With all the chatter about electronic
health records (EHRs) and their adoption by physicians and hospitals, there is little
buzz about EHR integration into the backbone of the health system safety
net—community health centers (CHCs).
Since they don't display a big neon "CHC" sign on their facility doors, they are often little known except to the patients who rely on their services, typically the uninsured or those receiving Medicaid or other public insurance.
However, those inside the health care industry and policymakers are fully aware of CHC services and understand their role in supporting primary care services to
communities in need who operate with inadequate staffing and funding. So with limited resources, using new technologies such as EHR's to gain
efficiencies for these key providers of health care would make good ‘cents’—simply
because it is directly tied to taxpayer dollars...right?
Wrong, there is little talk
about these specific providers and how the American Reinvestment and Recovery
Act (ARRA)—the stimulus package—supports or hinders their care
provision and overall operation in terms of the EHR sales pitch by the Fed. While there are funds for CHCs—over $3 billion—the focus is on keeping these providers afloat rather than making
strides in efficiency and quality of care that are promised by the EHR upgrade.
Some states, however are bucking the trend and are attempting to transition their vulnerable
population providers to a more tech savvy work environment. They, like their
private player peers, are hopeful that EHRs will be the ‘end all’
in jumpstarting habits that generate efficiency and long-term cost savings.
Of
course, there are blips along the way. A study by California Health Care
Institute reports that there are substantial financial hurdles for CHCs in the
adoption of EHRs simply because the revenue pay-back is not there as it is for
private providers. The reimbursement mechanisms for a CHC are different than a private practice
due to the composition of patients (unique billing systems for Medicaid, the uninsured,
and multi-language needs, etc.). However, there are tremendous quality
benefits to EHRs such as safety in prescribing, less redundancy, and
coordination of care. For many vulnerable patients, these small changes can reduce frequency of visits and improve care giving.
But for most CHCs, funding from the stimulus
package is aimed at simply keeping the doors open and not on growing the technology
capabilities of the operation through EHR adoption. It should be noted
that many CHCs are highlighted as recipients of stimulus funding in order to
save themselves from closing. Just this week, the Lehrer News Hour
spotlighted a health center in Lorain, Ohio that benefited from ARRA
funding and there are over 1200 nationally that are receiving federal
assistance.
With an increasing demand for CHC services as more people
lose insurance due to job loss, health care reform that promotes technology adoption without CHC integration fails to hit the mark.
More on EHRs:
[+] Choose your electronic health record carefully
[+] Doctors aided by emerging offshoot of EHR softwarem
[+] EHR standards committee meets and prepares to sprint