Electronic health records are now a fact of life in federally-funded community health centers, with nearly all of the centers using EHRs in some or all their sites in 2013, according to the latest data from the Health Resources and Services Administration.

Almost 96 percent of the 1,152 federally-funded health centers are deploying EHRs to some degree, with 87.8 percent available for all providers at all sites while another 8.1 percent had EHR systems open to some sites and providers, according to HRSA

"Community health centers are the largest providers of health care to underserved individuals in the United States and in many communities are at the forefront of health IT innovation," Kerry Souza, epidemiologist at the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health’s and Michael A Wittie wrote in Health IT Buzz blog, outlining the HRSA data.

[See also: Community health centers land $4.25M.]

"Health centers have long worked to improve the quality and efficiency of the care they provide, and have adopted health IT as a tool to facilitate that improvement," they wrote in the ONC blog.

The centers provided care to more than 21.7 million patients (more than 62 percent of whom are racial/ethnic minorities, and almost 35 percent of whom are uninsured) in 2013, while 84.5 percent of the centers reported that their providers are receiving meaningful use payments.

[See also: Some community health centers live up to their name.]

"Health centers are not just using health IT, they are using it as part of clinical transformation: More than 54 percent of centers achieved recognition as Patient Centered Medical Homes, a key indicator of high-quality care," the authors wrote.

In addition, HRSA found that the 1,151 health centers reported EHR functionalities that included:

• 99.9 percent patient history and demographics;
• 99.9 percent clinical notes;
• 99.9 percent protections in place for electronic health data;
• 99.5 percent electronic prescription capabilities;
• 99.5 percent capability to provide clinical summaries for patients on each provider visit;
• 98.6 percent computerized provider order entry for lab tests;
• 97.2 percent reminders for guidance-based interventions or screening tests;
• 95.9 percent capability to provide patients with a copy of their medical data upon request;
• 85.9 percent could electronically share clinical data among care providers and patient-authorized entities;
• 80.3 percent CPOE for radiology tests;
• 74.9 percent capability to electronically report data to immunization registries.

The health centers are leveraging EHRs to capture and use patient work information to learn more about their patients’ work and health, the authors found. Working with the health centers, the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health EHR Working Group is guiding them to improve the collection and use of work information in EHRs. 

To incorporate patient industry and occupation fields into a commercial EHR, NIOSH selected St. John’s Well Child and Family Center in Los Angeles, a community health center with experience in achieving health and social justice gains for its patients. The project aims to modify the GE Centricity EHR used by the center to include patient industry and occupation information.

“The ability to collect patient industry and occupation data leads to more informed medical care and treatment, which perpetuates St. John’s mission to address salient structural determinants of health, promote health equity, and foster community well-being by providing comprehensive, evidence-based, high-quality care to the sick and poor in South Los Angeles,” said Shom Dasgupta-Tsinikas MD, director of social medicine and health equity for St. John’s, in the Health IT Buzz blog.