HIT Project Management: Managing HIT Projects in Rural Settings

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HIT Project Management Managing HIT Projects in
Rural Settings
Agency for Healthcare Research Qualitys 2005
Patient Safety HIT Grantee Conference

• June 9, 2005
• Washington, D.C.
• Michael P. Rodriguez
• HIT Projects Director

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Goals for Todays Discussion

• Outline what rural means
• Discuss approaches to rural HIT projects
• Answer questions

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Whats Rural?

• Limited healthcare access options
• Healthcare is old fashioned
• Information is inconsistent
• Public transportation not the norm
• Chronic healthcare conditions abound

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The Case of Wyoming

• 500,000 people living in 97,818 sq. miles
• More than 90 of land is considered frontier
• 48th among the 50 states in physicians per
  100,000 population
• Nearly half its 23 counties qualify as Health
  Professional Shortage Areas
• No passenger trains in state, no point-to-point
  air links limited taxis and buses in smaller
  towns

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Interoperability Framework
Full Integration Networked Systems Stand
Alone Electronic Systems Paper Medical Records
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Cascading Method of Evaluation

• Cultural Barriers
• Financial Constraints
• Systemic Barriers
• Technological Considerations
• HIT Solutions

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Cultural Barriers

• Fiercely independent
• Desire for local control
• Limited history of collaboration
• Fear of unknown technology
• Resistance to change in workflows

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Financial Constraints

• Cost
• Hardware/software
• Implementation time and effort/productivity
• Sustainability/maintenance/upgrades
• Limited capital sources
• Uncertain return on investment for most
  constituencies

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Systemic Barriers

• Majority of physician practices are small (1-2
  providers) and single specialty
• Majority of hospitals under 100 beds
• Relative physician shortage
• High out-migration for care
• Market considerations for HIT vendors
• HIT training and education gap

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Technological Considerations

• Low penetration of HIT in physician practices
• Limited electronic capture of health information
• Broadband more limited/expensive
• Provider education around HIT is a key

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Take Away Messages

• Start with healthcare issues not HIT approaches
• Moving toward collaboration will facilitate HIT
  options -- focus on building trust
• Be willing to change directions when new ideas
  come along
• Dont forget about the patients