Becker's Hospital Review

10 EXECUTIVE BRIEFING 1 EXECUTIVE BRIEFING Rural healthcare leaders are turning resource limits into a sharper lens for technology investment. As federal initiatives like the $50 billion Rural Health Transformation Program infuse rural health systems with new capital, the organizations seeing the most impact are not spending the most — they're spending most intentionally. Innovation is judged less by novelty than by results: whether a tool can extend clinical capacity, improve access and health outcomes, or support financial sustainability. "There's a real desire to measure the gain that you're going to get," said Kat Smith, executive director of customer success at athenahealth, who specializes in FQHC and community health center technology adoption. "Right now, organizations can't afford to implement a technology and not have it drive impact." This article, the second in a four-part series, "Rural healthcare excellence in 2026: 26 lessons in making less do more," examines seven ways rural healthcare organizations are approaching innovation under constraint, drawing on executive insights into how priorities are set and tools are evaluated. 1. Go all-in on virtual infrastructure Telehealth has matured from a pandemic-era stopgap into a core care delivery strategy. In West Virginia, where 50 of 55 counties are federally designated mental health professional shortage areas, Morgantown-based WVU Medicine has made virtual care central to behavioral health, with more than half of adult visits conducted virtually and roughly one-third of pediatric appointments via telehealth — reducing no-shows and improving access. At UCHealth Yampa Valley Medical Center in Steamboat Springs, Colo., all specialties are capable of providing telehealth, with physicians and other clinicians blending virtual and in-person care based on clinical judgment. UCHealth's Virtual Health Center adds a "layered" approach: a bedside team backed by remote specialists monitoring patients in real time. Olivia (Minn.) Hospital & Clinic uses primary care virtualist programs, e-consults and video visits to give rural patients personalized, same-day access to clinicians — bypassing hours of travel for specialty opinions. "By giving every patient a personalized digital experience, we're empowering them to take charge of their health, and we're delivering more proactive, connected and efficient care," Jen Macik, MSN, RN, chief nursing officer for Olivia, told Becker's. 2. Harness shared technology infrastructure to expand collective capacity With 81% of rural providers citing financial limitations as the primary barrier to IT modernization, few organizations can afford to build sophisticated infrastructure independently. Rural Health Transformation funds and collaborative models are filling that gap, as three-quarters of rural hospitals report participating in, evaluating or planning to join a Rural Health Transformation Collaborative — though in ambulatory settings, the picture differs. athenahealth's research found that 68.6% of rural clinicians are unfamiliar with the RHT Program, suggesting participation remains more aspirational than active, Ms. Smith said. Among the collaborative models already in motion, Opelousas (La.) General Health System has emerged as a regional anchor, extending its centralized infrastructure — network operations, security, data centers, EHR management — to partner hospitals at comparable cost, with three systems already joined and a fourth in preparation. "The goal was that hospitals could pay roughly what they're paying today but receive higher-qualified personnel, stronger security and more IT services," Lance Armentor, Opelousas' president and CEO, told Becker's. Ms. Smith has observed similar patterns. "We are seeing states rely on each other very differently, not just for group purchasing power and shared resourcing, but around what's working philosophically and structurally," she said. That ethos is also built into athenaOne®, which connects health centers to a shared national infrastructure — standardized data inputs, pre-built integrations and HIE connectivity — giving under- resourced organizations access to capabilities they couldn't build independently. "Your inputs will be the same as every other health center around you," Ms. Smith said. "When you look at that data, you can really compare apples to apples." 3. Extend care beyond the care center — and meet patients where they are Eleven states have outlined plans to address post-acute care coordination as part of the Rural Health Transformation Program, incorporating hospital-at-home models, EMS treat-in-place care and mobile-integrated healthcare teams serving rural communities directly. Cloud-based technology is enabling these models wherever patients can be reached. Ms. Smith has observed health centers using cloud-based tools to support compliant, community-based outreach — from mobile or pop-up services to partnerships with trusted local organizations like social clubs and libraries — helping teams reach patients who may face transportation, broadband or clinic access barriers. "Part of it is cloud-based technology giving care teams the flexibility to support appropriate, community-based outreach beyond the four walls of the clinic. But the larger point is meeting patients where access already exists," she said. Kristen Toth, vice president of women's services at Orlando-based AdventHealth for Women — which is employing telemedicine, phone calls, mobile health units and community visits to reach rural patients — echoed this sentiment: "If we truly want to serve rural communities, we can't expect families to come to us," she told Becker's. "So we need to think about mobility — how do we go beyond our brick-and-mortar buildings and bring care to them?" Innovation Under Pressure 7 ways rural leaders are turning constraint into tech-driven advantage Rural Healthcare Excellence in 2026

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