Tuesday, December 16, 2014

How Can an FQHC Use Health IT to Improve the Quality of Care?

Background

The Health Resources and Services Administration (HRSA), www.hrsa.gov, an agency of the U.S. Department of Health and Human Services, is the primary Federal agency for improving access to health care by strengthening the health care workforce, building healthy communities, and achieving health equity. HRSA’s programs provide health care to people who are geographically isolated, economically or medically vulnerable.

Federally Qualified Health Centers (FQHCs)
are health care organizations that meet certain criteria under the Medicare and Medicaid Programs and receive funds under the Health Center Program of HRSA’s Bureau of Primary Health Care (BPHC). FQHCs provide comprehensive, culturally competent, quality primary health care services to medically underserved communities and vulnerable populations.

Health Center Controlled Networks
(HCCNs) are networks of health centers working together to improve access to care, enhance quality of care, and achieve cost efficiencies through the provision of management, financial, administrative, technological, and clinical support services. Most HCCNs are heavily engaged in clinical quality improvement, technology, and project management services.

Primary Care Associations
(PCAs) provide advocacy, training and technical assistance to health centers and other “safety net” providers (a system of health care providers that primarily serve patients who otherwise cannot afford or gain access to care); support the development of health centers in their state; and enhance the operations and performance of health centers.

HCCN Grant Project Overview

HRSA awarded a total of $18 million over three years to thirty seven HCCNs for a grant project that started December 1, 2012. This grant aims to improve the quality of care at more than six hundred community health centers through the adoption and meaningful use of certified electronic health record technology and technology-enabled quality-improvement strategies in health centers. For this grant project, some HCCNs partnered with their sibling PCAs to leverage resources in order to deliver the best possible results.

The grant project activities include:

1.       Adoption and Implementation: activities to assist participating health centers with effectively adopting and implementing certified Electronic Health Record (EHR) technology at all sites by the end of the project period.

2.       Meaningful Use (MU): activities to support participating health centers in making the necessary technical upgrades and workflow changes to meet meaningful use requirements and access incentive payments under the Medicare and Medicaid EHRs Incentive Programs.

3.       Quality Improvement (QI): activities to advance participating health centers’ QI initiatives to improve clinical and operational quality, reduce health disparities, improve population health through Health IT, and achieve Patient Centered Medical Home (PCMH) recognition.

In addition to measuring the annual progress of adopting and implementing EHRs, attesting for MU Stages 1 and 2, and achieving PCMH recognition, the following Clinical Quality Measures (CQMs) are monitored for each health center (note: annual progress is measured using the Health People 2020 Goals which are in parentheses):

1.       Hypertension Control (HDS12: 61.2%)

2.       Childhood Immunization Performance Rate (IID8: 80.0%)

3.       Start of Prenatal Care (MICH10.1: 77.9%)

4.       Low Birth Weight Statistics (MICH8.1: 7.8%)

5.       Diabetes Control (Complement of D5.1: 83.9%)

6.       Cervical Cancer Screening (C15: 93.0%)

7.       Tobacco Screening (TU9.1: 68.6%)

8.       Tobacco Cessation Counseling (TU10.1: 21.1%)

Sustaining the Activities of the HCCN Grant Project

As part of the QI effort, several of the HCCNs have implemented a Data Warehouse and/or Population Health Management System as one of the grant project activities. There are also activities for ensuring HIPAA compliance. These data tools and HIPAA compliance activities along with the MU and PCMH efforts need to be continued well beyond November 30, 2015, which is the end of this grant project.

HCCNs will be exploring additional funding opportunities to sustain these all-important QI activities that use Health IT tools. The lessons learned and best practices that have emerged from this grant project will be instrumental in continuing to improve the quality of health care for the patients served by the health centers. After all, it’s all about continuing to improve the quality of patient care!

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