Difference between revisions of "Community EHR Models"
| Line 1: | Line 1: | ||
| − | For years the healthcare | + | For years the healthcare and information technology industries have urged adoption of electronic health records (EHR's) for all providers. A review of the literature suggests that many have tried; some succeeded, others failed. Often the industry's have provided information in support of EHR's in terms of subjective quality improvement initiatives or measures of obscure financial gain. In 2009, as World and the United States economies struggled, public policy strategies began to emerge aimed at curbing the increasing unemployment rate as well as encouraging fiscal restraint in the cost of healthcare. Within the economically stressed environment, several 2009 enacted public policies have energized the drive for adoption of EHR's; the question is how? Of the many approaches, one approach may be developing or joining a Community based EHR. |
Revision as of 13:32, 20 May 2011
For years the healthcare and information technology industries have urged adoption of electronic health records (EHR's) for all providers. A review of the literature suggests that many have tried; some succeeded, others failed. Often the industry's have provided information in support of EHR's in terms of subjective quality improvement initiatives or measures of obscure financial gain. In 2009, as World and the United States economies struggled, public policy strategies began to emerge aimed at curbing the increasing unemployment rate as well as encouraging fiscal restraint in the cost of healthcare. Within the economically stressed environment, several 2009 enacted public policies have energized the drive for adoption of EHR's; the question is how? Of the many approaches, one approach may be developing or joining a Community based EHR.
Each organization begins conceptualization often unaware that they need not go at it alone. In addition to recently established Regional Extension Centers whom provide a wide array of guidance, their are community organizations (many years to decades old) that may be available, or serve as a model for developing one in your own community. The focus of this article is to provide examples of organized Community EHR models. One is not better than the other; only one fits better than another given the environment it is or will be operating in.
The first organization to review is Oregon Community Health Information Network (OCHIN). OCHIN was established in 2000 following a State of Oregon sponsored study recommended enhanced use of information systems to improve organization, coordination, financial stability and management of safety net health centers [1]. OCHIN, a consortium of Integrated Practice Management (IPM) Partners and a larger group of non-IPM collaboration partners, began during an era in which safety net clinics where failing due to adverse business conditions created under Oregon Health Plan (OHP) Medicaid waiver 1115 program [2]. OCHIN, under the organization of CareOregon, received initial funding through a federal Health Resources and Services Administration (HRSA) Community Access Program (CAP), and with the funding hired OCHIN’s first staff [1].
OCHIN’s initial focus driven by the HRSA CAP funding was two fold: (1) drive improvements in safety net health center administrative systems and (2) collect and distribute high quality information on the health status and health care experience of vulnerable populations through a coordinated central data warehouse [1]. To reach the first goal, in 2001 OCHIN procured a sophisticated practice management (PM) system known as EPIC, which also included an electronic medical record (EMR) system [1]. The first PM system was installed 2002 with 3 more to follow that year [3]. As of October 2005, OCHIN continued work toward the second focus,
however it has not yet been achieved [1].
A review of OCHIN operations in 2005 found that although the various partners where dissimilar in infrastructure, they had similar motivations for partnering in OCHIN: Billing – OCHIN provides access to the reliable billing component of EPIC PM; Reporting – OCHIN provided EPIC capabilities enabled administrative reporting for the various grantors; Local training, support, and collaboration – OCHIN provided more responsive technical staff than experienced with other national practice management vendors; EMR – OCHIN’s plan to implement EPIC EMR [1].
OCHIN’s 2010 Annual Report [3] provides a snapshot of a decade of operations. In 2002 4 IPM’s had installed PM, whereas by 2010, there where a total of 37; In 2005 1 IPM had installed OCHIN’s billing services (OBS) as compared to 7 by 2010; and in 2006 3 IPM’s installed EHR's and by 2010 31 had been installed. OCHIN’s 2009 Annual Report [4] alluded to new challenges in 2010. In preparation, OCHIN changed it’s mission for a third time to read: We pioneer the best and most innovative use of information and information technology for the medically underserved. In addition OCHIN has established 2 operational Divisions to meet the new challenges: Practice-Based Research Network (PBRN) named Safety Net West established in 2007 a Community Health Applied Research Network (CHARN) [5];and Oregon Health Information Technology Extension Center (O-HITEC) an Office of the National Coordinator for Health Information Technology approved extension center [6].
