Rural Health Transformation Program Offers Bold Opportunity to Reimagine Realtime Hospital Capacity Reporting, Ease Access Challenges in Rural Communities
Freedman HealthCare (FHC) has supported multiple states in developing and implementing their Rural Health Transformation Programs. FHC specializes in integrated health data systems, healthcare measurement and benchmarking, and workforce data infrastructure and reporting.
By Emma Harrigan, MS, Senior Consultant
Hospital closures, inadequate staffing, and overburdened primary care systems are making it increasingly difficult for rural hospitals to meet patient needs. Since 2005, more than 200 rural hospitals have completely or partially closed, and 400 more are at risk of closure today.1 Others are cutting back on services. Rural primary care is under similar pressure, pushing more care into emergency departments (EDs). In fact, more than a third of adults living in rural areas report using the ED for care that could have been handled in primary care.2
The rural hospitals that do remain open are stretched thin. A critical access hospital may have only a handful of staffed beds or a single on-call specialist, and frequently needs to transfer acute patients to tertiary care facilities for critical care, as well as accept back patients from these systems. But arranging these transfers can take a rural ED many hours. Missed phone calls and out-of-date information equal lost time for providers who are needed at the bedside. The result is long ED waits, often referred to as “patient boarding”, which the Joint Commission recognizes as a patient safety risk. And beyond the clinical consequences, there is also moral injury to providers distressed by their inability to transfer and receive patients fast enough.
Real-Time Data Improves Patient Flow, Outcomes
Today, states have a historic chance to address these challenges. The Rural Health Transformation Program (RHTP) offers rural hospitals funding to modernize their data infrastructure and support real-time reporting and long-term planning.
Real-time reporting gives hospitals, regions, and states live visibility into bed availability, staffing levels, patient flow, and transfer status. For rural hospitals still relying on phone calls and systems that are regularly out of sync with actual bed capacity, this is a fundamental shift. Instead of an ED spending hours on the phone to find a bed, providers can quickly see which facilities can accept transfers, where intensive care unit (ICU) beds are staffed and available, and how patient volume is distributed across a region. Real-time reporting also ensures providers are acting on the most up-to-date information when coordinating patient care. And, over time, the same data that supports day-to-day care coordination also becomes a planning backbone for states. Understanding trends in ED boarding, seasonal surges, and chronic capacity gaps helps states allocate funding, support threatened rural hospitals, and make strategic investments in telehealth, trauma systems of care, and EMS.
How it Works
Today’s real-time hospital capacity tools pull data directly from hospital EMRs into a central repository through automated data feeds that require minimal IT resources to create and maintain. Because data flows continuously, available resources can be identified faster, and because the process is automated, clinical teams no longer have to spend time manually communicating their own availability by phone or fax.
States can serve a valuable role as conveners by bringing together hospitals and facilities interested in participating in such a data exchange. With stakeholder input, states can establish rules around data exchange and governance, help identify a shared vendor, and negotiate a single contract to host the service on behalf of the participating hospitals. For example, in Oregon, hospitals feed availability data from their EMR’s into the Oregon State Capacity System, which provides near real-time, fully automated reporting while protecting patient privacy.
For rural communities where every bed and every minute matters, this isn’t just a technology upgrade – it is foundational infrastructure. Real-time capacity reporting has the potential to truly transform healthcare, improve patient outcomes, and strengthen the long-term stability of the health system. And the Rural Health Transformation Program can provide the funding needed to make it happen.
Have questions about how your state can use RHTP funding to build or strengthen real-time hospital reporting? I’d love to hear from you.
Reach out to me at [email protected]
Footnotes:
1 Horstman, C., & Shah, A. (2026, February). Why rural hospitals are facing a funding crisis — and how it could get worse. The Commonwealth Fund. Retrieved from: https://www.commonwealthfund.org/publications/explainer/2026/feb/why-rural-hospitals-face-funding-crisis-how-it-could-get-worse
2 Horstman, C., & Shah, A. (2025, November 17). The state of rural primary care in the United States. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2025/nov/state-rural-primary-care-united-states