Wow! Over 1000 critical access and small, rural hospitals meet the Meaningful Use challenge!

Last year, we issued a nationwide challenge to see 1000 critical access hospitals (CAHs) and small, rural hospitals get to Meaningful Use by 2014. The call to action was met with support; we could feel everyone roll up their sleeves in unison.

As of July 31, 2013, we passed the goal with 1,115 (65%) CAHs and small, rural hospitals achieving Meaningful Use. Specifically, 62% (approximately 822 of 1,332) of CAHs and 77% (approximately 293 of 383) of small, rural hospitals (those generally with less than 50 staffed beds) had attested to meaningful use of EHRs.

Small Rural and Critical Access Hospitals that Attested to Meaningful Use Cover the Nation
The small rural and CAHs that have achieved this milestone are well distributed across the country – success has not been limited to one region. The map below illustrates the nationwide distribution of the CAHs and small rural hospitals that attested to Meaningful Use.

Photo 1

 

Challenges faced by Small Rural and Critical Access Hospitals Achieving Meaningful Use

These hospitals face unique challenges because of their:

  1. Remote geographic location,
  2. Small size and low patient-volume,
  3. Limited workforce,
  4. Shortage of clinicians,
  5. Constrained financial resources and
  6. Lack of adequate, affordable connectivity

Follow this link for information on how CAHs may overcome challenges to Health IT: http://www.healthit.gov/providers-professionals/benefits-critical-access-hospitals-and-other-small-rural-hospitals

 

Safety net hospitals made huge gains in Meaningful Use since 2011

With hard work and grit, these safety-net hospitals have made amazing progress since 2011, despite the real challenges they face. The two figures below show the pathway of CAHs and of small, rural hospitals to Meaningful Use, respectively, between January 2011 and July 2013.

Photo 2

Note on legend: Hospitals were categorized into 1 of 6 hierarchical and mutually exclusive categories:  (1) Attested, Paid – hospitals have received payment for successfully attesting to Stage 1 Meaningful Use under the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program. (1) Attested, Not Paid– hospitals successfully attested to Stage 1 Meaningful Use under the Medicare EHR Incentive Program but have not yet received payment.  (2) AIU only – hospitals received Medicaid EHR Incentive Program payment for AIU but not yet attested or received payment for attesting to Meaningful Use.  (3) Registered EHR incentive program – hospitals registered for the Medicare or Medicaid EHR Incentive Program but had not yet attested or received payment for AIU or Meaningful Use.  (4) Enrolled REC – hospitals enrolled with a Health IT Regional Extension Center but not yet registered for the Medicare or Medicaid EHR Incentive Program.  (5) Not participating – hospitals not registered for the Medicare or Medicaid EHR Incentive Program and not enrolled with an REC.

Note on legend: Hospitals were categorized into 1 of 6 hierarchical and mutually exclusive categories:
(1) Attested, Paid – hospitals have received payment for successfully attesting to Stage 1 Meaningful Use under the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program.
(1) Attested, Not Paid– hospitals successfully attested to Stage 1 Meaningful Use under the Medicare EHR Incentive Program but have not yet received payment.
(2) AIU only – hospitals received Medicaid EHR Incentive Program payment for AIU but not yet attested or received payment for attesting to Meaningful Use.
(3) Registered EHR incentive program – hospitals registered for the Medicare or Medicaid EHR Incentive Program but had not yet attested or received payment for AIU or Meaningful Use.
(4) Enrolled REC – hospitals enrolled with a Health IT Regional Extension Center but not yet registered for the Medicare or Medicaid EHR Incentive Program.
(5) Not participating – hospitals not registered for the Medicare or Medicaid EHR Incentive Program and not enrolled with an REC.

 

Rising to the Meaningful Use Challenge

Many rural and CAHs are trailblazers; these hospitals are leading the way toward leveraging health IT to transform and improve the delivery of care to their rural communities.  They help us show case leading practices that may help shape the path for other organizations.

Read more about how one CAH in Michigan, Harbor Beach Community Hospital, used Meaningful Use as a jumping off point to accelerate its progress to becoming a certified Patient Centered Medical Home.

 

2012 and 2013 Critical Access and Rural Hospital Champion Award

While we can’t thank everybody, those who received the Critical Access and Rural Hospital Champion Award from the National Coordinator for Health IT Farzad Mostashari in 2012 and 2013 are listed below.  This award recognizes the groundbreaking collaborative efforts these individuals  have taken with public and private sector partners to accelerate Meaningful Use among CAHs and small, rural hospitals nationwide. What we’re most delighted to note about this award is that it is also in recognition of continued collaborations since 2012. These awards are not simply for a single instance of dedicated effort.

Critical Access and Rural Hospital Champion Award Recipients

2012

2012

2012

2013

Barry Little

Bill Sonterre

Brock Slabach

Chuck Christian

Harry Wolin

Jac Davies

Joe Wivoda

Kay Gooding

Kevin Driesen

Louis Wenzlow

Lynette Dickson

Melissa Hungerford

Patricia Alafaireet

Patricia Dombrowski

Paul Kleeberg

Phil Deering

Randy McCleese

Roger Holloway

Sally Buck

Shanti Wilson

Tammy Flick

Terry Alexander

Terry Hill

Val Schott

Kathy Whitmire

Bill Menner

David Willis

Ed Gamache

Jessica Zufolo

Kendra Siler-Marsiglio

Mark Renfro

Marty Fattig

Norma Morganti

 

ONC is continuing to support CAHs and small, rural hospitals in achieving Meaningful Use

Here are four examples of ONC’s efforts to support these rural safety-net hospitals:

  • Rural Community of Practice: We convened experts from across the country dedicated to identifying the most pressing challenges that rural safety-net hospitals face, developing tools and resources for overcoming these challenges and then hand-picking the best among these tools to make publicly available on the healthit.gov Rural Health landing page.  To do so, the group convened the 10 subcommittees focused on:
    1. Tracking progress, needs and challenges
    2. Vendor issues: Pilot vendor-specific meaningful use acceleration efforts
    3. Hospital leadership tools
    4. Adoption and meaningful use roadmap and tools
    5. Demonstrating quality improvement through health IT
    6. Workforce: Grow your own rural health IT workforce!
    7. Consumer engagement: The patient in the center and empowered!
    8. Access to capital
    9. Broadband
    10. Dissemination
  • Technical Assistance: ONC established support to these safety-net providers as a priority for the Health IT Regional Extension Centers. So far, 1370 critical access and rural hospitals across the nation have enrolled with a Health IT Regional Extension Center for assistance on their path to Meaningful Use.
  • Situational Awareness:  We tracked and monitored data from a variety of sources on the challenges and progress of CAHs and rural hospitals on their path to adopt and use health IT.
  • Federal Coordination: With support from the White House Rural Council and in partnership with the Department of Health and Humans Service’s Office of Rural Health Policy, we collaborated with Federal and private sector partners, including the US Departments of Agriculture, Labor and Education as well as the Federal Communications Commission—to identify and address health IT infrastructure challenges in rural communities.  We convened in-person workshops with CAHs and small, rural hospitals to expand access to information and federal funding to support their Health IT infrastructure and workforce needs. Two of them were in Iowa and Mississippi.

A collaborative initiative between ONC and USDA Rural Development generated $32 Million in funding to CAHs and rural hospitals across 4 states. For more information about the projects funded for these CAHs, follow this link: http://www.usda.gov/wps/portal/usda/usdahome?contentidonly=true&contentid=2013/09/0181.xml

 

The Road Ahead for Meaningful Use

As we look to the road ahead, we see that we – and the rural hospitals and providers – are just at the end of the beginning. There is still much work to do in our continued support for rural health care.  We are committed to helping those CAHs and rural hospitals and providers that have yet to achieve Meaningful Use; we are also committed to those that have already achieved Meaningful Use by helping them continue to make progress and use those tools meaningfully.

So, we’ll leave you with this figure—a map that shows CAHs and small, rural hospitals that attested to Meaningful Use as well as those that have not yet attested so you can see the success, but also the challenges ahead.

Photo 5

15 Comments

  1. D Willis says:

    It’s exciting to see some accolades going to rural healthcare for the accomplishments they are making in HIT efforts. Many of these institutions may be small and stand against significant obstacles, but are proving they can lead through their efforts of cooperation, innovation, and commitment to a better healthcare system for those they serve.

  2. Edward Gamache says:

    I appreciate the rural focus developed by your office and believe we are on track to use the meaningful use structure as a launching pad for demonstrating how small rural providers can actually lead in moving HIT into the workflow of clinical information sharing and care transitions across communities. Please keep up the good work.

  3. Neal Neuberger says:

    On behalf of the Rural HIT Coalition which I helped found, I want to offer my sincere appreciation to Dr. Mostashari and the entire ONC Staff – particularly Leila Samy – for your tremendous efforts in helping to serve the interests of rural, underserved, minority and disparate healthcare organizations.

    ONC and the rural healthcare communities have worked tirelessly to help get them on board per the Stages of Meaningful Use. At the same time, there is much more to do, and we urge all concerned to keep pressing the case.

    Thanks again Dr. Mostashari — and best wishes in your next endeavors.

    Neal Neuberger

  4. Kathy Whitmire says:

    Honored to be recognized in this effort to help critical access and rural hospitals achieve Meaningful Use and ultimately exchange vital health information with providers and patients that will improve the health of all Americans!
    Thanks to the ONC and to Matt and Leila for their tireless work and dedication to make this effort happen nationwide! It is amazing to look at this map and think that before the 1000 hospital challenge, that less than 100 hospitals had achieve Stage One MU! We have come a long way and must keep the momentum going to ensure that our hospitals complete Stage 2 and 3!

  5. Dr Michael Bolten says:

    After reading this, I started thinking how behind we are in the dental industry. There are so many practices that are not paperless. Also, meaningful use objectives outlined by the Centers for Medicare & Medicaid Services are not applicable to a dental provider’s clinical practice. Once the differences between medical and dental are ironed out with a clear pathway, capturing structured data should become easier.

  6. Dan CFO says:

    Our small rural facility has a great EHR in place. Unfortunately, the cost to maintain the electronic dictionaries to sustain EHR requirements for government plans is far outstripping the efficiencies of the electronic system. To this, add our very high Medicaid population, the expanded Medicaid program not being put in place in Florida, the eligible uninsured population may not have the wherewithal to purchase from the HIX, and the extremely significant Medicare program reimbursement reductions. I don’t believe we will be able to achieve any tiype of sustainable growth rate. But, we do have a wonderful EHR.

  7. interesting articles says:

    It’s exciting to see some accolades going to rural healthcare for the accomplishments they are making in HIT efforts. Many of these institutions may be small and stand against significant obstacles, but are proving they can lead through their efforts of cooperation .

  8. Jone says:

    Thanks to the ONC and to Matt and Leila for their tireless work and dedication to make this effort happen nationwide! It is amazing to look at this map and think that before the 1000 hospital challenge, that less than 100 hospitals had achieve Stage One MU! We have come a long way and must keep the momentum going to ensure that our hospitals complete Stage 2 and 3!

  9. Donald T. Clark says:

    Good write-up. I certainly appreciate this site.
    Continue the good work!

  10. Harry says:

    wonderful. Many poor people can get benefit for that. Many of these organizations may be small and stand against hurdles, but are proving they can lead through their efforts of assistance, creativity, and commitment to a better healthcare system for anyone they serve.

  11. xuan hai says:

    ONC and the rural healthcare communities have worked tirelessly to help get them on board per the Stages of Meaningful Use. At the same time, there is much more to do, and we urge all concerned to keep pressing the case.

    Thanks again Dr. Mostashari — and best wishes in your next endeavors.

    Mr.XuanHai

  12. Additive Analytics says:

    Wow, that’s fantastic progress! It’s amazing to see how far we’ve come in terms of EHR usage in just the past couple of years.

  13. Mac Saxe says:

    What an incredible amount of work has been undertaken to bring these essential centers to attestation. It’s heartening to see such widespread successes across almost all states with consistent results despite such a wide range of challenges.

    I say almost all states though – is there any reason for the significantly lower ratio of attested to not attested CAHs and rural hospitals in Montana and Idaho? I didn’t see mention of any particular difficulties.

    Again congratulations to all concerned – these are superb results.

  14. priyanka says:

    Wow, that’s fantastic progress! It’s amazing to see how far we’ve come in terms of EHR usage in just the past couple of years.

  15. mcafee discount says:

    Wow, that’s fantastic progress! It’s amazing to see how far we’ve come in terms of EHR usage in just the past couple of years.

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