Adoption of EHR Systems in Community Health Centers: Lessons Learned and Best Practices

The health care “safety net” consists of a broad rage of health care providers that provide a substantial level of high quality community-based primary care and other related services to the under- and un-insured, Medicaid, and other vulnerable populations. An emerging issue is the increasing adoption and utilization of health management information systems to improve the quality of health care. Systems such as electronic health records (EHR) can enhance coordination and integration of services, increase organizational efficiencies, improve client and staff satisfaction, improve population health management, and establish comprehensive data repositories for data management. Information technology, along with increasing levels of health information exchange, has the potential to restructure and reform the safety net system, improving delivery of, and access to, health care services.

A multi-year initiative, funded through Kaiser Permanente Northwest and the Northwest Health Foundation, is supporting the implementation of electronic health record systems in three community health centers (CHC) in the Portland, OR metropolitan area. An evaluation team is studying the organizational impact and challenges with adoption of an EHR within these CHCs. To date, findings of this study have identified and improved our understanding of the unique and complex organizational barriers and challenges to EHR adoption faced in CHCs. These key barriers and challenges have been assessed during multiple phases of EHR adoption: (1) Decision-making; (2) Pre-implementation; (3) Implementation; and (4) Maintenance and optimization. This presentation will highlight findings of the study and explore promising practices for successful EHR implementation and sustained operation in CHCs.