What electronic health record implementation issues are unique to rural settings?

There are many barriers unique to electronic health record (EHR) implementation in rural health care settings, including:

Prohibitive cost of many EHR systems/limited access to capital and infrastructure
Access to EHR vendor information and technical assistance
Suitability of EHR products for rural health care settings
Difficulty connecting to or obtaining broadband service
Limited health information technology (IT) workforce
Difficulty in obtaining community buy-in
Limited opportunities for collaboration with other rural health stakeholders
Limited buy-in from rural practice/hospital/health center staff with multiple roles and busy schedules

These challenges can be overcome. For information on how you can overcome challenges and mitigate EHR implementation disruptions in rural health care settings, see the table below for related FAQs and rural health information technology (HIT) resources.

Rural EHR Implementation Issue	Related Rural HIT Resources
Prohibitive cost of many EHR systems/limited access to capital and infrastructure	Step 2: Plan Your Approach What resources other than incentive payments are available for health information technology in rural settings? What available health information technology resources are specific to rural communities?
Access to EHR vendor information and technical assistance	Step 3: Select or Upgrade to a Certified EHR How should rural health providers evaluate electronic health record vendors? Where can I find local electronic health record implementation support?
Suitability of EHR products for rural settings	Step 3: Select or Upgrade to a Certified EHR How should rural health providers evaluate electronic health record vendors? What available health information technology resources are specific to rural communities?
Difficulty connecting to or obtaining broadband service	Step 2: Plan Your Approach How can my organization access broadband? What if my community does not have access to broadband?
Limited information technology (IT) workforce	Step 2: Plan Your Approach What resources are available to help rural communities recruit highly skilled health information technology experts? What strategies can rural providers use to overcome limited numbers of qualified staff?
Difficulty in obtaining community buy-in	Robert Deluca's EHR Story: Benefits of EHRs for Rural Providers What are the advantages of electronic health records? How will adopting electronic health records (EHR) improve providers' ability to service their patients?
Limited opportunities for collaboration with other rural health stakeholders	Regional Extension Centers National Rural Health Resource Center National Rural Health Association Opportunities for Collaboration
Limited buy-in from rural practice/hospital/health center staff with multiple roles and busy schedules	Step 1: Assess Your Practice Readiness One of the providers in my practice is adamantly opposed to using an electronic health record (EHR). Are there any suggestions for helping us move forward? How can I increase electronic health record (EHR) stakeholder involvement?

Learn more about how real providers successfully implement EHRs in rural settings in these case studies/interviews:

Certification of Health IT

Health Information Technology Advisory Committee (HITAC)

Health Equity

HTI-1 Final Rule

HTI-2 Proposed Rule

Information Blocking

Interoperability

Patient Access to Health Records

Clinical Quality and Safety

Health IT and Health Information Exchange Basics

Health IT in Health Care Settings

Health IT Resources

Laws, Regulation, and Policy

ONC Funding Opportunities

ONC HITECH Programs

Privacy, Security, and HIPAA

Scientific Initiatives

Standards & Technology

Usability and Provider Burden

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