regardless of whether or not the system is in a rural setting, there can be nuances in terms of patient volumes, patient access to resources and billing rules.

What rural providers want

According to the Centers for Disease Control and Prevention (CDC), roughly 46 million Americans — or 15 percent of the country’s population — live in rural areas. As the CDC notes, people living in rural areas have a higher mortality rate related to heart disease, cancer, chronic lower respiratory disease and stroke, compared with those living in urban areas.

At the same time … rural health systems are experiencing a significant strain on financial resources.

According to the American Hospital Association, the number of rural hospitals declined by 81 between 2015 and 2019. Of the overall decline in the number of hospitals, 59 percent were rural hospitals. More closed amid the COVID-19 pandemic and may continue to do so in the post-pandemic era.

A KFF analysis found that in 2019, about four in 10 rural hospitals (41 percent) had negative operating margins. Roughly one in three (32 percent) had operating margins at or above 5 percent.

It’s no surprise rural providers are often price sensitive. However, that doesn’t mean they’re not focused on functionality — and how solutions might grow and evolve as their practice does.

They still need to provide the highest level of health services to their patients and the community — sacrificing quality or functionality over price should not have to be the way in which decisions are weighed.

Solving the issues

Rural health systems are experiencing a significant strain on their people resources.

There is a significant shortage of skilled talent, and burnout levels among nurses, doctors and other clinical staff are at an all-time high. A 2022 Bain survey shows that 25 percent of the country’s clinicians are contemplating switching careers, mainly because of burnout.

A deeper dive into the survey reveals that roughly 40 percent of all clinicians say they don’t have the necessary resources to operate at full potential and say their organizations lack effective processes and workflows, supplies and equipment. While more than half (59 percent) say their teams are not adequately staffed, the wrong — or inadequate — technology makes burnout a self-fulfilling prophecy.

Clinicians across the board are more or less exhausted, and this is exacerbated in rural communities as resources move to areas where higher-paying jobs are, typically in urban areas. During the COVID-19 pandemic, they were making as much as four times the amount they would in rural areas.

It is a real threat facing healthcare providers, and it has long-term ramifications for the patient experience if the industry doesn’t make it a point to reverse its current trajectory.

Improving workflow, eliminating burden

Too often, healthcare solutions such as EHRs have a reputation that they add more time and effort to a practitioner’s workload. Each minute of added administrative burden is time they can’t spend with their patients.

While there’s a shortage of resources, specifically when it comes to clinicians, the most significant opportunity an organization can grab is to deploy a system that doesn’t add more burden to the workload. Instead, they need solutions that help teams gain efficiency.

How do we return to that place where physicians and nurses practice medicine vs. being anchored to an electronic system? The answer isn’t less technology; it’s better-tailored technology.

Thinking further ahead, artificial intelligence has been added to the ever-growing list of technologies available. It holds endless potential to revolutionize how practitioners identify and diagnose illnesses and the course of treatment they prescribe.

But AI requires a foundation of data, and rural providers will only succeed if they begin laying that foundation today with the technology available to them. Properly enabling today’s technology helps ensure that the next revolution — whether AI or any other technology — will be set up for success.

Expanding access

Maternal and infant mortality rates are higher in rural areas in the country than urban or suburban markets. 

Many ob-gyn specialists say there are preventive measures that could help reverse that trend. Improving broadband access to patients in rural areas would enable providers to increase the use of remote patient monitoring technologies. Coupling that with proper reimbursement policy, could improve management of this mortality rate in some cases.

The outlook is positive on both fronts, however. The reimbursement model is changing to accommodate more virtual healthcare solutions, while the federal Infrastructure Investment and Jobs Act included billions to help close the digital divide in rural areas. Rural providers need to advocate for both solutions at every point possible; it’s a change that will take time, but more voices in favor of change will make it more difficult to ignore the demand.

According to the J.D. Power 2022 U.S. Telehealth Satisfaction Study, two-thirds (67 percent) of survey respondents accessed video telehealth services during the past year, up from 37 percent in 2019, before the pandemic. The survey further found that patients like it, with the top reasons for telehealth use being convenience (61 percent), receiving care quickly (49 percent) and easily accessing health information (28 percent).

Nearly all respondents (94 percent) said they would use telehealth to receive medical services in the future.

Being able to pay a bill online may seem commonplace for many. However, this is not a foregone conclusion in rural health markets based on the available technology and broadband accessibility.

Adding the ability for patients or caregivers to pay their bills online through a patient engagement solution is just one small feature that benefits patients and providers. It’s easier for patients, while improving provider collection rates.

Streamline and simplify

Overall, workflow efficiencies can help teams decrease the number of “clicks” a practitioner needs to make on a system to manage digital records or care. Given practitioners’ workloads, even modest time savings add up and can result in more patient time.

The healthcare system we know today didn’t emerge overnight, and it will take time to build a better, more connected system. But providers have an opportunity to implement solutions that will lead to incremental change and lay the foundation for the healthcare system of tomorrow that benefits and serves every patient.

Brian Kenah is chief technology officer for Azalea Health.

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