: The national discussion of quality and patient safety has only recently begun to identify and understand the unique quality and patient safety issues facing rural hospitals, as opposed to those of their much larger and far more complex, urban counterparts. Serious questions arise about whether commonly proposed health information technology (HIT) interventions for quality and patient safety issues actually make sense in rural hospitals. Moreover, very few rural hospitals currently have the necessary HIT capacities because of expense, limited in-house HIT expertise, and mismatches among HIT applications. The project we propose is designed to meet the special needs of rural hospitals for assistance with planning HIT enhancements to address patient's safety and healthcare quality concerns. This project was developed in response to RFA HS-04-012 which states that """"""""AHRQ is specifically interested in...applications that explore the unique barriers faced by rural and small community providers in adopting HIT and opportunities for overcoming these barriers"""""""" and """"""""Research areas that are of particular interest to AHRQ include: development and evaluation of toolkits...that can be used by...decision-makers to help them understand the value of HIT and assist them to make HIT purchasing and implementation decisions."""""""" The proposed project has four primary objectives. First, we will document the patient safety and healthcare quality challenges unique to rural hospitals. Second, we will explore the current HIT capacity in rural hospitals, the potential use of HIT by rural hospitals to address their unique patient safety and healthcare quality issues, and the unique barriers faced by rural hospitals in adopting HIT. Third, we will measure value derived from HIT in rural hospitals and identify which HIT solutions for enhancing patient safety and healthcare quality have the greatest potential in terms of generating a positive return on investment. Fourth, we will create decision-making HIT toolkits to address barriers and provide solutions that are appropriate for rural hospitals. Once the toolkits are developed, we will make them available to rural hospital decision-makers. The toolkits will facilitate rural hospitals' ability to utilize current and emerging evidence to guide HIT investment and implementation decisions that fit their particular healthcare environment.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
1R01HS015009-01
Application #
6890121
Study Section
Special Emphasis Panel (ZHS1-HSR-H (01))
Program Officer
Mutter, Ryan
Project Start
2004-09-01
Project End
2007-08-31
Budget Start
2004-09-01
Budget End
2005-08-31
Support Year
1
Fiscal Year
2004
Total Cost
Indirect Cost
Name
University of Iowa
Department
Public Health & Prev Medicine
Type
Other Domestic Higher Education
DUNS #
062761671
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Bahensky, James A; Ward, Marcia M; Nyarko, Kwame et al. (2011) HIT implementation in critical access hospitals: extent of implementation and business strategies supporting IT use. J Med Syst 35:599-607
Allareddy, Veerasathpurush; Ward, Marcia M; Allareddy, Veerajalandhar et al. (2010) Effect of meeting Leapfrog volume thresholds on complication rates following complex surgical procedures. Ann Surg 251:377-83
Mills, Troy R; Vavroch, Jared; Bahensky, James A et al. (2010) Electronic medical record systems in critical access hospitals: leadership perspectives on anticipated and realized benefits. Perspect Health Inf Manag 7:1c
Li, Pengxiang; Schneider, John E; Ward, Marcia M (2009) Converting to critical access status: how does it affect rural hospitals' financial performance? Inquiry 46:46-57
Li, Pengxiang; Ward, Marcia M; Schneider, John E (2009) Factors associated with Iowa rural hospitals' decision to convert to critical access hospital status. J Rural Health 25:70-6
Li, Pengxiang; Bahensky, James A; Jaana, Mirou et al. (2008) Role of multihospital system membership in electronic medical record adoption. Health Care Manage Rev 33:169-77
Bahensky, James A; Moreau, Brian; Frieden, Rob et al. (2008) Critical access hospital informatics: how two rural Iowa hospitals overcame challenges to achieve IT excellence. J Healthc Inf Manag 22:16-22
Bahensky, James A; Jaana, Mirou; Ward, Marcia M (2008) Health care information technology in rural America: electronic medical record adoption status in meeting the national agenda. J Rural Health 24:101-5
Clabaugh, Gerd; Ward, Marcia M (2008) Cost-of-illness studies in the United States: a systematic review of methodologies used for direct cost. Value Health 11:13-21