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JSI Conducts National Evaluation of EHRs in FQHCs

February 23, 2016

New research from JSI’s Health Information Technology Training and Technical Assistance Center (HITEQ) reveals community health centers around the United States may experience data issues when using electronic health records (EHRs).

HITEQ, funded by HRSA, is designed to help community health centers around the U.S. utilize EHRs more effectively as many of them adapt to electronic systems. As the center’s technical lead, JSI assessed the current usage of digital records in order to tailor technical assistance to the health center’s specific needs and challenges. The assessment compared the quality of data collected by health centers manually through sampling versus data gathered automatically from EHRs.

JSI analyzed 13 clinical performance measures gathered from 1400 health centers across the United States over the last four years. These clinical measures are part of HRSA’s Uniform Data System (UDS), a standardized data set reported by all federally qualified health centers. These performance measures include routine and preventive services (e.g., childhood immunization rates, cervical cancer screening rates, colorectal cancer screening rates) and management of chronic conditions (e.g., hypertension, persistent asthma, diabetes)

Community health centers are increasingly adopting EHR systems, with more than 91% actively using EHRs at all sites and with all providers. Ideally, a health center that switches to an EHR system from a manual system would have no change in clinical performance based on UDS data. Yet, the HITEQ evaluation revealed the collection method for data had a lot to do with the measured quality of care. In fact, the differences between data gathered manually and data gathered through EHRs were sizeable and statistically significant by most clinical measures.

The issue is not that the EHR systems are faulty, but instead that health centers don’t know exactly what data their computer systems are seeing and what data they’re missing.

“EHRs are like black boxes when it comes to UDS reports. You go to a menu, click it and see what the data is for the report without knowing specifically what the report was seeing or not seeing on a chart,” said Eric Turer, a health systems consultant at JSI, who performed the analysis on the community health centers’ data.

According to Turer, although the EHR systems are a more effective way of gathering data, without understanding how the systems work, health centers may report lower performance than actual.

HITEQ will move forward by helping community health centers improve the accuracy of the data reported from their EHRs. In the coming months, JSI will focus on helping community health centers to maximizing the use of their EHRs and strengthen staff capacity for accessing and utilizing data to achieve improved health outcomes.

Learn more about JSI’s work with Community Health Centers