Mat Kendall, MPHDirector of the Office of Provider Adoption Support (OPAS) Leila Samy, MPHRural Health IT Coordinator

Rural and Critical Access Hospital Update Health IT Policy Committee MeetingDecember 4, 2013

Office of the National Coordinator for Health IT

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As of July 31, 20131,115 (65%) CAHs and small, rural hospitals achieving

Meaningful Use. – 62% (approximately 822 of 1,332) of CAHs– 77% (approximately 293 of 383) of small, rural hospitals

(those generally with less than 50 staffed beds)

Jan-11 Mar-11 May-11 Jul-11 Sep-11 Nov-11 Jan-12 Mar-12 May-12 Jul-12 Sep-12 Nov-12 Jan-13 Mar-13 May-13 Jul-130%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Not engagedREC enrolled onlyRegistered, not AIU or At-testAIU, not AttestAttested, Not PaidAttested, Paid

48%

62%

76%

86%

96%

Based on CMS EHR Incentive data through July 31, 2013 and ONC CRM data through Au-gust 14, 2013. Total number of Critical Ac-cess Hospitals=1,332.

Progress Over Time Among Critical Access Hospitals

Progress Over Time Among Small Rural Hospitals (non Critical Access Hospitals)

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11Jul-1

1

Aug-11

Sep-11

Oct-11

Nov-11

Dec-11

Jan-12

Feb-12

Mar-12

Apr-12

May-12

Jun-12Jul-1

2

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12

Jan-13

Feb-13

Mar-13

Apr-13

May-13

Jun-13Jul-1

30%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Not engaged

REC enrolled only

Registered, not AIU or Attest

AIU, not Attest

Attested, Not Paid

Attested, Paid

74%

77%

84%

89%91%

Based on CMS EHR Incentive data through July 31, 2013 and ONC CRM data through August 14, 2013.

Total number of small rural hospitals =383. This count does not include Critical Ac-cess Hospitals and does in-clude rural hospitals covered by the Small Hospital Im-provement Program, which serves rural hospitals with fewer than 50 staffed beds.

Attested Not Attested

from the HHS Office of the National Coordinator for Health IT

Location of Critical Access & Small Rural Hospitals by Attestation StatusJuly 2013

Map of Critical Access Hospitals as well as small rural hospitals (those covered by the Small Hospital Improvement Program, which serves rural hospitals with fewer than 50 staffed beds). Hospitals are identified as attested or not attested based on CMS EHR Incentive Program Meaningful Use attestation status as of July 31, 2013.

We’re only at the end of the Beginning

Office of the National Coordinator for Health IT

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Severe Challenges: Funding, Broadband, Workforce, Technical

Broadband Unavailable or Insufficient

Vendor Selection/EHR Usability

Lack of Technical Support from EHR Vendor

Security and/or Privacy Risks

Leadership/Executive Cooperation

Inadequate EHR training for Employees

Clinical Staff Cooperation

Lack of IT Personnel

Workflow changes

Broadband Implementation Costs

Availability of Grants/Loans to Support EHR

EHR Implementation Costs

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

11%

15%

16%

20%

7%

17%

22%

27%

30%

23%

35%

50%

Percent of Critical Access Hospitals Reporting Significant Challenges

Cost-Related Chal-lenges

Workforce and Staffing Chal-lenges

Technical and Other Challenges

Rural Community of PracticeMaintain Situational Awareness

Office of the National Coordinator for Health IT

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Expand Funding for Rural Health IT

ONC and USDA Rural Development launched an initiative to expand funding for CAHs and rural hospitals.

FY 2013 Pilots: Over $38 Million in funding to CAHs and rural hospitals across 4 states.

FY 2014: ONC and Rural Development are taking this initiative to scale nationwide.

Office of the National Coordinator for Health IT

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Rural Community of PracticeDevelop tools and resources

www.HealthIT.gov/RuralHealth