How can informatics improve health center operations?

Challenge

The Health Resources and Services Administration’s (HRSA’s) Bureau of Primary Health Care (BPHC) funds about 1,400 health centers, which run more than 15,000 service sites in all U.S. states, territories, and the District of Columbia. In 2023, more than 31 million people went to health centers, totaling 132.5 million visits; 90% of these patients were at or below 200% of the federal poverty level. Despite being a critical component of the U.S. health care system, health centers struggled with funding, constant provider turn-over, and understaffing. A particularly challenging area for health centers, similar to many U.S. provider practices, is the lack of support for health information technology (known as health IT or HIT) and clinical informatics.

The proper use of health IT is recognized as core to optimal health care operations. Informatics tools such as clinical decision support systems help providers choose the best treatment for patients. Patient portals and telemedicine are also essential patient support tools, especially, during times of increased need. BPHC envisioned creating a national entity to provide informatics expertise to health centers to more easily integrate health IT, optimize health center operations, and incorporate best clinical informatics practices.

Solutions

ESTABLISHING A NATIONAL RESOURCE CENTER

Westat supported JSI to co-found the HITEQ center in September 2015 to support health IT in health centers. The HITEQ Center is a National Training and Technical Assistance Partner (NTTAP) that collaborates with HRSA partners, including Federally Qualified Health Centers (FQHC), Health Center Controlled Networks (HCCN), Primary Care Associations (PCA), and other NTTAPs, to help health centers optimize health IT for addressing key needs. HITEQ’s services are free for health centers and partners and include a comprehensive national website (HITEQ Center.org) offering tools, resources, interactive data dashboards, self-paced learning opportunities, and event information.

The HITEQ Center also provides learning collaboratives focused on advancing health IT, telehealth, and interoperability, along with monthly national webinars and regional or national workshops aimed at building knowledge and skills. Current topics include health IT-enabled quality improvement, electronic health record (EHR) selection and implementation, health information exchange, advancing interoperability, health IT/QI workforce development, value-based payment, privacy and security, electronic patient engagement, population health, and telehealth.

TAILORING RESOURCES TO THE SECTOR

A key activity of this work has been developing health IT-related content, toolkits, presentations, and training materials that support health center TTA efforts. To date, the HITEQ Center has published more than 2,000 resources that have been accessed over 10 million times, including more than 100,000 resource downloads.

A major component was to customize national resources created for the health care sector at large, or even those addressing large academic centers and teaching hospitals, and transform them to the needs and constraints of the health center environment. The HITEQ team took federal resources such as the ASTP/ONC SAFER guides and adapted them to the health center context.

To further address the reporting needs of health centers and their supporting organizations, HITEQ has also adopted Google marketing metrics and commercial training costs to develop a HRSA-approved return-on-investment (ROI) model to demonstrate the value of HITEQ and similar organizations that provided training, resources, and web presence on behalf of federal agencies and initiatives.

CONDUCTING TARGETED TRAINING

An initial focus of the HITEQ Center was to support health centers in meeting Meaningful Use requirements and receiving EHR incentives. The HITEQ Center reached out to every health center that had yet to receive Meaningful Use incentives and provided technical assistance for meeting requirements wherever possible. This effort continued with promoting interoperability support, as well as health center-specific cybersecurity training in both preparedness and incident response. More recently, HITEQ provided national, regional, and local training to help health centers understand information blocking and the required policy and workflow changes.

To address health center-specific concerns, HITEQ also hosted webinars addressing special topics. Since 2024, over 100 TTA activities were conducted through webinars, learning collaboratives, technical support, and online resources that include topics, such as:

• Preparing Your People, Processes, and Technology for UDS+ and Other Patient-Level Reporting
• Crossing the Chasm of Innovation: One FQHC’s Journey to Operationalize Its Telehealth Strategy
• Security Risk Assessment
• Patient Portal Best Practices: Engaging Patients to Improve Access for All
• Advancing the Use of SDOH Data to Support Value-Based Care
• Complying with Security Incident Procedures Standard: Creating and Maintaining an Incident Response Strategy
• Advancing Interoperability and Health Information Exchange for Health Centers: An Overview and Discussion on Enhancing Health Outcomes with the Oklahoma MyHealth Access Network
• Mobile Health, Third-Party Apps, and Security
• Integrating Patient Self-Monitoring Blood Pressure Within Office-Based Hypertension Management

Results

HITEQ addresses many of today’s challenges:

• Optimizing EHR use: Many health centers struggle with maximizing EHRs for clinical and operational improvements.
• Health IT adoption and interoperability: Assisting health centers in integrating and effectively using health IT to ensure data sharing across systems.
• Data reporting and quality improvement: Helping health centers use data for performance measurement, population health management, and meeting reporting requirements like UDS (Uniform Data System) and value-based care metrics.
• Cybersecurity and data privacy: Providing guidance on protecting patient information and complying with HIPAA regulations.
• Patient engagement and telehealth: Promoting digital tools that enhance patient access, such as patient portals, telehealth, and remote monitoring.
• Workforce training and capacity building: Helping staff at health centers build IT skills and knowledge to use health data effectively.