Health centers represent a critical resource for individuals and families who face barriers to securing medical insurance or seeking care through private providers. In FY 2003, health centers provided medical care to approximately 12.5 million Americans, the majority of whom live below the poverty level. In addition to assuring this population access to primary care medicine and ancillary services (such as radiology, clinical laboratories and pharmacy), health centers often link these individuals to Federal, state and local social services programs such as Temporary Assistance for Needy Families (TANF), Medicaid, mental health and substance abuse treatment, and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).1
In the past decade many health centers have served the growing national uninsured population comprised increasingly of immigrants and selected minorities while working with reduced Medicaid reimbursement rates and managed care. During this period, health centers have also increased their emphasis on quality improvement for care delivered to patients with chronic illness as well as more effective use of diagnostic and preventive services through participation in a variety of initiatives sponsored by BPHC.
Seeking to achieve administrative efficiencies, optimized reimbursement from third party payers, improvements in clinical decision-making, and better management of chronic illness, many health centers rely on IT applications such as practice management, electronic health records (EHR), disease registries, community-wide client tracking programs and health data repositories. Health centers seek to maximize gains from IT while navigating challenges related to selecting vendors, implementing and customizing the chosen systems, training providers in appropriate use of the systems, and complying with Federal health data standards and privacy rules.
This project is unique in that it provides policy stakeholders with a detailed understanding of health centers’ use of IT — including the challenges related to obtaining systems, funding IT, managing vendor products and relationships, training clinical and administrative staff to use IT, providing user assistance and the technical infrastructure to support IT and using information systems for overall quality improvement. This report comes at an opportune time as the nation’s leading policy makers have identified health IT as an important component to improving the quality and efficiency of care across the health care system. Health centers and health center networks described in this report represent an early laboratory for IT, and specifically health IT, implementation, use and impact among ambulatory health care providers. As such, we anticipate that findings from this study will not only inform efforts to improve health center use of health IT, but will provide guidance to providers, policy makers and other stakeholders interested in understanding the broad potential for IT to improve the way health care is delivered in the United States.