Because the body of literature relevant to IT use and adoption among health centers is relatively limited, we conducted an environmental scan, completed between February and September 2003, which included review of both published and unpublished materials relevant to key study topics. Materials summarized in the environmental scan were gathered through formal searches in health services research databases such as PubMed, paired with searches of popular, non-peer reviewed publications using Internet search engines such as google.com. Searches were conducted using a range of subject-level key words crossing “community health centers” or “FQHC” with words such as “information technology”, “HIPAA”, “practice management”, and “electronic medical or health records”.
Additional sources were identified by contacting individuals at relevant organizations to gain access to unpublished information or publications that were not readily available through public sources. These organizations included HRSA, BPHC, the National Association of Community Health Centers (NACHC), state level primary care associations (PCAs) and others. Overall, we reviewed content from over 100 documents including peer-reviewed articles, market reports, program notices, government evaluations, provider association newsletters, requests for application and other relevant sources.
In addition to review of secondary sources, the environmental scan included loosely structured, one hour discussions with thought leaders in the field of IT and health centers. The 16 thought leaders included consultants working with health centers, health center staff, network representatives, associations and Federal government officials from BPHC and the Veterans Health Administration.
Finally, the environmental scan included a targeted analysis of four practice management systems that cater to the health center market. On direction from ASPE, we focused on practice management because at the time that the environmental scan was conducted in 2003, relatively few health centers or health center networks had made substantial progress with EHR — with increasing EHR activity as the study progressed. Discussion of practice management systems for the environmental scan was based on a detailed review of vendor websites and targeted thought leader discussions. The full environmental scan report is included in this report as Appendix A with key findings highlighted in the Background section of this report.