EHRs in Underserved Areas

Physician practices especially those in medically underserved areas, face multiple barriers to adopting and using EHRs due to financial burdens and the lack of IT resources and expertise. EHRs are particularly valuable in underserved areas because they can flag much needed services to prevent illnesses, make records more accurate, and be easily shared among providers.

With approval by the mayor of New York, the NYC Department of Health and Mental Hygiene (DOHMH) established a new bureau within the Division of Healthcare Access Improvement called the Primary Care Information Project (PCIP).

PCIP helps primary care practices in medically underserved areas implement and effectively use EHRs to improve care. Eligible practices received two years of subsidized EHR software from the vendor eClinicalWorks along with ongoing training and support. The program has significantly increased the adoption and use of EHRs by primary care doctors in the medically underserved areas.

As of January 2013, PCIP has implemented eClinicalWorks software for more than 3,300 providers who collectively care for 3.5 million patients, making it the largest community-based program to promote EHR implementation in the country.

Overall, an estimated 40 percent of physicians in New York City using eClinicalWorks and other EHR systems have received assistance on EHR adoption and meaningful use from NYC REACH.  As of April 30, 2013, the total receiving help from eClinicalWorks and REACH was 6,383 eligible providers. In addition, providers participating in Meaningful Use incentive programs in New York City have received $365 million.

As a result of PCIP, EHR adoption in participating practices has improved care. For example, in PCIP practices submitting data for analysis, the proportion of hypertensive patients with their blood pressure under control rose from 46 percent to 54 percent.

The funding for PCIP came from several sources that included AHRQ, CDC, HHS Office of Health IT, Robin Hood Foundation WellPoint Foundation, Emblem Health Plan, New York State Health Efficiency and Affordability Law, and from a New York City tax levy. In addition PCIP collected a onetime $4,000 fee for each full time equivalent provider who enrolled in the program before the availability of ARRA funding.

For more information, contact Sarah Shih, Executive Director of health Care Quality Information and Evaluation for the New York City Department of Health and Mental Hygiene at sshih@health.nyc.gov.

 

Source: AHRQ Innovation Exchange at www.innovations.ahrq.gov.