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Use of IT more than doubled at community health centers since 2009, report finds

By Joseph Conn



The use of health information technology by federally qualified health centers has more than doubled since the advent of the federal electronic health record incentive-payment program, a report by the Commonwealth Fund suggests.

“Clearly, targeted federal funding and incentives have played a significant role in the widespread implementation of EHRs and advanced health information systems by FQHCs,” the report authors concluded.

The 10-page Commonwealth report, “The Adoption and Use of Health Information Technology by Community Health Centers, 2009–2013,” compares results from two surveys, one in 2009 as the federal health IT program under the ARRA was being organized, and the other between June and October 2013 as the incentive program was in its third payment year.

The more recent survey obtained responses to a 12-page questionnaire from 679 executive directors or clinical directors of FQHCs (out of a total of 1,128 centers nationwide).

According to the 2013 survey, 93% of respondents indicated their organizations had an electronic health-record system, up from 40% in the 2009 survey, while 85% had “advanced” systems (up from 30% in 2009) with at least nine of 13 key functions.

For example, in the 2013 survey, 91% had systems with e-prescribing, 87% had computerized order entry and 83% had alerts to warn a clinician of a possible drug-drug interaction; but only 35% could send patients electronic reminder notes for preventive or follow-up care.

Other interoperability functions were similarly scarce. Only 41% of IT systems in the survey, according to respondents, could electronically share lab results outside their organizations, 37% could provide medication lists and 34% could create a patient-care summary.

So far, 76% of FQHCs whose leaders responded to the survey have received federal EHR incentive payments with 51% of the leaders indicating their EHR system has the functionality they need to meet Stage 2 meaningful usecriteria.

By far, according to respondents, the most formidable barrier to using an EHR was the loss of provider productivity when making the transition, cited by 55% of FQHC leaders, followed by annual system maintenance costs, 44%; and staff training and the usefulness of templates for population management, each cited by 36% of survey respondents.

The Commonwealth Fund’s president is Dr. David Blumenthal, the former head of the Office of the National Coordinator for Health Information Technology, which, along with the CMS, are responsible for administration of the EHR incentive-payment program under the 2009 American Recovery and Reinvestment Act.

Thus far, the program has paid out $22.9 billion since its inception through March of this year.

Blumenthal is ranked 24th on this year’s Modern Healthcare list of the 50 Most Influential Physician Executives and Leaders. He was not listed among the report’s four co-authors.

Follow Joseph Conn on Twitter: @MHJConn

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