Generally speaking, the needs of CHCs are quite similar to mainstream, private practices: both have significant practice management and record-keeping needs. As a result, the most prevalent applications in use at CHCs are practice management and EMR systems. As expected, we also discovered that CHCs have some unique characteristics that complicate their needs when compared with private practices. These needs include special reporting needs (i.e. the uniform data set) and eligibility/coverage determination. In the paragraphs below we briefly describe the two prominent applications that are currently in use, or are being contemplated by CHCs, as well as CHC-specific data needs.
Practice Management Systems. From discussion with thought leaders and review of environmental scan materials, it appears that practice management systems are the most widely implemented recent infrastructure enhancement at many CHCs and networks and, as described above, are a focus of many grantees to the SIMIS or CAP programs. Furthermore, tailoring practice management systems for CHC-use has been a focus of some software vendors, most notably Medical Manager.
Electronic Medical Records. Like other providers, CHCs are cautious in adopting EMR software and integrating its use into every day practice. Thought leaders cite multiple specific challenges. These include the computer literacy of the providers and their overall comfort with using the technology; staff turnover that necessitates an ongoing training plan; the inefficiency of information transfer from existing medical records; and a hesitance on the part of some administrative staff and providers to invest in technologies that are still evolving and might quickly become obsolete or unsupported. However, once the EMR has been implemented, doctors and administrative professionals tend to be highly satisfied with the system, and especially appreciate EMR for preventing lost medical records and making the effort associated with losing this information a thing of the past, as well as the constant availability of organized, current information. There some CHCs that are working with EMR software both through the grant programs described above and through an EMR pilot study involving three California CHCs. A pilot study for EMR systems is currently being conducted by the Central Valley Health Network in Central San Joaquin, California. Three of the Networks 12 health centers, are participating in the pilot study: the Darin M. Camarena Health Centers; the Family Healthcare Network; and the Golden Valley Health Centers.
In addition to the pilot study in California, thought leader discussions revealed that other CHCs are also planning EMR system implementations. One example of this is planned implementation of an EMR program by the Oregon Community Health Information Network (OCHIN), a network of CHCs and other community provider stakeholders in Oregon, which they are attempting to fund, partially, through a SIMIS grant application.