The Promise & Challenge of Health Care IT in Community Clinics: Insights from the California Community Clinics Initiative Prepared for the convening on Realizing the Benefits of Health IT for Community Health Centers Prepared by The Community Clinics Initiative & Blueprint Research & Design, Inc. November 11, 2005

Community Clinics Initiative: Facts Launched 1999, broad mandate to strengthen IT in CA clinics Partnership between Tides & CA Endowment Distributed $41 million to 163 clinics Averaged $176,612 per clinic Initial emphasis on infrastructure & operational efficiency, clinical technology focus added later Funded hardware & software, training, connectivity, planning, and improving data use FY 2004: 140 clinics had combined IT budgets of $29.7 million

The CCI Evaluation: Our Data To inform evolving grant program Qualitative and quantitative data over 5 years Information Management Assessment Survey 140 clinics, 4 times, 70 to 80% response rate Case studies of 6 representative clinics (2000, 2001 and 2003) Inventory of consortia IT services & priorities Clinic organizational capacity self-assessment (2004) Stakeholder assessment of CCI impact

CCI’s Particular Expertise Experience of 5-year initiative promoting widespread adoption of IT Understanding of how human and organizational issues impact technology implementation Insight on variation across range of clinics – early adopters, typical clinics and small clinics Familiarity with the role of private funding

Five Key Lessons on Building IT Capacity Across the Field

Lessons About Building IT Capacity Across the Field 1.A clinic’s information needs should drive Health IT decisions 2.IT projects are organizational change processes in disguise – It’s about people 3.Complex IT projects require sophisticated business skills –as well as technology expertise - that most clinics don’t have 4.Clinics will need outside money to innovate 5.IT requires clinics to collaborate in new ways

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Extra slides

Summary of CA Progress Data Analysis Skills: New IT provided more & higher quality data Unclear how much clinics have improved data analysis skills CCI only indirectly addressed this area Vision : Staff more comfortable with IT Better planning & decision-making Most clinics still lack visionaries to ID trends & ways for IT to advance mission Collaboration : More complex than anticipated Learned importance of managing human aspects of partnerships Tech partners best based on shared business need rather than geographic proximity Infrastructure : More robust basic infrastructure, particularly internal connectivity PMS, electronic linkages, and staffing solutions remain as challenges

Data Collection Data Analysis Data-Informed Decision-Making Population Health Data Collection Data Analysis Data-Informed Decision-Making Patient Health Path to Information Management Growth Stronger and Healthier Communities! Data Collection Data Analysis Data-Informed Decision-Making Clinical Operations Levels of information management Data Collection Data Analysis Data-Informed Decision-Making Business operations Infrastructure: Hardware Software Trained staff IT Plan