And More News.
- The April 2010 issue of Health Affairs has two articles on the use of EHR technology in the patient-centered medical home. Both articles show that current EHRs leave much to be desired as technology to provide aspects of the medical home. Bates and Britton provide a roadmap for how EHRs need to evolve to increase their effectiveness in the medical home (http://content.healthaffairs.org/cgi/content/abstract/29/4/614).
- Fernandopulle and Patel show that the use of a specific (though widely used and typical commercial) EHR in a large, not-for-profit health system in southern New Jersey do not facilitate medical home capabilities, especially in the treatment of patients with chronic diseases (http://content.healthaffairs.org/cgi/content/abstract/29/4/622). The relationship of EHR technology to both the meaningful use and medical home standards is critical for health centers, as FQHCs will be required to adopt certified EHRs in order for providers to qualify for Medicaid incentive payments. Adopting health centers and other organizations will face real challenges if this technology does not adequately support the medical home requirements.
- In addition, in an article in the same issue of Health Affairs titled “Easing The Adoption And Use Of Electronic Health Records In Small Practices” (http://content.healthaffairs.org/cgi/content/abstract/29/4/668) authors Torda, Han and Scholle note that in excess of $640 million over four years has been made available to establish a national program of Regional Health Information Technology Extension Centers. These centers are intended to help small practices adopt and become meaningful users of health information technology by providing technical assistance and guidance to practices. The authors conclude that the centers will need to provide more than just assistance with technical problems and further, will require additional funding after 2011. This article, based on a study of existing support programs, was published a few days before the Department of Health and Human Services released $267 million in funds from the Health Information Technology for Economic and Clinical Health Act for 28 regional centers, bringing the total number of centers to 60.
- The spring issue of the Journal of Healthcare Information Management (jhim Spring 2010 volume 24 / Number 2) has an article on the implementation of an ambulatory care EHR in a Health Center Controlled Network (HCCN) in New York City. The network consists of four FQHCs and 18 sites in the greater New York metropolitan area. The lessons learned in this implementation are important including: the need for clinicians to participate and lead in all phases of implementation, the need for early adopter organizations to mentor late adopting ones, the need to prepare and plan (and prepare and plan), the need to customize function for specific practices and workflows, the need to have lab interfaces planned as an early part of the deployment, the need to have an open communication policy for all participants, the need to present a common front to vendors and finally the need to collaborate in all aspects of the effort. A PDF of the article titled, A Health Center Controlled Network’s Experience in Ambulatory Care E H R Implementation: Lessons Learned From Four Community Health Centers by Nick Egelson et.al is “HRSA’s Office of Rural Health Policy released a new publication in April, titled “A Manual on Effective Collaboration Between Critical Access Hospitals and Federally Qualified Health Centers”. The intent of the manual is to illustrate how CAHs and FQHCs in close proximity to each other and serving similar communities, can coordinate to better meet community need. This timely and important manual is available at available here.