Given that formal assessment of IT use among ambulatory health care providers is still at its early stages, ASPE specified a multi-tiered qualitative approach to data gathering and analysis for this study beginning with an environmental scan where existing literature was reviewed and thought leaders were consulted. We then conducted detailed case-based data collection among health centers and stakeholders in seven geographic locations and analyzed findings across the entire study.
Because this is a qualitative study of providers and networks at various stages of IT adoption, we emphasize similarities and differences across different models for IT adoption as well as the facilitators, barriers, challenges and opportunities specific to each model and to IT use in general. Findings are framed as potential lessons learned relevant to the desirability, sustainability and replicability of the various approaches encountered in our study. The remainder of this report is organized as follows:
- Study Methods. We begin with a brief discussion of the overall approach and specific methods used to collect and analyze information gathered during the two main phases of the project: the environmental scan, which included in-depth discussions with sixteen thought leaders as well as a review of existing documentation, and seven case studies comprised of telephone and in-person meetings with 120 respondents across 38 health centers and seven health center networks.
- Background. We follow the methods section with a brief overview of the health center landscape, including the health center program’s history, funding structure, special issues and challenges for health centers, and the rise in IT adoption by health centers. We also present key themes and conclusions drawn from the environmental scan, which informed the design of and findings from the seven case studies.
- Health Center Network-Level Findings. We begin our discussion of findings from case studies by presenting findings at the level of the “leading edge” health center networks, including the impetus behind their development, key characteristics and trends, the benefits of network membership for health centers, and ongoing challenges for networks.
- Health Center-Level Findings. Next, we review the IT status and experience of individual health centers, including their approach to IT infrastructure (staffing, resources), uses of IT, including health IT, and participation in health center networks.
- Conclusions. We conclude the Final Report with a discussion of broad conclusions following from the environmental scan activities and the seven case studies. These conclusions include lessons learned from the experience of health centers and health center networks implementing IT and implications of these findings for key stakeholders such as policymakers and other providers.