Becker's Hospital Review

11 EXECUTIVE BRIEFING 2 EXECUTIVE BRIEFING 4. Put AI and automation to work where the need is greatest AI adoption in rural healthcare remains nascent — just 8% of critical access and rural community hospitals have implemented AI-driven analytics for predictive healthcare — but organizations that have moved deliberately are seeing tangible results. At Lewistown-based Central Montana Medical Center, a 25-bed critical access hospital, ambient AI scribing reduced after-hours charting demands so significantly that some physicians said they would consider leaving if the tool were taken away. Sioux Falls, S.D.-based Sanford Health raised appointment connect rates from 40% to 56% with an AI-powered outreach tool, while a virtual care program supported by AI infrastructure helped more than 12,000 patients access mental health services for the first time. Zeshan Anwar, MD, associate chief medical officer at The Guthrie Clinic (Sayre, Pa.), told the "Becker's Healthcare Podcast" that patient mobility detection is among AI's strongest rural use cases; his organization is using it to reduce falls and prevent pressure injuries. "As leaders, we should aggressively pursue federal funding to advance digital and workforce innovation, reinforce financial sustainability and protect access to essential services," Dr. Anwar said. 5. Build AI governance structures that keep pace with adoption While 88% of health systems report using AI internally, only 17% have a mature governance structure and a fully formed AI strategy. ECRI flagged the "AI diagnostic dilemma" as 2026's top patient safety concern, citing risks of diagnostic errors and automation bias when AI operates without proper oversight. Ms. Smith noted this challenge is especially acute at rural organizations, where IT teams often amount to one person. Successful deployment, she has observed, requires governance frameworks built before implementation — defining appropriate use cases, building in bias checks and establishing expectations for human oversight. Grant timelines and funding pressures can push deployment before those frameworks exist, making the discipline harder but more essential. "It's not enough to just say, 'I'm going to activate this new tool,'" she said. "It's having structure around how to deploy it, how to get it to patients and how to make sure all staff are using it consistently." 6. Measure what matters: let financial returns lead your tech strategy In constrained environments, there is no margin for technology that cannot prove its worth — and rural leaders increasingly demand that proof in financial terms. At Parkview Health, AI-assisted evaluation and management coding tools helped clinicians accurately capture service complexity, improving reimbursement accuracy. Generative AI applied to discharge summaries and revenue cycle workflows created further efficiencies. "Finding those key AI functionalities where you can absolutely see a financial ROI is key to getting things started," Dr. Mabus said. "And then those help pay for some of the other functionalities that may have more of that 'soft ROI' based more on efficiency and time savings." Parkview has also embedded an AI review into its vendor intake process — requiring teams to document the clinical need and confirm existing vendors don't already offer comparable capability before any new solution is approved. James Wellman, vice president and CIO of Nathan Littauer Hospital & Nursing Home in Gloversville, N.Y., is prioritizing revenue cycle management as the highest-return AI use case. "Rural health is under amazing pressures we've never seen before," he told Becker's. "I really think the appropriate use of AI is something that can make a difference — making sure we're getting fully reimbursed for the work we're doing." 7. Choose partners that bring more than a product When nearly 90% of rural providers say vendors promote tools as "rural-ready" that appear repackaged from urban designs — and more than half cite procurement complexity as their greatest execution risk — selecting the right partner has become as consequential as selecting the right technology. Typically understaffed in IT, governance and training, rural organizations are seeking vendors that supplement that deficit rather than simply sell into it. "We are a rural health organization, and the broad, generalized, built-in solutions may not fit our needs," Mr. Wellman told Becker's. "Third-party vendors are working for us every day to keep our trust." Ms. Smith at athenahealth shares that view. "The entire role of our team is to help make sure organizations are not just implementing technology, but realizing the operational and patient-access outcomes they expected," she said. "That service layer matters because many rural health centers do not have deep implementation, governance or training infrastructure internally — so the partnership has to bring more than the product." Turning constraint into a 'silent accelerator' Across the country, rural leaders are demonstrating that constraint has sharpened their capacity for innovation, marked by disciplined governance, selective partnerships and a patient-centered philosophy that treats technology as a means of extending scarce clinical capacity and earning trust. The most effective technology, in Ms. Smith's words, functions as a "silent accelerator" — enabling clinical efficiency without creating friction between clinicians and patients. "The less we ask providers to put technology between themselves and the patient, the more we preserve the trust that keeps patients coming back," she said. To access the first article in the series, visit: https://www.beckershospitalreview.com/digital-health/closing- the-access-gap/ athenahealth is curing complexity for ambulatory healthcare practices and their patients with intuitive AI-native technology and embedded services that improve clinical effectiveness, patient experience, and financial performance. athenahealth's vision is to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Learn more at www.athenahealth.com. Rural Healthcare Excellence in 2026

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