Health IT Strategic Framework
Attachment 3
III. Background
As one of the nation's largest healthcare providers, DoD has a lengthy and comprehensive history working in remote and medically underserved areas throughout the world in peacetime and wartime. DoD has experience in applying innovative business and information technology solutions in such areas as capturing, storing, and securely transmitting patient data electronically; keeping providers in remote locations trained on the latest advances in medicine; educating patients long distance; medical surveillance; deploying unique infrastructure solutions, data aggregation and analysis; and conducting long-distance consultations. This history translates into significant intellectual capital capable of exerting influence upon the health IT industry, specifically for the purpose of improving healthcare, patient safety and population health management.
A. Rural and Underserved Requirements
Providers in rural and medically underserved communities encounter many and varied challenges in serving their communities. (Definitions are found in Appendix A.)
The Rural Public Health Research Agenda of April 2004, held at the University of Pittsburgh Center for Rural Health Practice, identified the following core themes for Rural Public Health:
Rural communities differ significantly across and within geographic regions, necessitating local solutions to local challenges that include economic factors, demographic makeup, population density, terrain, and distance from urban areas, community resources, and public health presence. The vast majority of rural public health workers have little or no specialty training in public health, and an additional barrier to needed education and training is the inability to take time away from often understaffed local health departments. There is a need for surveillance systems to be sensitive enough to address small numbers issues and broad enough to track emerging infections. The systems should have the capability of communicating across county and state boundaries.
Technology, which has been instrumental in providing access to information and training in most other areas, is lacking in rural areas. As reported by the National Advisory Committee on Rural Health, fewer than half of public health agencies have adequate communications and infrastructures.
Medically underserved communities are areas in which residents have a shortage of personal health services. These communities may be in rural or urban settings. There may be a shortage of health professionals and/or economic, cultural, or linguistic barriers to healthcare. Access to care is an issue critical to improving health status throughout rural America. Access to specialty care is an issue for both provider and beneficiary in rural and medically underserved communities.
The Institute of Medicine is conducting a study on "The Future of Rural Healthcare," which is anticipated to include the development of "a conceptual framework for a core set of services and the essential infrastructure necessary to deliver those services to rural communities." When completed, this study could provide a basis for focusing federal and industry efforts to provide affordable options for providers in rural and medically underserved communities.
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