Electronic health information exchange in underserved settings: examining initiatives in small physician practices & community health centers

Introduction

Health information exchange (HIE) can improve both quality and safety in healthcare and is required by the Centers for Medicare and Medicaid Services (CMS) requires providers to meet Meaningful Use (MU) certification. Two underserved areas, small physician practices and federally qualified health centers, still do not have the ability to exchange data, making this potentially cost-saving measure, hard to achieve.

Methods

Data was collected via semi-structured interviews from Citrus Valley Health Partners (CVHP) and Federally Qualified Health Center Urban Health Network (FUHN) informants. Over 12 hours of interviews from 24 providers, administrators, and office staff in 16 practices and clinics was analyzed.

Results

The authors identified barriers and benefits in CVHP practices and FUHN clinics at three levels: intra-organizational, inter-organizational, and regional. Barriers (difficult integration, high prevalence of Epic EMR, as-needed approach, incomplete patient information in Collaborate use by CVHP, were most noticeable at the inter-organizational and regional levels and benefits (a complete patient record, timeliness, attractive user-interface, improved workflow, cost-savings) were most noticeable at intra-organizational level.

Discussion

This was among the first studies to look at the barriers and benefits of HIEs in the underserved areas of small physician practices and federally qualified health centers. The study identifies why HIEs may not succeed in these underserved areas.

Conclusion

The study identified barriers and benefits to HIEs in small physician practices and federally qualified health centers. The use of HIE in underserved areas is hindered by regional, inter-organizational, and intra-organizational factors.

Comments

This was an interesting article about underserved practices and clinics regarding HIEs and implementation. While HIEs can improve the quality and safety of healthcare, implementation in an underserved setting is hindered by several barriers that do not affect larger organizations. I would like more information and statistics on the success rate of HIE implementation at the small physician practice level and whether that implementation success was improved by increased incentives.