CHCs in Southern New Hampshire organized CHAN in 1995 to strengthen their collective ability to provide comprehensive primary care to underserved populations. As we’ve seen with the formation of CHC networks in other sites, CHAN developed, partially, in anticipation of Medicaid managed care. Overall, respondents indicated that CHAN’s formation was aimed at:
- expanding health center capacity by hiring more physician staff and broadening services offered;
- ensuring implementation of health care “best practices” across all centers;
- preparing the health centers to deal effectively with the administrative and financial challenges of impending mandatory managed care; and
- improving the centers’ ability to track patient care and enhance quality of care.
Defying some predictions, NH Medicaid did not go to mandatory managed care in the mid-1990s. Even without substantial pressures related to managed care, however, CHAN members decided that collaboration was the best method to remain competitive and solvent. In particular, they saw great value in using the network to support, plan and implement improvements in IS used by health centers. Beginning in 1997 CHAN took advantage of state funds set aside to encourage community interagency collaboration. Two years later CHAN secured its first BPHC SIMIS grant allowing the organization to purchase centralized servers and other components of a network systems infrastructure. Subsequently, CHAN obtained additional grants from the state and BPHC as well as from private donors including corporations and local foundations.
While CHAN has long prioritized development of networked EMR and practice management applications, this goal has become a reality only in the last few years with the roll-out of GE’s Logician package for the EMR system and Millbrook for practice management. Currently, the services CHAN provides to its member health centers include:
- access to shared applications for practice management, EMR and accounting accessed through a Wide Area Network/virtual private network (WAN/VPN);
- technical and user support to health centers using shared applications;
- standardized care management for chronic illnesses including diabetes, asthma and hypertension;
- development of a triage support through a phone notes tool for use in all sites;
- annual survey of patient perceptions regarding quality of care and services provided;
- development of shared corporate management services including compliance and accreditation.
We discuss these services and the health centers’ experiences participating in CHAN in subsequent sections of this report.