Community Health Center Information Systems Assessment: Issues and Opportunities. Final Report. 1. Introduction

10/30/2005

NORC at the University of Chicago (NORC) is pleased to present this report detailing findings from our recent site visit to Florida for “Community Health Center Information Systems Assessment: Issues and Opportunities.” NORC conducted this site visit 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).  The Health Resources and Services Administration (HRSA) and the Bureau of Primary Healthcare (BPHC) work in conjunction with ASPE to guide activities under this project. Findings presented in this report describe the information systems capacity of consolidated health centers and safety net hospitals in Florida focusing on health centers affiliated with the Health Choice Network (HCN), a consortium of independent Community Health Centers and affiliates.

Site Visit Methods

With a diverse population of approximately 16 million, Florida is the nation’s fourth most populous state.  The state has numerous community health centers, many of which belong to one of two major consortia, the Health Choice Network (HCN) and the Community Health Centers Alliance (CHCA).  This report focuses on HCN, the larger of these two consortia, which serves pproximately 350,000 patients annually at 10 centers across Florida and at affiliated centers in Utah (7) and New Mexico (6).  HCN is a non-profit health center governed network that provides information systems (IS) and administrative services to its member health centers using a centralized model.

The site visit to Florida, which took place on September 8th and 9th, 2004, involved initial telephone and email contacts followed by in-person interviews with eighteen respondents representing six institutions involved in the state’s primary health care safety net, as well as telephone meetings with two representatives from a seventh institution on October 6th. Table 1 below lists all health centers and other stakeholders interviewed as part of the site visit and follow-up telephone calls.

Table 1. Florida Site Visit Respondent Organizations
Respondent Organization Description
Health Choice Network (HCN) HCN is a network of 10 health centers in FL, plus 7 in UT and 6 in NM. The network provides a centralized IS and administrative services to member health centers.
Community Health of South Dade (CHI) CHI provides comprehensive primary and behavioral health services, including pediatrics, dental, vision, lab and pharmacy services.  It served approximately 40,000 patients in 2003 at its 12 sites. 
Camillus Health Concern (CHC) Sponsored by the US Catholic Church, CHC has been a BPHC Healthcare for the Homeless grantee since 1989, and provides services at four sites, seeing approximately 5,200 patients in 2003. 
Helen B. Bentley Family Health Center (HBB) HBB provides primary and some specialty services, including pediatrics, dental care, vision, and social services at its 2 sites, seeing approximately 12,500 patients in 2003.
Economic Opportunity Family Health Center (EOFHC) EOFHC provides primary care services, including dental and vision, at its 19 sites serving approximately 26,000 patients in 2003.
Broward Community & Family Health Centers (BCFHC) BCFHC provides primary care, including pediatric, geriatric, lab and pharmacy services, at its 2 locations and approximately 3,000 patients in 2003.
Family Health Centers of Southwest Florida (FHC) (Interviewed by telephone conference) FHC provides family health services, including OB-GYN, dental pediatrics, vision and social services at its 12 sites for approximately 46,500 patients (2003).   

Telephone and in-person interviews with respondents were conducted using open-ended discussion guides, providing a consistent structure to each exchange while allowing sufficient flexibility to capture all relevant information from respondents. In addition, a table shell was emailed to information systems staff at respondent health centers prior to the site visit to facilitate collection of standard information relating to infrastructure and technical capacity. For each scheduled site visit interview, the NORC team prepared materials that outlined our preliminary knowledge of the respondent and highlighted outstanding questions to address during the interview.

The remainder of this report is organized around findings from site visit activities related to HCN evolution, activities and governance model as well as the IS infrastructure and experience of health centers in South Florida. We end the report with a series of conclusions highlighting issues relevant to the effectiveness, sustainability and replicability of the approach represented by HCN.

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