Electronic Health Records

Adoption & Implementation News

From EHR Use to Information Exchange for Community Health

Enabling community health centers to leverage health information exchange has the potential to help whole patient populations.

By Kyle Murphy, PhD

Community health centers rely on EHR use for providing care to high-risk patient populations and reporting required quality metrics for the purposes of certification or grant funding.

The Massachusetts League of Community Health Centers is looking to do one better by connecting the various EHR technologies at use in its 49 member sites to the state's health information exchange and each other.

"Health information exchange is critical as I envision it for quality of care in the short run now as well as the long run," Executive Vice President and Chief Operating Officer Ellen Hafer, MTS, MBA, tells EHRIntelligence.com.  

Much of those benefits revolve around connecting disparate aspects of the care continuum at the community-health level.

"Community health centers are often independent organizations," Hafer continues. "They do offer integrated care, but it's often across the spectrum of clinical specialties like behavioral health or oral health but not necessarily the full complexity of medical specialties."

Most recently, Massachusetts League of Community Health Centers has worked with healthcare IT consultants eMedApps to pilot interfaces for its members to use in connecting to Mass HIway, the Commonwealth's official HIE.

"One of the core projects is to use it to partner and connect with our state health information exchange," Hafer explains. "eMedApps has worked with us and we're working with a group of health centers on NextGen with the hopes that we can replicate it with other systems. They're helping us to connect and exchange data to make that interface work."

The recent focus on health information exchange follows years of work on EHR use by community health centers. One of Hafer's main goals in her role at the state primary care association was 100-percent EHR adoption, a process that has revealed stumbling blocks.

"One of the stumbling blocks we walked into was the weakness of EHRs around reporting, especially because community health centers are early adopters of population health management and have grants that require good quality reporting," she adds.

Many community health centers function as federally quality health centers (FQHCs) and the state primary care association has worked closely with them to satisfy the requirements necessary for maintaining their official status. What's more, the reliance of several community health centers on grant funding also provides an impetus for building out a robust health IT infrastructure for fulfilling quality reporting expectations.

This led the Massachusetts League of Community Health Centers to stand up a centralized data repository.

"We got into that space fairly early, so our next evolution of work since 2007 was the creation of a centralized data warehouse where we capture data from different EHRs and create web-based reporting solutions for them to use to manage quality," says Hafer.

The evolution from EHR use to health information exchange brings with it a need for improved connectivity that will allow community health centers to meet the needs of their patients.

"Even in a state that's highly insured, we're still on average dealing with the 15-percent uninsured," Hafer explains. "That creates barriers for people in terms of where they might go and care coordination. The more we can do to make sure we have good health information exchange where patients do land and that other specialists would have access to us and the information we have in a timely fashion at points of service — that's important."

The state primary care association has set out to connect its member facilities to emergency departments and other costly service sites to steer patients toward primary care and prevention. The work has also raised the need for connecting these facilities with community liaisons to spread the message to patients more effectively.

"We're also engaging more community health workers in outreach so that we get improved compliance with patients on both utilizing resources to augment medical interventions. We need community activity interventions as well in many cases," Hafer notes.

Akin to non-acute care providers across the care continuum, community health centers have all the motivation required for connecting with primary care and other mainline care settings. The challenge remains making these connections efficient and effective.




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