Adoption Of Health Information Technology In Community Health Centers: Results Of A National Survey

Abstract

To the extent that health information technology (IT) improves health care quality, differential adoption among providers that serve vulnerable populations may exacerbate health disparities. This first national survey of federally funded community health centers (CHCs) shows that although 26 percent reported some electronic health record (EHR) capacity and 13 percent have the minimal set of EHR functionalities, CHCs serving the most poor and uninsured patients were less likely to have a functional EHR. CHCs cited lack of capital as the top barrier to adoption. Ensuring comparable health IT capacity among providers that disproportionately serve disadvantaged patients will have increasing relevance for disparities; thus, monitoring adoption among such providers should be a priority. [Health Affairs 26, no. 5 (2007): 1373-1383 10.1377/hlthaff.26.5.1373 E s t i m at e s o f health information technology (IT) adoption differ as a result of variable definitions, sampling techniques, and data quality; however, the broad consensus is that health IT-and electronic health records (EHRs) in particular-can greatly improve health care quality, safety, and efficiency. 1 The potential to reduce health disparities also has been frequently noted. 2 At least one recent study has documented significant quality improvements achieved by community health centers (CHCs) through the use of electronic patient registries. 3 New federal initiatives have also emphasized the critical role of health IT in realizing the future potential of genomic medicine to improve clinical care. 4 Recent analyses report adoption rates ranging from 9 percent to 24 percent, de-

Health Reform Holds Both Risks And Rewards For Safety-Net Providers And Racially And Ethnically Diverse Patients

“…Racial and ethnic minorities make up nearly two-thirds of the population served by these institutions. 4,6 Although many health care reform provisions support the goals of eliminating disparities and achieving health equity, the future of safety-net providers in this new environment is far from clear. Many opportunities may emerge that could strengthen the position of these hospitals and health centers.…”

“…However, safety-net providers, particularly health centers that serve disproportionately high numbers of uninsured people, are much less likely to have implemented technology such as electronic medical records than are hospitals, centers, or private practices with fewer uninsured patients. 6 And although financial incentives through Medicaid and Medicare are provided to encourage the use of electronic medical records at health centers, the costs of doing so exceed the available funding. 21 Similarly, safety-net hospitals with low or negative operating margins and few capital reserves may also be handicapped in their ability to adapt to or benefit from delivery and payment innovation.…”

Offering Annual Fecal Occult Blood Tests at Annual Flu Shot Clinics Increases Colorectal Cancer Screening Rates

“…[36][37][38] Electronic medical records with preventive health prompts that are accessible to nonphysician staff are becoming more common, even in safetynet settings. 39 We are studying these and additional adaptations to extend the reach and effectiveness of the fl u shot-FOBT program at the San Francisco Department of Public Health and in other clinical settings.In conclusion, annual fl u shot activities represent an opportunity for nonphysician staff to offer a FOBT to eligible patients who need it at a time when they are already thinking about annual prevention. Combining annual FOBT and fl u shot activities could become a powerful way to promote CRCS in primary care settings, especially in communities and clinics where FOBT remains the primary screening option.…”

Readiness for Meaningful Use of Health Information Technology and Patient Centered Medical Home Recognition Survey Results

“…Nearly a third of CHC patients have a chronic condition. 1 CHCs' EHR use has increased rapidly in the past years; in 2008, 49% of surveyed CHCs had full or partial EHR adoption, compared to 26% of surveyed CHCs in 2006 (Shields et al, 2007;Lardiere, 2009). HIT capacity at CHCs has been significantly associated with improved quality of care, as measured by patients' ease in getting a timely appointment for specialty care, patients' receipt of follow-up or preventive care reminder notifications, and CHCs' receipt of discharge summaries following their patients' hospital admissions (Frimpong et al, 2013).…”