NORC at the University of Chicago (NORC) is pleased to present this report detailing findings from our recent case study looking at use of health information systems by rural ambulatory care safety net providers in and around Hazard, Kentucky. This case study is part of “Community Health Center Information Systems Assessment: Issues and Opportunities” a project being conducted by NORC under contract with the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services (HHS). In collaboration with ASPE, the Health Resources and Services Administration (HRSA) and its Bureau of Primary Healthcare (BPHC) provide technical direction for this project.
The Kentucky case study involved telephone and e-mail exchanges with 14 respondents representing nine institutions involved in the primary health care safety net in Southeastern Kentucky. Overall, the site visit explored two main themes: (1) the state of information systems use among ambulatory care safety net providers in southeastern Kentucky, and (2) stakeholder experience with the Southeastern Kentucky Community Access Program (SKYCAP) a community-based rural health outreach and client tracking system initiated as a rural demonstration project in September 2000. SKYCAP aims to improve access to health care, social services, and housing for the underinsured and uninsured residents of Harlan, Perry, Knott and Leslie Counties in Kentucky. Findings presented here will be combined with those from other case studies and site visits to inform a final report on the use of information systems in community health centers and other ambulatory care settings. The remainder of this report is organized into four main sections:
- Background and Methods. This section describes key features of the site visit including background on the safety net in the State of Kentucky and the four-county SKYCAP service area along with a description of the stakeholders who contributed to our findings.
- Consortium Activity. This section describes the development and organization of SKYCAP including an overview of the information systems currently used by the consortium.
- Provider Information Systems (IS) Capacity and Experience. This section summarizes findings relevant to the overall state of health information system use among safety net ambulatory care providers interviewed for this study. We will also review the provider experience working with the SKYCAP program.
- Conclusions. Finally, we present a set of conclusions that explore issues related to the sustainability and replicability of the SKYCAP model and challenges facing consolidated health centers and other safety net stakeholders in Kentucky.