Improving Patient Care at Community Health Centers Using an Electronic Health Record

Background/Purpose – The Primary Care Information Project (PCIP) seeks to improve population health through health information technology (HIT) and data exchange. PCIP facilitates the adoption and use of Electronic Health Records (EHRs) among primary care and specialty providers in New York City's underserved communities.

Methods – Community Health Centers (CHCs) receive Quality Improvement (QI) technical assistance after EHR implementation. The PCIP QI specialist provides them with summarized practice and provider level reports on how specific features of the EHR are used as well as whether patients are receiving recommended preventative care. Practices receive training using their real time EHR data to identify areas of where patient care can improve. Reports are created to stratify information by physician, patient race/ethnicity and insurance type, and list whether patients have met recommended treatment goals.

Results – Twelve CHCs with approximately 200,000 patients received monthly summarized reports. Challenges identified in quality improvement include: deficiencies in documentation, system functionality and data transmission. Seven CHCs are participating in an incentive program to track cardiovascular care and are regularly creating summary reports on their own. Practices learn to use the registry functionality and quality reports to track the care for diverse patient populations.

Conclusion – HIT has helped CHCs understand where patient care needs to improve. Practices are using these tools to track the delivery of patient care through team-based care strategies and providing performance feedback to providers. However, technical assistance is still needed to perform ongoing quality improvement to align with new policies like Meaningful Use.