Purpose: This study assessed electronic
health record (EHR) and health information technology
(HIT) workforce resources needed by rural primary care
practices, and their workforce-related barriers to
implementing and using EHRs and HIT.
Methods: Rural primary care practices
(1,772) in 13 states (34.2% response) were surveyed in
2012 using mailed and Web-based questionnaires.
Key Findings: EHRs or HIT were used by
70% of respondents. Among practices using or intending to
use the technology, most did not plan to hire new
employees to obtain EHR/HIT skills and even fewer planned
to hire consultants or vendors to fill gaps. Many
practices had staff with some basic/entry, intermediate
and/or advanced-level skills, but nearly two-thirds
(61.4%) needed more staff training. Affordable access to
vendors/consultants who understand their needs and
availability of community college and baccalaureate-level
training were the workforce-related barriers cited by the
highest percentages of respondents. Accessing the
Web/Internet challenged nearly a quarter of practices in
isolated rural areas, and nearly a fifth in small rural
areas. Finding relevant vendors/consultants and qualified
staff were greater barriers in small and isolated rural
areas than in large rural areas.
Discussion/Conclusions: Rural primary
care practices mainly will rely on existing staff for
continued implementation and use of EHR/HIT systems.
Infrastructure and workforce-related barriers remain and
must be overcome before practices can fully manage
patient populations and exchange patient information
among care system partners. Efforts to monitor adoption
of these skills and ongoing support for continuing
education will likely benefit rural populations.