As with other community provider networking activities, the success of SKYCAP depends largely on active participation from community-based providers. In addition to technical challenges related to provider participation, network organizers face the challenge of assisting local providers to incorporate use of their application into the daily routine of administrative and clinical staff. In this section we summarize health center experience using the SKYCAP navigation services and client tracking systems both technically and on an organizational level.
Community Partnerships. Stakeholders generally reported that SKYCAP fostered a greater level of communication between hospitals, physicians and FHNs in the community. Most stakeholders felt that the human component fulfilled a need for greater communication between these parties in their care of a common client population. For example, participants noted that FHNs can pass on valuable information to physicians about a client’s home environment such as their need for transportation, housing or treatment they received from another provider. One respondent offered that the electronic tracking component facilitated this inter-provider communication by revealing within a client’s record all their previous episodes of care, in emergency room, mental health and primary care settings, so that providers who saw the same patient could consult each other about the most effective treatment strategy.
Provider Buy-In. Most physicians initially bought-in and continued to believe that SKYCAP provided benefits in terms of increased provider communication and networking. They also believed that viewing information in the SKYCAP client record before seeing patients had the potential to improve care and coordination. However, many providers noted that the latter goal has been a challenge to pursue in practice due to the system’s incompatibility with workflow. Since physicians had to note that their patient was a SKYCAP client and then go to a separate office to pull information from the terminal, the process became too time intensive and inconvenient to perform on a regular basis. One physician who did use the system on a regular basis found it useful to have access to the client information before the appointment so that he could anticipate any potential drug interactions or other conditions that might affect his treatment plan. Most of the respondents recognized the population-level data possibilities that the MIS system could contribute in theory, however, with the exception of FHNs, they rarely made use of the system to its full potential in practice. SKYCAP leadership recognized this as a “lesson learned” and hopes to increase provider use of the system by making it internet accessible in the future.