EHRs boost federal health center work

Study shows health IT adoption helped improve quality of care

Health IT adoption at Federally Qualified Health Centers (FQHCs) has yielded significant quality of care improvements, a new study has found, even as the health centers are still coming up to speed with meaningful use.

A study in the journal BMC Health Services Research examined 776 FQHCs using data from the Commonwealth Fund’s 2009 National Survey of Federally Qualified Health Centers, measuring the extent of electronic health record and health information exchange use and associated quality of care across several functions.

Columbia University public health policy professor Jemima Frimpong, along with researchers from the University of Alabama and Southern Illinois University, examined the centers by their level of health IT adoption and measured receipt of discharge summaries, frequency of patient reminders for preventive care and timely appointment for specialty care, finding an overall positive association between health IT use and quality of care.

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Using the Commonwealth Fund’s survey, Frimpong and colleagues measured access to care, care coordination across settings, quality reporting and improvement as well as the ability to serve as patient-centered medical homes. An FQHC having all hospital affiliations was associated with improvements in receipt of discharge summaries and specialty care scheduling.

At the same time, the researchers found, “nurse vacancies, greater proportion of minority clients, and geographic location outside the Northeast U.S. was associated with declines in receipts of discharge summaries,” amid physician vacancies and an increasing percent of Medicaid patients.

Frimpong and colleagues write that the current research shows an overall positive effect of health IT on care quality, and that their findings “indicate that future studies must look beyond the capacity of HIT and focus on specific aspects of IT that are more likely to lead to improvements in quality of care and ultimately clinical outcomes.”

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Their results also suggest that FQHCs could benefit greatly by developing more advanced IT functionalities. “Efforts to implement HIT must include strategies that facilitate the implementation of comprehensive and advanced functionalities, as well as promote meaningful use of these systems,” the researchers recommend.

Meaningful use of health IT and information exchange will be increasingly important for FQHCs in the coming years, the researchers noted. “In order for FQHCs’ to absorb the expected increase in demand and improve quality of care, they must leverage HIT as a tool for improving service delivery and patient outcomes.”