Nebraska's vulnerable rural populations need better health care data

In a state that’s 92% farmland, one of the biggest issues we face in our health care system is disparate outcomes for our rural population. Eighty-five of Nebraska’s rural communities are considered medically underserved areas, and that’s just for primary care services.

This is concerning — rural populations are significantly more vulnerable to health inequities and poor, often preventable outcomes. The age-adjusted death rate in rural areas is 20% higher than that of urban areas.

There’s a relatively simple solution: More rural health care providers and organizations in Nebraska need to connect and collaborate with our state designated health information exchange.

As a physician, I’ve seen the benefits of Nebraska’s state designated health information exchange, CyncHealth. The average Nebraskan may not know that we’re one of the few states with a robust and mature health information exchange or be aware of the power it has to improve community health. These electronic networks allow health care providers to securely access patients’ medical information, allowing for comprehensive records and real-time updates on patient care and status.

In states with well-established health information exchanges, this collaboration is proven to lead to better patient health outcomes, improved clinical efficiency and cost savings. Provider utilization of health information exchanges decreases hospitalizations by 10% and emergency department visits by 13%, which can save up to $160-$195 million annually in avoidable health care costs.

While Nebraska has a great health information exchange and is well-connected with larger hospitals and health systems in urban areas, rural health care organizations have lagged connecting.

Most counties across Nebraska are unable to provide specialized and acute care, forcing patients to seek it miles away from their homes — which is a problem when those providers can’t access their whole patient health record.

For example, a patient with chronic heart disease might visit an urgent care clinic for something seemingly common like a chest cold. Without an adequate history, the patient could be discharged as stable, without knowing about a chronic condition that could be exacerbated and require hospitalization.

I often see patients with little to no background information available. Tracking down medical information requires significant time when utilizing archaic, asynchronous methods such as fax machines. In acute situations, this time and labor-heavy investment is not a luxury we can afford and can sometimes pose real threats when considering treatment for a patient who may have a medication allergy or a chronic condition that could make certain treatments dangerous.

When patient information is available through our state health information exchange, it significantly improves the quality of informed care we’re able to provide as well as the speed at which we can provide it.

We need more rural physician practices and rural care clinics to collaborate with our health information exchange. Until the voices of more physicians join our statewide network, rural communities will continue to face obstacles toward receiving adequate care and will continue to slip through the cracks, facing increased costs and substandard outcomes.

Providers and care organizations gain immense value when joining our statewide network, including:

• More complete patient information. With the combined records of all historic health data, providers get the holistic view needed to better treat the patient in front of them. Access to the right data can alert providers to patterns suggesting a chronic condition or behavioral condition, allowing a treatment plan to be developed that fits that patient’s specific unique needs. Additionally, connection to the health information exchange provides insight into other types of data that impact a patient like social determinants of health — factors such as food and housing insecurity, transportation barriers or potential exposure to environmental hazards. When providers have visibility into these factors, they can better coordinate resources to get patients the level of support they need — such as a Nebraska maternal health pilot program designed to help at-risk mothers address care gaps.

• Increased clinical and financial efficiency. Studies estimate that approximately 30% of health care spending may be considered waste — including redundancies in testing or incorrect treatments based on limited, siloed information. When providers have access to the complete picture upfront, they deliver faster, more accurate clinical diagnoses. Patients also have better experiences, meaning they’re more likely to trust their doctors and comply with medical recommendations or treatment plans and overall, feel more empowered to proactively engage in their health care.

Achieving seamless information exchange between small clinics, independent physician practices and the larger health care network will take time. But the early successes of larger hospitals and health systems in our urban areas have clearly demonstrated that the groundwork is ultimately worth the reward.