Southern California Clinics, Health Centers And Consortia Building Clinic Capacity For Quality (BCCQ)

National, state and local leaders are actively promoting electronic health records as a tool for improving the quality of health care for Americans. However, the expense and complexity of health information technology present daunting challenges for healthcare providers, especially those serving the safety net.

UniHealth Foundation, Kaiser Permanente and L.A. Care Health Plan have been working with Object Health to help 51 community clinics and health centers and three clinic consortia in five Southern California counties assess their capacity to participate in technology-enabled quality improvement. The Building Clinic Capacity for Quality (BCCQ) project helped these safety-net providers measure their capacity for implementing health information technology. The assessments demonstrated that almost one-half of the community clinics and health centers in the program are highly or moderately prepared, but that most are not-yet-prepared for full electronic health record adoption. They could, however, potentially implement less complex health information technologies to achieve quality improvement goals.

One of the clinics that participated in the assessment, JWCH Institute, has provided medical care and health education to some of the neediest residents of Los Angeles. Its Skid Row Clinic logs 20,000 patient visits each year and conducts medical outreach on the streets in and around Skid Row, taking medical services to sites that the shelter-resistant population finds less-threatening. Maintaining medical records for these complex patients is a daunting task, and JWCH is working with other Skid Row clinics to design and implement a coordinated system of high-quality care for the homeless. The BCCQ Readiness Assessment provided JWCH with a game plan for accomplishing its goal of first integrating services throughout its own network of clinics, and then connecting with other Skid Row clinics.

Dr. Paul Gregerson, JWCH Chief Medical Officer, found that the readiness assessment enabled him to advance several of the clinic’s strategic goals. After reviewing the report‘s recommendations, the Institute’s Board of Directors decided to examine the opportunities available to create a system that could link various medical and social service agencies in Skid Row. In addition, Dr. Gregerson engaged a UCLA Robert Wood Johnson Foundation Scholar to examine how the clinic’s health information systems could interact with those of other Skid Row Clinics, and instituted a program to educate clinic staff on the connection between health information systems and the quality of care.

Ultimately, Dr. Gregerson would like to see a completely functional and integrated system for technology-enabled quality improvement. “We spend at least one-third of our time trying to improve quality of care for the patient, especially collecting data, so that patients receive the right medications for their particular illnesses,” he commented. “Technology has the potential to provide data at the point of care to inform clinical decisions.”