205 rural small and Critical Access Hospital IT, clinical, and financial users cite repackaged health-system solutions, misaligned implementation models, and limited vendor responsiveness to Rural Health Transformation Collaboratives NASHVILLE, TENNESSEE / ACCESS Newswire / January 16, 2026 / Black Book Research today released topline findings from a survey of two hundred rural small hospital and Critical Access Hospital (CAH) stakeholders spanning IT professionals and clinical and financial users assessing the value of Rural Health Transformation Collaboratives and whether technology vendors are solving rural-specific challenges or largely adapting solutions built for large urban health systems. Survey results indicate that rural providers continue to support modernization but remain concerned that many vendor solutions assume enterprise staffing, budgets, integration resources, and implementation capacity that are not available in rural markets. "Rural hospitals are not ‘small urban systems.'