Building clinic capacity for quality in Southern California: Improving the health of Southern California's safety-net population through the use of technology-enabled quality improvement strategies

Background: The Building Clinic Capacity for Quality program aims to improve the health of Southern California's safety-net population through the use of technology-enabled quality improvement strategies.

Objective: The first phase of this multi-phase program analyzed Community Clinics and Health Centers (CCHCs) current capacity for technology-enabled quality improvement and offered strategies for success, including organizational and technical interventions. The goal was to benchmark CCHCs to electronic health record adoption in order to understand health information technology opportunities that may be logical stepping stones to building capacity.

Methodology: Since electronic health record adoption is the most researched health information technology solution, as well as the “Gold Standard” application that is the focus of the national health information technology movement, the program evaluated CCHC participants' readiness for implementing and using an electronic health record. Specific technology-enabled quality improvement related categories were evaluated, four of which studied internal capacity. Criteria used to determine readiness included vision and leadership, quality improvement, people, process and finance, and technical capacity.

Results: Findings of overall readiness indicate that, across the 50 participating CCHCs in the program, the majority were not yet prepared for electronic health record adoption. Fifty-seven percent were found to be Not Yet Prepared; 41 percent were found to be Moderately Prepared; and two percent were found to be Highly Prepared.

Conclusion: Although most CCHCs would not have a high probability of successful electronic health record adoption today, there may be strong readiness for less complex health information technologies to achieve quality improvement goals and progress down the pathway. The findings also have implications on allocation of funding for health information technology -- technology alone is not the answer.