Health information technology capacity at federally qualified health centers: a mechanism for improving quality of care.
BACKGROUND
The adoption of health information technology has been recommended as a viable mechanism for improving quality of care and patient health outcomes. However, the capacity of health information technology (i.e., availability and use of multiple and advanced functionalities), particularly in federally qualified health centers (FQHCs) on improving quality of care is not well understood. We examined associations between health information technology (HIT) capacity at FQHCs and quality of care, measured by the receipt of discharge summary, frequency of patients receiving reminders/notifications for preventive care/follow-up care, and timely appointment for specialty care.


METHODS
The analyses used 2009 data from the National Survey of Federally Qualified Health Centers. The study included 776 of the FQHCs that participated in the survey. We examined the extent of HIT use and tested the hypothesis that level of HIT capacity is associated with quality of care. Multivariable logistic regressions, reporting unadjusted and adjusted odds ratios, were used to examine whether 'FQHCs' HIT capacity' is associated with the outcome measures.


RESULTS
The results showed a positive association between health information technology capacity and quality of care. FQHCs with higher HIT capacity were significantly more likely to have improved quality of care, measured by the receipt of discharge summaries (OR=1.43; CI=1.01, 2.40), the use of a patient notification system for preventive and follow-up care (OR=1.74; CI=1.23, 2.45), and timely appointment for specialty care (OR=1.77; CI=1.24, 2.53).


CONCLUSIONS
Our findings highlight the promise of HIT in improving quality of care, particularly for vulnerable populations who seek care at FQHCs. The results also show that FQHCs may not be maximizing the benefits of HIT. Efforts to implement HIT must include strategies that facilitate the implementation of comprehensive and advanced functionalities, as well as promote meaningful use of these systems. Further examination of the role of health information systems in clinical decision-making and improvements in patient outcomes are needed to better understand the benefits of HIT in improving overall quality of care.
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. jf2584@columbia.edu
Jemima A
JA
Frimpong
Bradford E
BE
Jackson
LaShonda M
LM
Stewart
Karan P
KP
Singh
Patrick A
PA
Rivers
Sejong
S
Bae
D001071:Appointments and Schedules; D057191:Capacity Building / Q000458:organization & administration*; D003151:Community Health Centers / Q000145:classification / Q000592:standards*; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational; D057286:Electronic Health Records / Q000706:statistics & numerical data; D035082:Federal Government; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008490:Medical Informatics; D017063:Outcome Assessment, Health Care / Q000379:methods; D010351:Patient Discharge; D011314:Preventive Health Services / Q000379:methods / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D017010:Reminder Systems; D014481:United States