"Health Information Technology (HIT) Value in Rural Hospitals"
Agency for Healthcare Research and Quality
September 1, 2004 through August 31, 2007
Role: Doug Wakefield, Co-Investigator

Abstract: The national discussion of quality and patient safety has only recently begun to address the unique quality and patient safety issues facing rural hospitals as opposed to those of the much larger and far more complex, urban counterparts. Given the inherent difference in the scope and complexity of healthcare services provided in rural and urban hospitals, major differences in the types and causes of poor quality and patient care errors are likely. The pronounced absence of information about rural hospital quality and safety issues raises serious questions about how well commonly proposed health information technology (HIT) interventions actually make sense in rural hospitals. Enormous progress has been made in HIT applications. Today, hospital-based IT includes enterprise-wide clinical information sharing and point-of-care decision support in such applications as electronic medical records and computerized physician order entry. However, very few rural hospitals have these HIT capacities because of expense, limited in-house HIT expertise, and the fact that many HIT applications are designed with the larger hospitals in mind. This project is designed to meet the special needs of rural hospitals for assistance with planning HIT enhancements to address patient safety and healthcare quality concerns. The overall goal of the project is to increase our knowledge and understanding of the value of HIT in rural hospitals, ultimately to help rural hospitals make cost-effective HIT investment decisions that enhance patient safety and healthcare quality. To accomplish this goal, the project has four primary objectives. First, the project will document the patient safety and healthcare quality challenges unique to rural hospitals. Second, it will explore the current HIT capacity in rural hospitals, the potential use of HIT by rural hospitals to address their unique patient safety and healthcare quality issues, and the unique barriers faced by rural hospitals in adopting HIT. Third, the project will measure value derived from HIT in rural hospitals and identify which HIT solutions for enhancing patient safety and healthcare quality have the greatest potential in terms of generating a positive return on investment. Fourth, the project will create decision-making HIT toolkits to address barriers and provide solutions that are appropriate for rural hospitals. To do so, this project will develop models and other tools that address clinical, financial, economic, organizational, effectiveness, efficiency and other aspects of HIT value. Once the toolkits are developed, the project will make them available to rural hospital decision-makers. The toolkits will facilitate rural hospitals' ability to utilize current and emerging evidence to guide HIT investment and implementation decisions that fit their particular healthcare environment.