"Smaller budgets have typically made it difficult for them to afford certain technologies and some rural areas have limited technology resources. But we are talking not just about technology, we are talking about leveraging technology for clinical practice redesign," said Ruth Bowen, MBA, CPHQ, CPHIMS, Business Management, MedSeries4, Siemens Healthcare. "It is really about evidence-based medicine, best practices, and how to use technology to get improved outcomes in patient safety. In order to do that, you have to bring a team together to think about how to use technology to better deliver care."

Funding and IT are essential issues, but training and changing long-held work processes can also stand in the way of progress.


"Implementing an electronic medical record is really not an IT project. It really is a clinical project ... that uses technology. So you have to bring those IT resources into the clinical area and build that team's core strength. That is one of Siemens' biggest Health IT goals with [government HIT stimulus for] training: making certain we have resources to be able to do that," Bowen said.

One positive for rural hospitals may be that their late adoption of health IT will ensure they get the best and latest solutions at the lowest cost since OEMs have worked out the kinks on earlier versions of EMR systems.

Technology to the Rescue in Remote Areas

Another example of a rural hospital tapping some high-tech solutions comes out of Alberta, Canada. Wainwright Healthcare Center, a 26-bed hospital, more than an hour's trip from the nearest stroke center, installed a portable CT scanner to triage stroke patients.




"Given their remoteness, most small outlying hospitals do not have fixed CT capability. It is just an expense they have been unable to justify given the relatively low volume," said Colin Timothy McDonald, M.D., who serves on the medical advisory board of NeuroLogica, Inc. The company's portable CereTom CT scanner is providing an affordable solution for initial evaluations and to connect Wainwright with the University of Edmonton.

Prior to the installation, whenever a patient was suffering from a traumatic brain injury or possible stroke, they were flown to Edmonton for initial imaging, costing precious time that could negatively affect outcome.

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