Family Planning Centers Face Myriad Challenges in Adopting Health Information Technology
Many publicly funded family planning centers have made only halting progress toward adopting electronic health records, electronic billing and other types of health information technology (HIT), according to a new Guttmacher Institute study and accompanying policy analysis. Experts say that, when implemented correctly, HIT can offer significant benefits, such as reduced administrative costs, improved care coordination and fewer medical errors.
"Our new research examines the numerous financial, technical and logistical challenges that family planning centers are facing in implementing and utilizing these important technological innovations," says Jennifer J. Frost, lead investigator of the new study. "We found that many publicly funded family planning providers will need varying degrees of help to adopt these technologies—a virtual prerequisite for survival in a rapidly changing and modernizing U.S. healthcare system."
Among publicly subsidized family planning providers, federally qualified health centers (often referred to as community health centers) have the highest current use of HIT, according to the study. Planned Parenthood affiliates and other agencies (including hospital-based agencies) fall somewhere in the middle, while state and local public health departments have comparatively little current use of HIT.
While the challenges for providers vary significantly by agency type, size and location, the top three barriers to adopting HIT were all financial ones: implementation costs were cited by 67% of agencies, followed by ongoing costs (62%) and acquisition costs (58%). Other common challenges include identifying or building an appropriate electronic health record system (37%) and obtaining necessary IT support and expertise (34%).
"Our study shows that many family planning providers face a range of concerns," says Frost. "They must find ways to tailor these technologies to the specific requirements, for instance, regarding confidentiality, of the federal Title X family planning program and other grant programs. Many agencies also lack the technical staff necessary to implement HIT for their clinical practices. Further, clinical providers may not be trained in the use of electronic health records systems."
Not only are health information technology costs significant, providers are facing these costs at a time when funding for even basic patient care is being cut in unprecedented ways. That is why, according to the new study, agencies need financial assistance designated specifically for HIT-related expenses. And, whether they are Title X providers or not, they need guidance to achieve economies of scale in purchasing and implementing HIT systems and reduce other expenses.
"Federal incentives for providers serving Medicaid clients are one potential funding source for family planning providers to implement HIT," says Adam Sonfield, author of the accompanying policy analysis. "But many Title X-supported providers will have difficulty qualifying for these incentives since many of them may not be able to meet the requirement that at least 30% of their patients be Medicaid enrollees. And even then, the funds can’t fill the financial gap entirely."
Sonfield argues that the Office of Population Affairs (OPA)—the agency that runs Title X—could be another crucial source of assistance for Title X-supported providers. Among other measures, OPA could allow providers to devote more of their Title X grant funds toward investments in information infrastructure and could also shift some of its own technical assistance resources toward health information technology issues.
Publicly funded family planning centers provide critically important sexual and reproductive health services to millions of poor and low-income women and men each year. They allow women and couples to avoid unintended pregnancies, plan the timing of wanted pregnancies, and receive a range of preventive health services, treatment for sexually transmitted infections (STIs) and referrals for other needed care. For many women, visits to publicly funded family planning providers are the only regular health care they receive.
Click here for "Family Planning Centers Confront Roadblocks on the Information Superhighway," by Adam Sonfield.
Click here for "Health Information Technology and Publicly Funded Family Planning Agencies: Readiness, Use and Challenges," by Jennifer J. Frost, Jenna Jerman and Adam Sonfield.