NCRHTP Initiative Six: Digital Health

The NC Rural Health Transformation Program has six core initiatives. Initiative six is focused on digital health and technology. This work includes improving health information sharing, deploying cutting-edge artificial intelligence to support rural providers and ensuring digital literacy for all residents. 

The digital health and technology initiative includes multiple programs including partnership with the NC Department of Information Technology. Learn more about these programs using the drop down below.

The Rural Health Innovation Fund (RHIF) will serve as a kickstart investment to help rural health care providers modernize operations and health IT infrastructure. This fund will enable providers to access funding to assess existing data systems and identify technology needs. 

Eligible investment projects include telehealth expansion, AI-enabled clinical decision support, electronic health record upgrades, cybersecurity enhancements and more. NCDHHS will work with partners to ensure that RHIF investments are scalable, sustainable and aligned with broader statewide goals to improve quality of care for rural communities 

Funds will be available through a competitive application process beginning on Sept. 30, 2026 and will be posted on the Rural Health Transformation Program Grant Opportunities webpage.

RHIF Appeals

Background

The Rural Health Innovation Fund (RHIF) application process is a competitive grant which has eligibility rules. Upon submission and review of the intake assessment or the application, applicants can be notified of being ineligible or their application not being approved. If you are ineligible or your application was not approved, you may appeal. To appeal an ineligibility or non-approval determination of your RHIF application, you may follow the process outlined below.

RHIF Eligibility Criteria

Before submitting the application, please review the eligibility criteria immediately below.

1. Meet the definition of “health care organization” outlined in the North Carolina Administrative Code (NCAC) 10A NCAC 41A .0206(a)(1). Examples of some of the facility types which meet this definition are below.

  • Hospitals,
  • Physician practices,
  • Federally qualified health centers (FQHCs),
  • Rural health clinics,
  • Behavioral health providers, or
  • Any other organization that provides clinical care.

2. Facility location in one (1) of the 85 Federal Office of Rural Health Policy designated rural counties OR have 40% or more patients who reside in rural areas.

3. Not be under sanction or debarment from receiving federal funds by the United States Government System for Award Management (SAM.gov) or the North Carolina Division of Health Benefits (NC Medicaid).

4. Have a risk assessment rating of low or medium.

  • All recipients of federal funds are required to undergo a risk assessment. Risk assessment ratings can be low, medium or high.

Appeals Process

The appeals process is outlined below. Please note, the RHIF application evaluation process is the same for all applicants. Successful appeals should contain supportive or clarifying information not already submitted in the application process. If no such new information is presented, there is a high probability the determination will be unchanged.

1. Download the RHIF Appeals Form, Spanish version.

2. Gather your supporting information (3 pages maximum)

3. Fully complete all fields of the RHIF Appeals Form.

4. Submit the appeal to RHIF@nc.gov 

5. Await a determination via email (21 calendar days). 

Applicants have 21 calendar days from receiving the ineligibility or non-approval determination, provided via email, to appeal. If you are successful, you will be contacted via the email provided in the RHIF Appeals Form regarding next steps.

This project supports rural providers in adopting AI and emerging digital technologies by establishing the NC Rural Digital Health Collaborative (NCRDHC). The Collaborative will serve as a centralized resource to guide rural providers through the fast‑changing digital health landscape and help providers evaluate which AI and digital tools are safe, effective and sustainable for their care settings.

The NCRDHC includes two core components: a Rural Community of Practice and a Rural Technical Assistance Center. The Community of Practice will foster shared learning, collaboration and centralized support across rural health organizations. The Technical Assistance Center will offer hands‑on education, implementation guidance and real-time support to help providers adopt and monitor digital tools responsibly.  

The NC Health Information Exchange Authority oversees and administers North Carolina’s Health Information Exchange (HIE) Network also known as NC HealthConnex. NC HealthConnex is a tool to link different systems and existing HIE networks together to deliver a holistic view of patient records. It allows providers to access patients’ comprehensive records across multiple providers, as well as review labs, diagnostics, history, allergies, medications and more.  

Currently, only 41% of rural provider facilities with signed participation agreements are actively exchanging data. NCRHTP is focused on increasing rural provider participation in NC HealthConnex by addressing operational, technical and financial barriers that prevent providers from fully participating. This project will offer capacity‑building, tailored connection solutions, technical assistance, and strategic planning support to help providers implement and sustain high‑quality data exchange.  

The project also upgrades existing rural connections to meet data quality standards for accuracy, timeliness and completeness. Over time, this infrastructure will establish the foundation for rural precision medicine by enabling more targeted, data‑driven care. Learn more about the NC HealthConnex program on their NC Rural Health Transformation webpage.

Digital health literacy is critical for ensuring rural residents can fully benefit from technology enabled health services. Because in-person care is often limited in rural areas, this project focuses on helping patients confidently use telehealth, patient portals, health information exchange tools and digital questionnaires.  

The project is in partnership between the NCDIT Division of Broadband and Digital Opportunity and the United Way of North Carolina’s NC 211 program, which already provides multilingual, 24/7 digital navigation support. Together we will offer personalized, one-on-one training on essential digital health skills, provide digital health skills assessments and help connect residents to in-person digital health literacy support.  This support will be available beginning July 1, 2026. 

This project’s goal is to strengthen rural health care by integrating Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Hospital‑at‑Home and virtual‑first care models. It targets high‑risk patients with chronic conditions to improve access, patient flow and workforce efficiency in underserved areas.  

This activity will deliver RPM and CCM services that are fully integrated with NC HealthConnex. The program will begin with a pilot in a few rural provider settings before scaling statewide. Long‑term sustainability will be supported through reimbursement, optimized workforce models and standardized care pathways. This project also promotes patient-centered chronic disease management that empowers individuals to better manage their health.  

Stevens Amendment Disclosure: This webpage is supported by the Centers for Medicare and Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $213,008,356.47 with 100% funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government. 

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