Initiative Five

Initiative Five: Leveraging Technology for Healthcare Innovations in Rural Georgia 

  • RHT Program Strategic Goal: Technology Innovation

  • GREAT Health Vision Alignment: Needs for Rural Progress

Each of the strategies in this initiative plays a specific role in healthcare, but when strategically integrated, they work together to create a modern, efficient, secure, and patient-centered healthcare system. For example, cybersecurity efforts will safeguard patient data, telehealth platforms, and connected medical devices; an innovation fund is planned to provide capital investments to support both starting up and scaling up technology innovations in rural communities; and EMR and consumer engagement technology enhancements will promote engagement in data analysis activities supporting population health efforts. With this initiative, rural Georgia will have access to a healthcare system that harnesses the power of technology to improve consumer access to information, improve training and skills of the healthcare workforce, and foster an environment of data sharing that results in collaborative, coordinated care for the patient.

The following are key outcome metrics associated with this initiative. Additional metrics are included in the Metrics and Evaluation plan section. Unless otherwise indicated, baseline measures are zero and will be established at Year 0 of the program; the proposed outcomes will be observed by FY31. 

Outcomes

The outcomes of this initiative will be measured by: increased number of hospitals with population health reporting capacity (target based on assessment); reductions in health IT staff position vacancies (target is 20%); increase in number of consumers directly engaged in new health technology (target based on program enrollment); and reduction in number of reportable cybersecurity incidents at the county-level (target based on assessment).

Overall Funding for this Initiative

$54,949,384

Table 6: Strategies of Leveraging Technology for Healthcare Innovations in Rural Georgia

This table was reformatted as an ordered list for better readability.

  • Cybersecurity Enhancements
    • Key Challenges        
      • Rural hospitals face growing cybersecurity risks, threatening continuity of patient care, security of PHI, and integrity of systems that support operations
      • Many rural hospitals lack resources to address the HIPAA Security Rule and CMS’s July 2021 guidance on Medicaid security
      • Insufficient cybersecurity workforce pool in Georgia
    • Innovative Care Solution: Cybersecurity Workforce Pipeline and Enhancements
      • Based on a highly successful pilot project, DCH will collaborate with academic institutions and private-sector partners to implement a comprehensive and scalable strategy to deliver cybersecurity risk assessments, managed threat detection, and strategic cyber support services to high-risk rural healthcare providers in Georgia
        • Note: Reports from the hospital pilot site detailed the activity of 531 monitored devices, providing complete visibility into their connected systems. As a result, the hospital has achieved a 94% detection rate of threat actors upon initial contact, while also preventing a coordinated exploitation attempt in early July.
      • Services provided by end-degree internship pipeline via partnerships with accredited academic institutions
    • Key Activities
      • Development of two-phase support model providing foundational assessments and continuous, long-term security management
      • Model will be offered to all at-risk rural hospitals lacking robust cybersecurity systems
      • Conducting assessment and strategy for baseline understanding of cybersecurity
      • Assess existing technology and infrastructure
      • Software deployment
      • Developing cybersecurity policies
      • Training staff
    • Use of Funds
      • D. Training and Technical Assistance, 
      • E. Workforce, 
      • F. IT Advances
    • Technical Score Factors        
      • D.1. Talent Recruitment
      • F.2. Data infrastructure
    • Key Stakeholders        
      • Rural hospitals, accredited academic institutions and universities, internship programs, cybersecurity firms and organizations
    • Measurable Outcomes        
      • Percent of rural hospitals implementing a modern endpoint detection and response (EDR) solution on critical servers and endpoints (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding        
      • $14,200,000 total / $4,600,000 in Budget Period 1
    • Results and impact        
      • Strengthened security systems within rural hospitals throughout the state
         
  • Advancing Access to Robust Care and Health in Rural Georgia (ARCHER) Tech Catalyst Fund
    • Key Challenges        
      • Need for sustained, improved access and quality in health outcomes for rural healthcare populations, which are disproportionately affected by chronic diseases and healthcare access shortages
    • Transformative Care Solution: ARCHER Fund        
      • Establish an investment fund dedicated to rural health technology that is high-impact, consumer-facing, care-enabling, and tailored to rural needs
    • Key Activities
      • Identify gaps through data analysis and provider engagement
      • Identify/validate eligible companies to receive up to $3 million in non-dilutive funding and critical support
      • Deploy/support selected technology in rural systems such as AI-driven diagnostics
      • Conduct evaluation and monitor outcomes for enhanced rural healthcare delivery, attract follow-on investment, and produce scalable, evidence-backed models for use in other rural regions
    • Use of Funds        
      • A. Prevention & Chronic Disease, 
      • C. Consumer Tech Solutions, 
      • F. IT Advances
    • Technical Score Factors        
      • F.3. Consumer-facing Tech
    • Key Stakeholders        
      • Rural health systems, providers, patients and consumers, private investors and venture capital firms, tech industry.
    • Measurable Outcomes        
      • Total dollars of funding for technology innovations in rural Georgia (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding        
      • $45,000,000 total / $9,000,000 in Budget Period 1
    • Results and impact
      • Improvements in chronic disease management, patient care, and healthcare system capacity for rural populations
      • A collaborative effort between state and universities to enhance technology validation, investment, deployment, and long-term impact tracking of rural healthcare needs
      • Rapid implementation to align with community priorities (within 6 months of intake)
         
  • EMR Enhancements
    • Key Challenges        
      • Need to comprehensively assess and enhance EMR capabilities of state’s 159 hospitals, which currently operate across 11 different systems, with varying functionalities to avoid exclusion of rural hospitals from AHEAD participation and widen the gap in healthcare access and quality
    • Transformative Care Solution: EMR enhancement for population health metrics
      • Assess hospital EMR capabilities and identify rural hospitals most in need of support, particularly ones with poor health outcomes and limited financial resources
      • Support transition to value-based care & global payment models under AHEAD model to ensure hospitals and clinics can leverage population health modules to identify at-risk populations, promote proactive care, and integrate services across all healthcare areas
    • Key Activities
      • Year 1, hospital assessments and release Request for Grant Applications (RFGA)
      • Years 2-5, expand to rural health clinics & FQHCs as budget permits
      • Funded entities develop population health strategic plans with process for selecting and purchasing EMR enhancement via alignment with AHEAD reporting and quality metrics
      • Collaboration among Chief Information Officers, healthcare leadership, and GREAT Health leads supported by quarterly stakeholder meetings promoting interoperability with upgrades to EMRs
    • Use of Funds
      • A. Prevention and chronic disease, 
      • F. IT advances, 
      • I. Innovative care
    • Technical Score Factors        
      • B.1. Population health clinical infrastructure
      • F.2. Data infrastructure
    • Key Stakeholders        
      • Rural hospitals, health clinics and FQHCs, chief information officers, EMR systems, providers
    • Measurable Outcomes        
      • Percent of hospitals completing EMR population health enhancements (desired trend increase)
    • Counties Impacted        
      • 126 Georgia counties/rural counties designated as rural by HRSA
    • Estimated Funding        
      • $44,000,000 total/ $0 in Budget Period 1 (assessment occurring through administrative contract)
    • Results and impact        
      • Improved interoperability by promoting equitable access to value-based care tools and reducing unnecessary service duplication
      • Enablement of data-driven strategies aligning with AHEAD objectives, including financial sustainability, enhanced care coordination, and investment in preventive care
         
  • Workforce Retention Technology
    • Key Challenges        
      • Insufficient surgical services promoting smaller rural hospital financial stability due to lack of equipment and related issues
    • Transformative Care Solution: Surgical Robotics Procurement        
      • Provide grant funding opportunity to rural hospitals for initial costs of surgical robots to allow surgeons to perform more complex procedures, resulting in more precise and less invasive results, reduced client recovery time and pain, less blood loss, lower risks of infection, and shorter hospital stays
      • Costs beyond initial funding will be funded by respective hospital(s) pursuant to plans provided with their application(s), along with an analysis by applicant(s) of baseline case volume/predicted revenue metrics with demonstrated financial stability
      • Goal of placing 2 robots per year for total of 10 robots in rural hospitals
    • Key Activities        
      • Determine rural hospital candidates, develop grant process, purchase surgical robots, train staff and providers, provide technical assistance, maintain systems
    • Use of Funds        
      • D. Training and Technical Assistance, 
      • E. Workforce, 
      • G. Appropriate Care Availability
    • Technical Score Factors        
      • D.1. Talent Recruitment
    • Key Stakeholders        
      • Rural hospitals, surgeons, academic institutions, vendors
    • Measurable Outcomes        
      • Number of procedures performed by surgical robots in rural hospitals (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural Georgia counties/portions of counties
    • Estimated Funding        
      • $20,000,000 total / $2,000,000 in Budget Period 1
    • Results and impact        
      • Significant enhancement of patient care and hospital capabilities with sustainability through billing
         
  • Eligibility System Enhancements
    • Key Challenge        
      • Backlogs in eligibility determinations create financial risk for rural providers
    • Transformative Care Solution: Streamlining Medicaid Eligibility
      • Beginning in 2026, Georgia will begin to modify its integrated eligibility system (Gateway) in order to transition the Modified Adjusted Gross Income (MAGI) population to a determination state, thereby automating approval for applicants who meet eligibility requirements
      • Gateway will interface with Georgia Access (state-based exchange, managed by the Office of Commissioner of Insurance and Safety Fire, or OCI) so those found to be Medicaid eligible can have their approved application automatically transferred and those who are ineligible can be referred to an exchange plan
    • Key Activities        
      • Determine enhancements needed for Gateway system to automate MAGI applications
      • Build interface with Georgia Access and implement enhancements
      • Test system and monitor data
    • Use of Funds        
      • C. Consumer Tech Solutions, 
      • F. IT Advances
    • Technical Score Factors        
      • F.2. Data Infrastructure
    • Key Stakeholders        
      • State agencies (DHS, DCH, OCI) and all constituents seeking public benefits
    • Measurable Outcomes        
      • Number of eligible applicants auto approved for Medicaid and transferred to Gateway system (desired trend increase)
      • Number of applicants referred to case worker for remedy (desired trend decrease)
    • Counties Impacted        
      • Statewide
    • Estimated Funding        
      • $30,000,000 total / $20,000,000 in Budget Period 1
    • Results/Impact        
      • Reduction in pending eligibility backlog
         
  • Consumer Engagement Enhancements
    • Key Challenge        
      • Lack of personal engagement in wellness is a contributing factor in poor population health
    • Key Context: Success of current wellness platform used by state employees        
      • State Health Benefit Plan (SHBP) offers a wellness platform to improve care engagement, consumer coaching, and data collection.
      • In the last 5 years, the program reduced overall health risk by 10%, including a 14.7% decrease in preventive risk, a 10.1% decrease in lifestyle risk, and a 1.4% decrease in biometric risk. (State Health Benefit Plan, 2025)
    • Transformative Care Solution: Expansion with AHEAD model        
      • Extend this consumer-facing technology to the full population anticipated to participate in AHEAD to encourage healthy lifestyles and preventive care
      • Includes diet/nutrition and wellness coaching
      • Adds an AI-generated Geospatial Health Risk Profile for the projected AHEAD counties; this personalized assessment will utilize artificial intelligence to analyze various data points about an individual (eg. medical history, lifestyle, genetics, environment, social determinants of health, and biometric data) to identify potential health risks and provide insights or recommendations.
    • Key Activities        
      • Assessment and identification of gaps
      • Define user requirements and ensure interoperability with existing systems
      • Develop protocols, marketing, and educational materials
      • Evaluate and plan for sustainability as part of AHEAD
    • Use of Funds        
      • A. Prevention and chronic disease, 
      • C. Consumer Tech Solutions
    • Technical Score Factors        
      • B.2. Health and Lifestyle
      • F.3. Consumer Facing Tech
    • Key Stakeholders        
      • Healthcare consumers, insurers— including public insurers and involved state agencies (DCH, OCI, DHS), providers
    • Measurable Outcomes        
      • Percent of members completing online wellness activities (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding        
      • $51,000,000 total /$10,200,000 in Budget Period 1
    • Outcomes        
      • Improved health indicators for rural Georgians
      • Consumer empowerment and motivation
         
  • Behavioral Health State Assessment of Technology (BHSAT)
    • Key Challenge        
      • Lack of a quick and accurate means to assess and respond to behavioral health needs, particularly in underserved rural areas
    • Transformative Care Solution: BHSAT        
      • Invest in modern, scalable health information technology systems with secure, compliant data sharing
      • Leverage existing data sources, such as the GA All Payer Claims Database (APCD)
      • Create a real-time system to enable the aggregation and analysis of data across multiple regions, identifying critical gaps in technology that support mental health, substance abuse disorder, ASD, and primary care services
    • Key Activities        
      • Develop behavioral health technology system
      • Conduct assessment of technology
      • Analyze data and deploy predictive analytics
    • Use of Funds        
      • A. Prevention and Chronic Disease, 
      • E. Workforce, 
      • F. IT Advances, 
      • G. Appropriate Care Availability, 
      • H. Behavioral Health
    • Technical Score Factors        
      • B.1. Population health clinical infrastructure
      • F.1. Remote care services
      • F.2. Data infrastructure
    • Key Stakeholders        
      • Behavioral healthcare facilities, behavioral health providers, advanced degree behavioral health providers, DBHDD
    • Measurable Outcomes        
      • Number of system participants completing data sharing agreements (desired trend increase)
    • Counties Impacted        
      • Statewide
    • Estimated Funding        
      • $25,000,000 total / $5,000,000 in Budget Period 1
    • Outcomes        
      • Improved data to identify ongoing workforce shortages
      • Enhanced care integration and service delivery statewide
      • Reduction in provider burnout for a more resilient and responsive behavioral health system
         
  • EMS Treat-versus-Transport (TVT)
    • Key Challenges        
      • Access to care in rural settings
    • Transformative Care Solution: Telehealth TVT        
      • “Treat versus Transport” telehealth model to integrate telehealth into emergency response for non-emergency/low-acuity 911 calls
      • Model allows EMS to conduct real-time, on-scene evaluations to help direct care for rural patients, while getting telehealth feedback from broader licensed providers for approval
    • Key Activities        
      • Procure and utilize ‘Starlink’ satellite tech in rural health areas
      • Enable real-time telehealth consultations between EMS team and remote healthcare staff via training, protocols, integration, and billing
      • Monitor and evaluate data
    • Use of Funds        
      • D. Training and Technical Assistance, 
      • F. IT Advances, 
      • G. Appropriate Care Availability,
      • K. Fostering Collaboration
    • Technical Score Factors        
      • C.2. EMS
    • Key Stakeholders        
      • DPH, EMS, rural hospitals, physician networks, Starlink/broadband providers
    • Measurable Outcomes        
      • Number of EMS units equipped with kits (desired trend increase)
      • Dollar amount of EMS-to-provider billing claims reimbursed for telehealth services (desired trend increase)
    • Counties Impacted        
      • 126 HRSA-rural counties/portions of counties
    • Estimated Funding        
      • $4,149,384 total / $4,149,384 in Budget Period 1
    • Results and impact        
      • Ensuring access to timely medical guidance regardless of location

Sustainability Efforts

Within this technology innovation initiative, there are multiple efforts related to sustainability, including: partner absorption of ongoing maintenance of the technology enhancements, revenue generated from billable services due to technological enhancements (such as increased rural resident eligibility for coverage), and more efficient use of population health tracking for additional savings due to improved management of risk. In addition, grant awards will require sustainability planning as part of the application and implementation cycle.

The combined strategies of the GREAT Health Program Leveraging Technology for Healthcare Innovations in Rural Georgia initiative and the RHT Program Technology Innovation strategic goal will support Georgia’s objective of ensuring a future in which all rural Georgians will benefit from technology that improves care delivery and gives providers and patients real time, secure access to health data information.