700 rural hospitals and counting: A journey in rural health resilience

It’s no secret rural health organizations face many resource constraints, with one of the most common impacts being strong cybersecurity.  

In June 2024, Microsoft launched its Cybersecurity Program for Rural Hospitals alongside several partners, including the National Rural Health Association, to help improve security and support innovation at rural hospitals. Since the program’s launch, more than one-third of all U.S. rural hospitals have participated, taking advantage of free cyber and AI innovation services and Microsoft product offers.

Working with more than 780 rural hospitals has revealed several trends. According to a survey conducted through the program by cyber experts, fewer than half of rural hospitals meet a passing score for cybersecurity fundamentals like strong encryption, network segmentation, and mitigating known vulnerabilities. 

Of course, preventing and mitigating cyberattacks — and the potential financial fallout from them — is just one element of better rural health resilience. Streamlining patchwork cybersecurity can also provide opportunities to save on IT costs and allocate funds to patient care, infrastructure, or workforce upskilling and hiring.

Dahl Memorial Healthcare Association’s cybersecurity journey

One rural hospital seeing proven financial and operational value through cybersecurity improvement is Dahl Memorial in Ekalaka Mont., pop. ~300. Dahl is the only hospital within a roughly 3.5-hour radius and “is a critical asset in the community, and [it’s] really important to keep the doors open,” says Ryan Thousand, Dahl Memorial CIO.

Like other rural hospitals, Dahl faced significant technology and security challenges. “It’s all the things I can’t see that keep me up at night with cybersecurity … those items, that mountain that never seems to be going down – it seems to be going up daily,” Thousand says. “Ultimately, we just don’t have the rigor that I would say we would need and that we really should have, as vital as an asset as the hospital is in the community.”

Dahl Memorial started its cybersecurity and IT modernization by consolidating and securing its IT foundation: consolidating existing applications, implementing metadata tagging to improve data loss prevention and protect patient data, and leveraging Azure, Dataverse, and PowerApps to build new in-house applications.  Streamlining its IT ecosystem on the Microsoft platform helped reduce third-party application cost and interfacing.

Dahl also took on other modernization projects, including Azure AD migration, Endpoint management through Intune, Defender Security Suite adoption, and cloud-based infrastructure improvements. These changes improved the security and stability of vital clinical and business systems.

“We were able to hit the ground running and immediately see a reduction in our operational costs,” Thousand says. “The biggest issue we have right now outside of security is revenue and making sure that we have enough to stay viable. Bringing Microsoft in, I was able to … take my licensing and immediately see some strides there, but it wasn’t just that. I was able to then take that licensing and start applying cost-avoidance.”

Dahl did more than harden its IT infrastructure and save licensing costs. Alongside that work, Dahl also standardized and expanded service and support to end users, including launching a 24/7 help desk, managing security and network services, and fully managing phones. 

Through Microsoft product offers, the hospital is saving $36,000 annually. What’s more, by its own estimates, the hospital will save roughly $425,000 over three years by reducing technology redundancy, increasing automation, and avoiding IT costs through standardization. “It’s brought us immense operational efficiencies because we’ve been able to automate a lot of processes that prior, we just didn’t even have licensing, functionality, and the security set up to do,” Thousand says.

The work undertaken by Dahl Memorial is not just an IT project — it’s a drive to create long-term resilience for the hospital and better serve Montana’s patients. 

Any U.S. rural hospital can participate in the Microsoft program Dahl Memorial leveraged in its security and modernization journey. As part of this program, independent critical access hospitals, rural emergency hospitals, and rural community hospitals are eligible for Microsoft nonprofit pricing – bringing savings of 60 to 75 percent on many Microsoft products. Additionally, Microsoft is providing all rural hospitals a Windows 10 Extended Security Update free through Oct. 14, 2026, for up to 250 devices.

How hospitals are improving efficiency through AI

AI innovation can also help small and rural hospitals outside of cybersecurity. 

With staff shortages and less competitive salaries than larger hospital systems, rural hospitals can use AI to bolster administration and prioritize patient care. Created as part of the Rural health Resiliency Program, Microsoft’s Claims Denial Navigator is one AI-powered tool hospitals are using to help process denied insurance claims. The tool — which surfaces recommendations for hospital billing offices to help resolve denied Medicaid, and Medicare insurance claims — is available for free download from GitHub.

Accessing tools for rural health resilience

Enrollment in the Microsoft Rural Health Resilience program is free and easy through the program's dedicated portal. Qualified organizations will receive confirmation and onboarding support. From there, these hospitals can access assessments, training, product discounts, and AI tools — all designed to meet the specific needs of rural health care providers.

NRHA adapted the above piece from Microsoft, a programmatic partner of NRHA, for publication within the Association’s Rural Health Voices blog.
 

Laura Kreofsky is a recognized leader in health care technology, focusing on innovation to accelerate digital transformation for social impact. She has worked in and with health care delivery organizations government agencies, tribal nations, rural health providers and community health centers. Today, Laura leads Microsoft Philanthropies’ Rural Health Tech Program that helps rural hospitals across the US build cyber resiliency and expand digital and AI capabilities.