Once rural providers implement EHRs and subsequent requirements to meet meaningful use, they are at more of a risk of falling behind with the upkeep and maintenance for meaningful use, according to a study in Annals of Family Medicine.
Researchers conducted two simultaneous projects, one conducting cognitive task analysis interviews to understand organization routines of three federally qualified health centers in Michigan and one conducting interviews with IT implementation specialists to determine themes relevant to maintenance.
Through the interviews, researchers found the following four themes related to successfully maintaining health IT systems: technology support, vendor relationships, special challenges facing rural practices and managerial, organizational and change management expertise.
Without ongoing support of these four themes, researchers said, "low-resource practices may achieve stage 1 meaningful use only to fall by the wayside, resulting in an ever-widening 'digital divide' as better-resourced practices continue to increase the sophistication of their health IT operations. The advances in clinical processes expected for stage 2 and stage 3 meaningful use will strain both the technological expertise and management experience of low-resource practices."
Researchers wrote that solutions to the lack of IT maintenance in rural providers should address both financial and operational needs, and caution what could happen if rural providers do continue to fall behind in IT upkeep.
"The multifaceted challenge of health IT maintenance will almost inevitably overwhelm low-resource practices," researchers wrote. "The operational and financial consequences of falling behind in maintenance will mean lower quality care for the patients in areas these practices serve — or quite possibly no care at all."