Critical access hospitals and small rural providers are finding it difficult to meet Meaningful Use requirements, due in part to limited resources and support from electronic health records vendors.

According to Shannon Sorenson, CEO of Brown County Hospital in Ainsworth, Neb., theEHR Incentive Program should be closing—not widening—the digital divide between rural and urban providers but data from the Centers for Medicare and Medicaid Services indicates that CAHs in particular are facing an uphill battle with a lower Meaningful Use achievement rate compared to non-CAH hospitals.

“While the impact of the incentive has been a positive experience for us, we are struggling with an older population which has less access to computers; consequently making it difficult to meet Meaningful Use requirements for the patient portal,” Sorenson testified this week before a House Ways and Means Health Subcommittee hearing on rural healthcare disparities.

CAHs represent approximately 30 percent of hospitals across the country, often providing critical healthcare services in underserved rural communities. Yet, they are less likely than other hospitals to have demonstrated Meaningful Use. In addition, determining payments for participating in the EHR Incentive Program is not as straightforward for CAHs as it is for other types of acute care hospitals.

Also See: Critical Access Hospitals Struggle with EHR Implementations

Limited access to capital also is a problem for CAHs. A 2014 Office of the National Coordinator for Health IT study found that CAHs that have certain types of technical assistance and resources available to support them are more likely to have adopted health IT capabilities and less likely to report significant challenges to EHR implementation and use compared to other hospitals.

“It is important to ensure that the necessary resources and support are available to critical-access hospitals, especially those that operate independently, to assist them in adopting health IT and becoming able to electronically link to the broader healthcare system,” concluded the ONC study.

CAHs that receive assistance from Regional Extension Centers (RECs)—created under the HITECH Act— are much more likely to achieve Meaningful Use than those that don’t receive assistance. According to ONC, the REC network includes 54 percent of all rural providers and 80 percent of all CAHs. Sixty-two RECs across the country have helped primary care and underserved providers navigate the complex EHR adoption process from vendor selection and workflow analysis to implementation and Meaningful Use.

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