Locating Rural Healthcare Gaps

Although most of the larger Veterans Administration (VA) medical centers are located in urban areas, the veteran population is spread throughout the country. Nearly 6 million veterans and 36 percent of the 8.3 million Veterans Health Administration (VHA) enrollees live in rural areas. It is very important for the VHA to determine where rural veterans live in relation to VA services in order to improve their access to care.

The VHA Office of Rural Health (ORH) uses Geographic Information System (GIS) tools to assist in determining gaps in locations that veterans face in accessing healthcare. The GeoSpatial Outcomes Division (GSOD) housed at the Veterans Rural Health Resource Center-Eastern Region in Gainesville Florida, provides maps and reports to help veterans find access to primary, acute, tertiary care, plus GSOD identifies gap areas for each of the VA networks.

The GSOD recently completed two major mapping initiatives for the VA Office of Rural Health (ORH) has identified broadband availability to support telehealth services in rural areas and identified optimal sites for a Health Information Exchange (HIE) pilot program.

To determine sites for the HIE pilot program, the GSOD team used data available from the FCC and the Department of Commerce’s National Telecommunications and Information Administration to map maximum download speed by census tract. This information can be used to assess whether telehealth is an option in select rural areas as well as to target areas for improved broadband infrastructure.

Another way to address gaps in healthcare access is through partnerships with non-VA providers that needs to be done through the exchange of health information. So far, the GSOD team in working with the HHS Office of the National Coordinator for Health IT, have identified sites for a HIE pilot program.

To do this, the team examined the geographic locations of rural VHA enrollees, locations of rural VA healthcare sites, as well as Critical Access Hospitals and rural clinics that are capable of transferring health records.

Another VHA ORH initiative is to provide information on rural veterans with specific diseases or conditions such as multiple sclerosis, stroke, traumatic injuries, diabetes, in order to examine sites for potential partnerships with non-VA critical access hospitals. There are also plans to identify locations for training rural clergy to provide support for returning troops and their families.

Source: VHA’s Office of Rural Health’s July 2013 issue of “The Rural Connection” at www.ruralhealth.va.gov.