To paraphrase Benjamin Franklin, rural communities “will all hang together, or else will all hang separately.” Networks and coops have historically been developed to address rural America’s most persistent problems. Farm coops, for example, were formed to deal with the financial challenges of small farmers during hard economic times. Electric coops, credit unions, school districts, and various other types of cooperative arrangements have become commonplace in this country, and widely acknowledged as efficient methods of problem solving.
Rural hospitals, clinics and other stakeholders have only recently begun thinking of collaborative ways to solve their most important challenges. Health coops, such as the Rural Wisconsin Health Cooperative, have been in existence since the late 1970s. Other networks were formed in the 1980s and 1990s, but it has been only recently that network development, partially sparked by rural health network grants funded by the Federal Office of Rural Health Policy, has gained momentum. The accepted wisdom now is that most hospitals and clinics are faced with two plausible alternatives: join a larger health system, or join or form a rural health network, governed by its members. Both options enable access to needed expertise, significant discounts, access to capital, education and peer support. Neither option constitutes business as usual for independent providers, and may well come with some loss of local control. Networks usually provide the option with most local control, but the challenge for the rural networks will be to build an extensive array of products and services, adequate to meet the most important provider needs.
March, 2012, saw the publication of a brilliant new book, entitled “Imagine," by Jonah Lehrer, which provides evidence of another major reason to network: innovation. According to Lehrer, who cites several recent studies, innovative adaption to our increasingly complex challenges requires frequent interaction and sharing among leaders who usually don’t work together. He cites networks of individuals with relatively weak ties (such as hospital networks that are horizontally structured) as three times as innovative as organizations that have limited ties with outside organizations. In other words, the weaker network ties enable sharing and improving of ideas and methods, which produces superior outcomes—three times that of the non-sharers. Lehrer offers Silicon Valley as an outstanding example of this principle. Starting with the Homebrew Computer Club started in a northern California garage, information technology innovation grew rapidly through an informal network of self-proclaimed computer nerds fully sharing ideas and approaches. In fact, Apple grew out of this type of networking and sharing, and Facebook’s Mark Zuckerberg moved to California from Boston to become part of that collaborative environment.
In short, collective wisdom far exceeds the wisdom of the sum of our individual parts. Networks, coops, and collaboratives will grow increasingly important as the world becomes increasingly complex. It is important that we build a national knowledge base of tools, methods, and models and other resources, so that networks can be more effectively formed and more efficiently operated. And, we must develop effective ways of managing and transferring knowledge, so that rural health networks across the country can learn from each other. Continued access to rural health services for millions of rural Americans may well be at stake.
