All thought leaders and stakeholders consulted in producing this report agreed on the importance of focusing on health center networks as the locus of advanced health center adoption of IT. While the reviews from health centers regarding their network participation were not uniformly positive, most reported important benefits that networks have over individual health centers in leveraging IT. For example, respondents from HCN indicated that they can relatively easily convene senior executives from WebMD to negotiate around functionality and price, and usually get a swift response from the vendor when problems arise. HCN respondents also noted that they have worked extensively with WebMD to customize the application for health center uses and that the relationship has helped WebMD’s efforts to increase market share among health centers. The health centers involved agreed that it would be difficult to see WebMD developing this same sort of partnership with an individual health center.
Some reviewers have referred to selected health center networks as application service providers (or ASPs). ASPs are third-party organizations that manage and distribute software-based services and solutions to customers across a wide area network from a central data center. Unlike typical ASP’s however, health center networks investigated were in the majority of cases governed by the health centers themselves and did not operate as for profit-enterprises organizationally independent from their customers. While in the private sector market, ASPs are decentralized organizations providing a menu of services at fixed prices remotely, health center networks tend to work very closely with individual health centers and develop user fees and dues that accommodate health centers’ financial circumstances. Finally, beyond providing software and data management services, networks often provide additional services such as billing and accreditation. Among health centers visited for this project, the majority are investing in IT, at least in part, through membership in their local network.