title: Against all odds: designing and implementing a grassroots, community-designed RHIO in a rural region.
abstract: Community Health Information Networks have provided lessons learned for RHIOs by bringing attention to issues of trust, buy-in, ownership and financing. This article reports the formation of a new rural RHIO, East Kern County Integrated Technology Association (EKCITA) and addresses unique rural demands and success themes specificto rural environments. A case study approach-grounded in action research and utilizing techniques of key informant interviews, participant observations and content review of written data sources from 2006-was utilized. Through a process of grassroots governance, transparency and consensus decision-making, EKCITA was incorporated in 2006. Taking lessons learned from past initiatives, this rural RHIO used a transparent and participative process while addressing unique challenges faced by rural regions. Through this process, seven additional success themes were identified, five of which are unique to rural regions. Rural communities can develop dynamic entities that address a host ofissues in addition to information technology.
authors.affiliation: University of California, Riverside, USA.
authors.forename: Kiki C
authors.initials: KC
authors.lastname: Nocella
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Horowitz
authors.forename: Jami J
authors.initials: JJ
authors.lastname: Young
mesh_terms: D002140:California; D019058:Community Networks; D004059:Diffusion of Innovation; D006801:Humans; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized; D019982:Organizational Case Studies; D012040:Regional Health Planning; D012424:Rural Population