America’s Voice for Community Health Care

The National Association of Community Health Centers (NACHC) represents Community and Migrant Health Centers, as well as Health Care for the Homeless and Public Housing Primary Care Programs and other community-based health centers.

Founded in 1971, NACHC is a nonprofit advocacy organization providing education, training and technical assistance to health centers in support of their mission to provide quality health care to medically underserved populations.

The NACHC Mission

To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved populations.

For further information about NACHC and America’s Health Centers

Visit us at www.nachc.com

A National Community Health Center Perspective

Issues & Challenges for Medicaid Eligible ProvidersFrom AIU to Stage 1 Meaningful Use

Shane C. Hickey, MBA, MSDirector, Information Technology AssistanceNational Association of Community Health Centers

3/16/2012

Health Center Strategic Priorities

EHR Adoption Among Health Centers

Source: 2010 HRSA BPHC UDS Data

Outreach to 35% of Non-Adopters

Primary Goals & Objectives

Issues and Challenges from Prior Non-Adopters

Issues and Challenges from Prior Non-Adopters

Health Center Issues & Barriers from a National Regional Extension Center Perspective

Courtesy of:

REC Sites By Barrier Type Reported

Data Source: ONC CRM Database (March 3, 2012).

Top Five Barriers for CHCs(Proportion of Providers Impacted)

Rank CHCs

1Administrative

2

MU Measures

3Certification

4Medicaid

5

Vendor Selection

# providers with barrier reports 2921

Data Source: ONC CRM Database (March 3, 2012). Non-priority hospitals did not report any barriers.

Attestation Process Practice Issue Vendor IssueMU Measure

Top Five MU Measure-Specific Barriers for CHCs(Proportion of Providers Impacted)

Rank CHCs

1Core 12: Electronic copy (17%)

2Menu 5: Electronic Access (17%)

3

Menu 7: Medication Reconciliation (16%)

4Core 15: Security Review (14%)

5Menu 9: Immunization (14%)

Data Source: ONC CRM Database (March 3, 2012). Rural Hospitals and non-priority hospitals did not report any MU Measure Barriers.Users may select multiple measure-specific issues as barriers within one report, therefore, these numbers may overestimate the total number of Barrier reports for Measure-specific issues.

Proportion of Providers at CHCs that Reported MU Measure Barriers: Core

CHCsCore 1: CPOE

Core 2: Drug Interactions

Core 3: Problem List

Core 4: eRx 1.10Core 5: Active Medication List Core 6: Active Medication Allergy List

Core 7: Demographics

Core 8: Vital Signs

Core 9: Smoking Status 1.32Core 10: Reporting Ambulatory CQMs

Core 11: Implement CDS 1.98

Core 12: Electronic Copy 16.70Core 13: Clinical Summary 5.71Core 14: Electronic Exchange 3.52

Core 15: Security Review 13.85

Data Source: ONC CRM Database (March 3, 2012). Rural Hospitals and non-priority hospitals did not report any MU Measure Barriers.Users may select multiple measure-specific issues as barriers within one report, therefore, these numbers may overestimate the total number of Barrier reports for Measure-specific issues.

Proportion of Providers at CHCs that Reported MU Measure Barriers: Menu

CHCsMenu 1: Drug Formulary Check

Menu 2: Laboratory Tests Menu 3: Patient Lists

Menu 4: Patient Reminders Menu 5: Electronic Access

16.70Menu 6: Educational Resources

Menu 7: Medication Reconciliation 15.60

Menu 8: Summary Care Record Menu 9: Immunization

13.85Menu 10: Syndromic

Surveillance 2.86

Data Source: ONC CRM Database (March 3, 2012). Private Practices with 11+ providers, Public Hospitals, Rural Hospitals, and non-priority hospitals did not report any MU Measure Barriers. Specialty Practices did not report any Menu-set specific Barrier Issues. Users may select multiple measure-specific issues as barriers within one report, therefore, these numbers may overestimate the total number of Barrier reports for Measure-specific issues.

Implications for Overcoming Challenges and Barriers Moving Forward

• Health centers will require assistance with more sophisticated and costly functionalities such as e-Rx, Patient Portals, HIE, etc.

• Patient Centered Medical Home intersects with Meaningful Use work and it will be beneficial to work on these goals together in lieu of silos

• Stage 2 MU brings new requirements and criteria that require development of new tools and education materials to assist CHCs (e.g. patient portal and interoperability requirements)

Questions?

Shane C. Hickey, MBA, MS

Director, Information Technology Assistance

National Association of Community Health Centers

301-347-0483 or shickey@nachc.com