HIT Project Management: Managing HIT Projects in Rural Settings June 9, 2005 Washington, D.C....
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HIT Project Management: HIT Project Management: Managing HIT Projects in Rural Managing HIT Projects in Rural Settings Settings June 9, 2005 June 9, 2005 Washington, D.C. Washington, D.C. Michael P. Rodriguez Michael P. Rodriguez HIT Projects Director HIT Projects Director Agency for Healthcare Research & Quality’s Agency for Healthcare Research & Quality’s 2005 Patient Safety & HIT Grantee 2005 Patient Safety & HIT Grantee Conference Conference
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Transcript of HIT Project Management: Managing HIT Projects in Rural Settings June 9, 2005 Washington, D.C....
HIT Project Management: HIT Project Management:
Managing HIT Projects in Rural SettingsManaging HIT Projects in Rural Settings
June 9, 2005June 9, 2005Washington, D.C.Washington, D.C.
Michael P. RodriguezMichael P. RodriguezHIT Projects DirectorHIT Projects Director
Agency for Healthcare Research & Quality’sAgency for Healthcare Research & Quality’s 2005 Patient Safety & HIT Grantee Conference2005 Patient Safety & HIT Grantee Conference
Page 2
• Outline what ‘rural’ means
• Discuss approaches to rural HIT projects
• Answer questions
Goals for Today’s Discussion
Page 3
• Limited healthcare access options
• Healthcare is ‘old fashioned’
• Information is inconsistent
• Public transportation not the norm
• Chronic healthcare conditions abound
What’s Rural?
Page 4
• 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
The Case of Wyoming
Page 5
Interoperability Framework
Full Integration
Networked Systems
Stand Alone Electronic Systems
Paper Medical Records
Page 6
• Cultural Barriers
• Financial Constraints
• Systemic Barriers
• Technological Considerations
• HIT Solutions
Cascading Method of Evaluation
Page 7
• Fiercely independent
• Desire for local control
• Limited history of collaboration
• Fear of unknown – technology
• Resistance to change in workflows
Cultural Barriers
Page 8
• Cost– Hardware/software– Implementation time and effort/productivity– Sustainability/maintenance/upgrades
• Limited capital sources
• Uncertain return on investment for most constituencies
Financial Constraints
Page 9
• 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
Systemic Barriers
Page 10
• Low penetration of HIT in physician practices
• Limited electronic capture of health information
• Broadband more limited/expensive
• Provider education around HIT is a key
Technological Considerations
Page 11
• 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
• Don’t forget about the patients
Take Away Messages
