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Diagnosing rural health with NRHA past president Beth O’Connor (part II)

Ken Misch, president of MEDHOST, recently had the opportunity to interview Beth O’Connor, executive director of the Virginia Rural Health Association and past president of NRHA.

In this two-part series, Misch and O’Connor discuss the developing nature of rural health care, some of its most pressing challenges, and how MEDHOST collaborates with rural health systems to continue serving their needs.

The first section of this interview emphasized the challenges of connectivity, population health management, and the impact COVID has had. In this section, Misch and O’Connor delve into the social determinants of health, interoperability, and the ongoing crisis of rural hospital closures.

KM: There is a general belief that social determinants of health present even more challenges for rural populations. Is NRHA aware of any community organizations trying to address these challenges, and if so, what best practices can rural providers adopt?

BO: The buzzword is changing.

If you take a look at the term “social determinants of health,” it makes it sound like the outcome is predetermined. Why would we spend time and resources on a population when we already know the outcome?

Instead, we’ve started talking about the “social drivers” of health. Indicators such as poverty, education, and race may drive health outcomes in a certain direction, but we can still do a course correction. Addressing these social drivers is absolutely essential for communities to make progress. Any hospital that wants to address social drivers of health needs to conduct a community health needs assessment that includes questions about those influences and how they should be addressed.

Most grant applications for the Federal Office of Rural Health Policy require that these social drivers be taken into consideration.

KM: What is your advice for rural health hospital leaders to achieve success?

BO: I would encourage hospital leaders to take advantage of the tools and resources the National Rural Health Association offers.

At the very least, sign up to receive announcements from NRHA, so you can stay on top of regulations and updates and what's going on in Congress that could impact your local facilities. No one has time to do all that themselves. Let NRHA do it for you. Then, attend NRHA’s Rural Hospital Innovation Summit in New Orleans next May. This is an opportunity to hear about best practices and talk to your peers about what's working on the ground and what's not. It's a great opportunity to connect with others that are dealing with the same issue you are and see what new ideas pop out.

When you’re ready to dig deeper, check out NRHA’s Rural Hospital CEO Certification Program. It arms rural CEOs with the competencies and skillsets to take on the unique challenges of rural hospitals and continue to be a top-performing CEO.

KM: One of the buzzwords we tech geeks have lived with for a while, especially in the provider environment, is the word “interoperability,” which basically means that systems need to talk to each other. What challenges does rural health face in achieving true interoperability?

BO: Software challenges apply to everyone. For rural areas, the issues are a lack of internet access and digital literacy.

I remember a few years ago, the Virginia secretary of technology had asked me to send out a survey to rural clinics about broadband access. I was annoyed because the request was to send it specifically to rural health clinic IT directors.

There isn't a single rural health clinic in Virginia with its own IT director. If they are part of a larger health care system, the IT director is based out of the hub facility and only visits the clinic when necessary.

If we’re talking about an independent facility, the person who installed the server is likely the office manager's nephew who visited over Thanksgiving. The smaller entities just don't have the capacity to keep up with many of the digital changes we are seeing.

KM: Health care IT companies like MEDHOST partner very closely with rural providers and we’ve become an integral part of that infrastructure. Can you elaborate on how you see the role of health care IT companies changing in the future?

BO: I see that role continuing to expand. Increasingly, rural entities are outsourcing tasks to control costs while maintaining quality. I think the line between health care providers and IT providers will become invisible.

KM: What is your vision for the future of rural health care IT?

BO: I’m going to touch back on interoperability here.
I would love to see a seamless interface between physicians and coders and insurance processes, all of them able to access the information they need without having to check multiple sets of software.

KM: That is certainly the goal and the vision I think for all of us IT companies that serve rural health care customers. We believe interoperability is good for efficiency, clinical care, and the financial well-being of companies in the long term.

NRHA adapted the above piece from MEDHOSTa trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.

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