As far back as the early 2000s, the healthcare industry started seeing electronic health record (EHR) as an integral part of the future of healthcare in the United States.  It is commonly agreed that EHR will revolutionize the way healthcare is delivered.  The vision of creating a seamless, interconnected electronic healthcare information system across the country and across multiple platforms promised improvements in quality at both the individual and population level. 

North East Medical Services (NEMS) was one of the early adopters of EHR in San Francisco, even before the heightened buzz generated by the Obama Administration and the recent passage of health care reform.  We have successfully implemented the NextGen system for electronic practice management (EPM), electronic health records (EHR) and electronic dental records (EDR) in a little over one year.

Even before the American Recovery and Reinvestment Act (ARRA) and the “Health Information Technology Implementation for Health Center-Controlled Networks (HCCN)” grant was announced, NEMS had discussed the possibility of reaching out to clinics in the San Francisco Community Clinic Consortium (SFCCC) to leverage our knowledge and infrastructure and to help other clinics avoid duplicating all the same mistakes and redundant costs associated with individual EHR implementations.  So when the HCCN grant was announced in January 2010, it was a logical decision to gather the other federally qualified health centers, and apply for the grant as a new network called “Community Access HCCN.”

We were very fortunate to have been selected by HRSA’s Bureau of Primary Health Care (BPHC) as one of the HCCN grantees this past month… but now the real work begins!

The primary goal of Community Access HCCN is to establish an HCCN model in the San Francisco Bay Area. Our initial plans are to first implement EPM, and then stagger EHR implementation across the individual clinic sites.  EPM/EHR implementation teams at each of the health centers will be supported and trained by the HCCN Team, which will be comprised of the NEMS’ EPM/EHR staff.  NEMS will share learnings and strategies developed during our implementation, with adjustments made to meet the unique workflow needs and requirements of each health center.  We will “push” NextGen across the local multi-protocol label switching (MPLS) network, leveraging our current IT infrastructure maintained centrally by the HCCN.  This provides the other clinics access to a stable, locally controlled IT system, minimizing IT costs associated with EHR implementations.  An established disaster recovery solution, at a second off site, will insure business continuity for all clinics linked to the HCCN. 

The HCCN grant will help Community Access HCCN lay the foundation for a broader proposal to establish a pseudo-health information exchange (HIE) among the participating community clinics, with the goal of one day linking the Bay Area’s safety net providers on a single platform.  Long term plans, will also look to one day integrate vertically into the City’s broader HIE infrastructure.

We believe that the investment in time and resources today will ultimately pay off in providing a higher level of health care and access for all San Franciscans.