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Progress in Electronic Health Record Implementation Through HRSA Grants to Health Center Controlled Networks

WHY WE DID THIS STUDY

One goal of HRSA is to ensure that all of its health centers implement health information technology (HIT), including electronic health record (EHR) systems. Since 2007, HRSA has awarded $176.9 million in grants to networks of health centers known as health center controlled networks (HCCNs) to support this goal through the acquisition, implementation, and "meaningful use" of EHR systems. To assess the grants' contributions toward HRSA's HIT goal, we assessed health centers' progress in using HRSA grants-funded by the American Recovery and Reinvestment Act (ARRA)-to implement EHR systems that support meaningful use. HRSA did not require demonstration of meaningful use as a condition of the grants, but has stated that Stage 1 meaningful use objectives, as set forth by the Centers for Medicare & Medicaid Services, are a reasonable baseline to assess health center progress in implementing EHR systems. We also did this study to determine whether health centers face challenges related to the financial sustainability of their EHR systems.

HOW WE DID THIS STUDY

We surveyed health centers that participated in HRSA's ARRA-funded HCCN grant projects that supported EHR implementations and enhancements. Using survey responses, we determined the extent to which health centers established the capability for the Stage 1 meaningful use objectives. We also determined whether health centers reported facing challenges related to the financial sustainability of their EHR systems. To supplement the survey responses, we reviewed grantee progress reports and conducted visits at 11 health centers.

WHAT WE FOUND

Most health centers established the capability for meaningful objectives related to capturing data. However, fewer health centers established the capability for meaningful use objectives related to sharing data. Establishing the capability for objectives relating to sharing data often requires health centers to incur additional EHR-related costs. Although 76 percent of health centers reported facing financial sustainability challenges, grantee progress reports contained limited information related to the financial sustainability of EHR systems at health centers.

WHAT WE RECOMMEND

We recommend that HRSA (1) use data to understand progress towards meaningful use objectives and to provide guidance and technical assistance to health centers, (2) ensure that HCCN grantees provide information on the financial sustainability of EHR systems at health centers, and (3) examine the feasibility of collecting information directly from health centers regarding the financial sustainability of their EHR systems. HRSA concurred with all of our recommendations.