Findings from the case studies are analyzed on two levels: the health center network level and the individual health center level. Overall, the case study findings provide insight into why leading edge health centers and health center networks wanted to invest in IT and what they experienced. In doing so, the findings offer substantive guidance for ASPE and HRSA with regard to policy on IT adoption among health centers. Key themes emerged in several areas.
First, it is clear that several health center networks, formed in response to an increasing emphasis on decreasing the cost of care, have relied on the coordination of IT services as an important strategy for meeting efficiency objectives and providing value-added benefits for their members. Network models, goals, and provision of services differ substantially, with some adopting an incremental approach in rolling out practice management systems for their members and then moving to electronic health records (EHR), while others adopt EHR first or concentrate on building community data warehouses.
Core network functions include convening local stakeholders, directing vendor selections, centralizing IT implementation and support, and administrative management. Many health centers reported receiving considerable benefits from their network membership, but positive experiences were not universal and we observed that networks face ongoing challenges in maintaining buy-in from their stakeholders and ensuring long-term sustainability.
Health centers in general are increasing their centralized planning for and investment in IT systems. Access to systems is widespread, although the majority of health centers we spoke with had acquired such access through their local health center network. The predominant uses of IT include practice management systems, which are perceived to promote financial stability and efficiencies, and EHR systems, which address quality of care, disease management, and practice workflow. Buy-in for adoption of both these technologies is widespread among health centers, and satisfaction with the applications implemented among the health centers we spoke with was overall high.