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by Michael Farrell
Published on October 16, 2017

Approximately 51 million Americans live in rural areas and depend upon the hospital in their community. That's roughly one in every six Americans - and yet, as rural hospitals face more and more closures, residents in those communities have increasingly limited options for health care.

Today's rural health care providers are fighting to stay in business. For many of the physicians and clinicians at these hospitals, the battle is personal, since they likely know the patient. They could be providing care for a neighbor, a coworker or a relative.

Rural hospitals are struggling to stay afloat

Rural health care organizations face a unique set of challenges. Increasingly, we're seeing an exodus of rural residents - especially millennials - as they relocate to urban areas. The remaining rural residents tend to be those that cannot easily uproot - the elderly, the less affluent and those that face a chronic illness. This juxtaposes rural communities with their more affluent and populous urban counterparts, and has contributed to more than 40 percent of rural hospitals today that are facing negative operating margins.

What does this lead to? Since 2010, there have been more than 80 rural hospital closures. That number will likely grow as more than 650 rural facilities are considered vulnerable or at risk of closing.

Technology limitations are often among the greatest challenges rural hospitals must overcome in today's landscape. Rural systems can't afford to wait for technology offerings to mature or even merely function at a passable level. They also shouldn't have to manage a large number of third-party offerings to make their system work.

We still see many organizations today running disparate technology systems across their various departments as they have tried to piecemeal platforms that were not built for long-term sustainability and growth. In some cases, organizations are still relying on paper documentation for portions of their workflow.

This is problematic, as it can lead to disconnection and confusion for the care team as clinicians try to understand the patient they are caring for. For example, it may be difficult for an emergency department nurse to tell if an incoming patient is taking medication prescribed by their primary care physician because the various source systems for the hospital don't integrate very well and can't pull patient data into a holistic view.

Rural health care providers deserve to have reliable, seamlessly integrated technology across all the departments they support. However, lacking a large IT department or extensive budget, many rural health care organizations simply don't have the resources available to run a traditional robust technology platform.

Cloud based technology delivery in rural health

Technology has shifted consumer behavior and expectations across the country. For evidence of this, we need only look to companies like Google, which has announced standalone virtual reality headsets that won't require a phone, or Amazon, which has continuously pioneered delivery models to provide goods to consumers now in as little as 30 minutes in some locations. Modern consumers expect their health care to be just as accessible as mobile apps have made banking or ordering groceries and Uber to the door. It's not just urban populations that have these expectations for health care - it's rural community residents, too.

Many technology providers today are offering a cloud-based or application service provider (ASP) platform. We know that most small-scale rural hospitals don't necessarily have extensive IT resources that can run, manage and maintain advanced technology and platforms, nor can they easily adapt to the frequent health care regulatory changes required by the federal government or the Centers for Medicare and Medicaid Services and Joint Commission change guidelines and restrictions.

Cloud-based technology can help with this. Consider the Ebola and Zika outbreaks, where there were certain forms and other requirements necessary to treat people who could potentially have either disease. In those instances, using a cloud-based delivery model allowed staff to focus on the patient while the technology provider leveraged their resources to generate and push out the necessary documentation forms in a quick, efficient way.

This highlights the scalable nature of cloud-based technology delivery allowing the technology provider to gain a broader range of experience and expertise at a rapid pace. A rural hospital is then able to leverage that experience and expertise instead of staffing or resourcing it themselves.

Consider the critical issue of cybersecurity. More than 17 million health records have been compromised by data breaches in the past 24 months alone, yet rural health care organizations often don't have the capacity to hire on a cybersecurity professional to their staff to monitor cyber-attack risks. Cloud-based technology providers can scale their cybersecurity protocols across their cloud platform.

When it comes to rural health care, we see the ability for users to access information anytime and anywhere. With cloud technology, clinicians are no longer tied to the office - they can login remotely, whether they're at their home computers or from their mobile phones. This accessibility empowers clinicians to ensure the proper information is making it into the patient's record.

Having better data inputs allows hospitals to have stronger, advanced data and reporting. With access to multiple pieces of data, organizations are better equipped to benchmark care processes against peers and use the data to improve organizational objectives.

Beyond the impact a robust, integrated cloud-based IT platform can have on data security and patient outcomes, cloud technology can also empower rural hospitals to feel like they are taking a step forward into the future. Cloud technology can help put rural health care organizations on a level playing field - at least when it comes to technology and databases. It can also allow rural hospitals to affiliate with other health care systems while still remaining independent.

What's next for cloud technology in rural health?

Cloud technology will continue to rise in popularity as more organizations adopt it, both inside and outside the health care industry. While we have seen that cloud technology alone in health care doesn't guarantee strong usability, solution breadth or built-in intelligence functionality, it will become increasingly important to not choose incorrectly on new technology. The strain placed on a staff and providers following a supplier failure stretches far beyond strict financial ramifications and could leave the hospital in worse shape than before.

This is something to be cognizant of as a growing number of health care organizations are already looking to cloud-based platforms as an alternative to technology systems that require continual updates and upkeep, unreliable servers or a large-scale IT infrastructure and department.

Moving forward with a cloud-based delivery model should allow rural health care providers to rely on their technology provider to continuously monitor, update, maintain and enhance the system on their behalf. In turn, this allows the hospital to do what they do best - focus on and care for the patient.

Cerner CommunityWorks has been delivering cloud-based EHR technology paired with managed services since 2011, empowering rural health care organizations to keep up with the ever-changing health care landscape. Learn more here.

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