Lessons on harnessing data to strengthen rural health

In rural America, providers aren’t just caregivers – they are the anchors that keep entire communities connected to essential health services. They are often the only clinicians patients can reach without traveling hours, and they carry a responsibility that extends well beyond the exam room. Those who work in rural health care understand the weight of that role and how difficult it is to meet rising clinical expectations, regulatory demands, and workforce pressures when operating with limited staff, aging infrastructure, and technology that rarely aligns across organizations.

The Eastern Plains Healthcare Consortium (EPHC), a collaborative of 15 hospitals (13 independent and 2 small system hospitals) in Eastern Colorado, understands these challenges intimately. Each hospital had its own EHR system, staffing constraints, and community demands. Geography compounded the complexity – long distances made collaboration difficult, and inconsistent workflows made it hard to compare performance or share best practices. For many providers, data felt like an obligation rather than a tool to improve care.

That dynamic shifted when Colorado’s Hospital Transformation Program (HTP) raised the stakes. With reimbursement tied to measurable improvement, no single hospital or provider group could shoulder the burden alone. EPHC recognized that succeeding in HTP would require a unified approach: common data, shared goals, and coordinated strategies that could lift the entire region.

EPHC has become one of the most coordinated rural hospital collaboratives in the nation, bringing together 15 hospitals through shared governance, aligned clinical workflows, and a regional data infrastructure that is unusually advanced for rural health care settings. Through its partnership with i2i Population Health (now part of Azara Healthcare), the consortium has implemented a sophisticated cross-platform data environment that enables consistent reporting, performance transparency, and system-level improvement across diverse EHRs and operational models. This level of alignment has positioned EPHC and i2i as leaders in building sustainable, data-driven transformation in rural communities.

Building a shared foundation for rural health care improvement

EPHC partnered i2i with to build a centralized data environment capable of aggregating information from all 15 hospitals, regardless of their technical maturity or EHR configuration. This was far more than a technology upgrade; it represented a shift in how rural providers approached quality, performance, and accountability.

By standardizing data across diverse sites, the consortium gained something it had never had before: a clean, consistent view of performance across the Eastern Plains. For the first time, providers and administrators could benchmark performance, identify outliers, and see regional trends in care gaps, social needs, and quality measures.

Turning insights into action

The real power of the centralized platform came from what rural teams did with the insights. Once providers could compare performance in real time, they were able to quickly pinpoint where HTP measures were slipping and where workflow variation was hindering progress.

Some hospitals adopted standardized workflows from high-performing peers. Others shared practical tips for screening, documentation, or patient engagement adapted for environments where clinicians wear multiple hats. Rural providers are resourceful by nature. With the right information in hand, they were able to design solutions that fit their realities, not abstract best practices from large systems.

Small adjustments including better documentation, more consistent follow-up, and refined care coordination were implemented across multiple sites. Over time, those incremental changes created measurable improvements across the entire consortium.

The power of dedicated coordination

A central data lead played a crucial role in keeping momentum. Acting as a connector across clinical teams, IT leads, and administrators, this coordinator ensured that insights from the platform were translated into real operational changes. They helped staff understand their performance trends, plan interventions, troubleshoot challenges, and stay aligned with HTP deadlines and requirements.

This kind of coordination is often where rural settings struggle — not with expertise or willingness but time. Leaders in rural hospitals typically juggle clinical duties, operational demands, compliance responsibilities, and quality reporting. A dedicated coordinator helps fill those gaps, making data actionable rather than overwhelming.

Improvement depends on clinician leadership

EPHC’s most substantial progress came from sites where clinicians took ownership of measure performance. Physicians, nurses, and department leaders reviewed dashboards regularly, asked questions about care gaps, and pushed for workflow adjustments that reflected their local realities.

In rural communities, providers already deliver comprehensive, whole-person care with limited resources. Giving clinicians timely, meaningful insight into their performance allows them to drive improvement that is both clinically sound and feasible within their environment. It also builds accountability and engagement at the local level — critical components of long-term sustainability.

Collaboration as a rural strength

Perhaps the most lasting achievement of EPHC’s work is the culture of shared governance and transparency it created. Providers and administrators across all 15 hospitals began meeting regularly to discuss performance, troubleshoot challenges, and share ideas. Benchmarking became an opportunity for growth rather than criticism, and regional collaboration replaced isolation.

This united approach also helped EPHC advocate more effectively for funding and regulatory support. By presenting data that reflected the needs and achievements of the entire Eastern Plains, the consortium strengthened its voice in statewide discussions about rural health care challenges.

The resulting infrastructure includes unified data, coordinated support, engaged clinicians, and collaborative governance, forming a durable foundation for ongoing improvement. HTP is only one program, but the systems built to support it will continue to drive better care well into the future.

What rural providers can take away

EPHC’s experience reinforces a simple but powerful truth: rural providers already have the expertise, commitment, and creativity needed to deliver excellent care. What they often need is the infrastructure to connect their work, reduce administrative burden, and give teams the information required to make the best possible decisions.

A few key takeaways from EPHC’s journey:

A unified data environment is transformative.

When rural sites share a single source of truth, performance becomes clearer, interventions become faster, and collaboration becomes natural.

Insights must translate into action.

Data is powerful only when it informs workflows, shapes decision-making, and supports clinicians on the ground.

Dedicated coordination fills critical gaps.

Rural leaders wear many hats. A central coordinator helps ensure insights are applied consistently and effectively.

Clinician ownership makes improvement real.

Local providers drive change when they understand their data, see their progress, and help shape workflows that work in their setting.

Collaboration creates long-term resilience.

When rural providers unite around shared data and goals, they build systems strong enough to meet today’s pressures while being prepared for tomorrow’s.

A path forward

EPHC’s work demonstrates that rural communities can not only keep pace with value-based care programs like HTP — they can excel. With the right combination of shared infrastructure, coordinated support, and clinician-led improvement, data becomes a strategic advantage rather than a burden.

For rural providers across the country, the message is encouraging: the innovation and commitment needed for high-quality care already exist within your teams and communities. By building systems that strengthen collaboration and turn data into action, rural regions can create lasting improvements that support both patients and providers for years to come.

NRHA adapted the above piece from i2i Population Health, a trusted NRHA partner, for publication within the Association’s Rural Health Voices blog.
 

Zachary D'Argonne is president and CEO for The Eastern Plains Healthcare Consortium, a rural health association in Colorado that specializes in advocacy and hospital sustainability. Zachary spent his early career with Health Corporation of America and held various roles including division vice president of rural health/telehealth and vice president of business development at Swedish Medical Center.