The US Congress established the designation of Critical Access Hospitals in 1997, recognising rural hospitals as vital links to health for rural and underserved populations. The intent of the reimbursement system is to improve financial performance, thereby reducing hospital closures. Informatics applications are thought to be tools that can enable the sustainabiity of such facilities. The aim of this study is to identify the current use of information and communication technology in Critical Access Hospitals, and to assess their readiness and receptiveness for the use of new software and hardware applications and their perceived information technology (IT) needs. A survey was mailed to the administrators of all Critical Access Hospitals in one US state (Missouri) and a reminder was mailed a few weeks later. Twenty-seven out of 33 surveys were filled out and returned (response rate 82%). While most respondents (66.7%) stated that their employees have been somewhat comfortable in using new technology, almost 15% stated that their employees have been somewhat uncomfortable. Similarly, almost 12% of the respondents stated that they themselves felt somewhat uncomfortable introducing new technology. While all facilities have computers, only half of them have a specific IT plan. Findings indicate that Critical Access Hospitals are often struggling with lack of resources and specific applications that address their needs. However, it is widely recognised that IT plays an essential role in the sustainability of their organisations. The study demonstrates that IT applications have to be customised to address the needs and infrastructure of the rural settings in order to be accepted and properly utilised. © 2007 PHCSG, British Computer Society.
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