Driving community health center sustainability with health IT

Transcript - Driving community health center sustainability with health IT

Hannah Nelson: Hello and welcome to Healthcare Strategies. My name is Hannah Nelson, assistant editor of Health IT and EHR. Community health centers are critical to serving underserved populations, but they face significant challenges including staffing shortages and rising operational costs. Joining us today are leaders from two nonprofit technology services organizations, Abby Sears, president and CEO of OCHIN, and Jeff Lowrance, CEO of OSIS, to discuss how the right EHR solutions can help community health centers better serve their patients. Abby and Jeff, thank you for joining us.

Abby Sears: Thank you.

Jeff Lowrance: Thank you.

Nelson: Now to kind of just dive into the conversation, from your perspectives, what are the most significant challenges that community health centers face?

Sears: Right now, the health centers have unprecedented economic and workforce challenges. They're experiencing incredible staffing shortages, but also rising labor costs as well. Their patient mix and patient population are some of the most complex in the whole country, and that adds to the cost of providing care for them as well.

So they're dealing with less funding, less staff, less resources, and as inflation continues to grow in this country, they have very few levers or tools to be able to manage through that effectively. So for Jeff and I, coming together and continuing to think about how we provide the highest quality that we can at the least price and using the power of our collective together to drive down costs, improve our quality and make things more affordable if at all possible, is really something that's important to us.

Lowrance: The main thing we can control really is how much things cost that we provide. We really can't do a lot for the funding side of the equation, which is the other side that is really costing the health centers as you move forward, because inflation is real and what they're experiencing is they can't raise their prices because they're funded in a different way.

Nelson: Yeah. I can definitely see how those types of challenges are making it difficult for these health centers to operate, especially considering that the patient populations are often facing higher degrees of chronic health conditions and social determinants of health. I definitely respect and appreciate you guys working toward creating solutions that are affordable and can help overcome some of these challenges. Could you just kind of walk me through the partnership between OCHIN and OSIS and how these organizations are coming together to support community health centers?

Lowrance: So this new arrangement really does allow us to share capabilities, technical and otherwise, that we have and may not be able to achieve by ourselves, and it does help us to generate some savings and efficiencies where possible. Cost reduction, again, is a huge piece of this, and together we can negotiate better pricing from third-party vendors.

Size and scale are important when you're creating that economy of scale and negotiating deals. The integration of departments, and the support tools that we use, that's a great opportunity for savings and increased leadership support. It also provides additional points of contact for our members.

To address the staffing challenges, this new arrangement allows us a little greater opportunity to provide some staff augmentation to clients we serve along with creating some shared resources among clients so they don't have to hire the director of IT themselves. They may be able to contract with us just for the service to be shared, but they can concentrate more on patient care and not recruiting for positions that are not in their primary focus.

It also allows us to offer a little greater assistance with data networking and cybersecurity. These areas are very critical for protecting the patient data and they often don't have the ability to hire those people in-house. These skill sets are hard to acquire and you're competing against hospitals and other payers, so our assistance will hopefully provide some relief there.

Nelson: Definitely. So walk me through what originally motivated this partnership between your two organizations.

Sears: What we found were two like-minded individuals, Jeff and myself, and two organizations that had a lot of compatibility, shared values, shared agendas and goals. So that was the first step. Anytime you build a partnership like this, you want to step back and make sure that you're aligned from a values and vision standpoint, and there was just incredible alignment between the two organizations.

And the second thing that we really looked at was: Do we have complementary skills? Are there areas where we can make each other better? I believe that we had a really strong assessment of that as well. We have capabilities at OCHIN that Jeff and his team at OSIS can take advantage of. We have some experience in his neck of the worlds and he has some experience in ours. He has skills and talents and experiences that actually broaden and make OCHIN actually better as well.

So those were two really important things that we assessed right up front. Would there be value and long-term value if we did this together? I mean, just one thing to think about is that 82% of health industry executives are saying they have difficulty attracting and retaining talent and that it's a significant risk to their business.

By being able to come together, we create opportunities between OCHIN and OSIS related to our own current workforce and make our workforce feel like it's a place where they want to work. It also creates more capabilities and better availability for our members so that they actually can tap into us. We absolutely have to be strong for them so that they can leverage us to actually help themselves.

The other thing I would say, and the last point I'd probably make related to this, is that healthcare spending grew by 4% in 2022 and has continued to grow over the last couple of years. It's outpaced the GDP and people of color and other marginalized groups, many of which are being seen by the organizations that we choose to work with, are more likely uninsured, which means that every dollar that we spend in any way in this part of the delivery system has got to go as far as possible.

What I really respect is Jeff and OSIS' commitment and OCHIN's commitment to thinking outside the box, being creative, valuing each other as people, valuing each other's organizations, but also saying we can do this better, smarter, cheaper and value the people that are involved, and also continuing to leverage the scale and the size so that we can drive down costs, so that we can continue to have redundancies in our positions and greater depth within the positions that we have.

Because the better partner we are to the organizations that we work with, the more efficient we are, the less expensive we are, the more they can use that money in other ways to provide more care for people that they might not be getting every revenue dollar that they need to actually cover the cost of care for that patient population.

Nelson: So specifically when it comes to EHR solutions, how is this partnership going to help enhance the support you're able to provide health centers?

Lowrance: So for one thing, as Abby had pointed out, we are very like-minded organizations and we work with those community health centers and the safety net providers, and that's where our mission is, that's where our heart is and that's where our experience is. And so we each have a product. OCHIN obviously predominantly supports Epic and OSIS supports NextGen. And we've built this from the ground up as a system tailored for the support of the groups that we serve.

So there's a lot of special needs and special things that are required to serve these populations with these FQHCs. And this whole partnership allows us to compete, as I said, with some of the larger healthcare systems that tend to take talent away. This allows us to maybe retain some talent, maybe recruit better talent than we could before because we're out in the marketplace with a louder voice, a bigger presence across the country, and we can draw from a lot of different areas.

We continue to operate independently and with our capabilities that we're sharing, we're trying to unlock some operational efficiencies by combining some departments where necessary or possible. We're trying to build a better support infrastructure for the groups that we serve. And as Abby said, we're trying to save costs where we can because we need to control those, because the health centers really don't have a mechanism to do that.

Sears: I would just add to what Jeff just said so eloquently there. Although we provide support to two different EHR platforms, we all know to use an electronic health record in healthcare and it's supporting parts of the delivery system -- like mental health, dental services, and addiction -- we have to continue to think about and evolve in our thinking all the additional areas of capabilities that we have to be able to bring to the table so that they can get the return on investment on the purchases they've made around these EHRs.

So sometimes it's about supporting the technology, and sometimes it's about all the additional support that they need to actually use the products really well, and that's expensive.

For example, OCHIN itself has upwards of 20 medical informaticists as part of the toolkit that we bring to our members. That is a huge investment. It's incredibly difficult to actually be able to afford to have that, and that's something we can bring to the table for the OSIS members.

Research, we have a huge research and strong research division specifically focused on this part of the delivery system. Those are assets, if you will, that we can bring to the table to some of the OSIS members without them feeling like they have to build that from scratch. That is incredibly valuable and it actually leverages the expertise of both organizations and it will make the entire delivery system better, which is the whole goal of the two organizations together is to actually create impact.

It's to drive outcomes, it's to use these tools to actually extend and provide the best quality care that we possibly can to the patient population that we serve. And it's more than just the support around the EHR, and that's what's incredibly important. And it's really hard to have the size and scope to be able to afford that.

Nelson: Thank you, Abby, for kind of underscoring that. And just kind of bringing it back to the patient, I'm curious to hear from both of you what the impact will be on the patients and providers that you serve.

Sears: Well, the hope is to have it be vast. Between OSIS and between OCHIN, we touch about 10 million patients directly receiving care. And that's huge. That is almost one in, I think three of the patients being seen by the community health centers in the country. And that reach is significant. So imagine having the amount of data that we have on that patient population, on their complexity, on how often they're being seen, around the social determinants of health that they are experiencing every day.

And being able to use that and leverage that to be able to tell their story so that they are now being seen by our country so that we can actually explain what's going on for them in a day-to-day way, that's the possibility and that's the potential impact, let alone the impact that we do on a day-to-day basis, making sure that they have access to care, even if it's through technological means. There's a lot that we can do. Jeff, would you add to that?

Lowrance: Yeah. I mean, obviously the patients, they're at the bottom of the equation. They're the goal. They're the aim that we're looking for to provide that better outcome for them. Serving the population we do, it is very complex, but with the tools that we are able to put together, and as Abby pointed out with the data and obviously by joining forces, we have more data than we had in the past to focus on. And that data can be used for a lot of things driving patient care.

Also, this larger organization allows for better advocacy with the federal government and payers and other groups that we're dealing with. And if we can drive that, we can drive outcomes, we can make the patient experience better.

It is also about providers and provider burnout and where can we aid that? And that's a real problem for health centers, so the more we can develop and use the research and the tools, the strategies, the workflows that we've put together for each of the products and provide that assistance, I mean that's what's going to drive those outcomes in the end. I mean, it really is about providing greater choice for health centers and for the patients and just ensuring equitable access to high-quality healthcare.

Nelson: Definitely. So now kind of switching gears here to just talk about population health as you were both touching on earlier. Generally, how do you think this partnership will contribute to health equity research and also advocacy efforts nationwide?

Sears: Well, one of the ways to change the trajectory of the healthcare of the population that we're serving is to be able to be at the table with everyone else and to be seen as of the same quality and ilk as everyone else sitting at the table.

I think we can all agree that spending on healthcare is going to be a challenge to continue to increase that rate of spend. So what we have to do now is take the money in the system and distribute it and use it as wisely as we possibly can. And that means that the story of how our patients are receiving care, what's working, what's not working has got to be communicated. It has to be elevated. And the amount of data and patients that we represent allows us to sit at the table and help design the policies of the future.

It allows us to be a significant component and contributor to the entire country. And that allows us to shape the policies not for our will, but to actually make sure that the money that's being spent in the system continues to go into the places that will create the best good and the best impact.

The OSIS members will have an opportunity to individually decide if they want to participate in our advanced clinical research network. We'll be adding their data into that research network, which is the largest de-identified community health center database in the country and part of the PCORI system. And that's incredibly powerful as well.

So we're no longer an afterthought as part of the delivery system. We're actually an equal partner and we're helping everyone continue to spread the funds that exist in the healthcare system and make sure that they're invested in the places that will produce the best outcome overall.

Nelson: Looking forward, how do you envision the partnership evolving over the next couple years?

Lowrance: We're in the early stages, but it's been a great partnership or relationship to this point. And we're still discovering new ways to work together. But I look forward to continuing to draw on those capabilities and expertise from each side and learning additional innovative things we can do together to support the health centers and the patients.

We can do more integration between the products we use, the third party things that we have to connect to. There'll be some more investment in our respective areas of expertise, new areas of service that will come online and expanding the capabilities that we have together for those health centers. And as I said, for OSIS members, credentialing was a very easy add-on that we were able to pick up by being part of this network together.

And then as Abby pointed out, just that larger voice, being at the table, being heard, being seen for the safety net because they don't get a lot of recognition and the healthcare system in this country, it tends to be a bit backwards and most of the dollars are going to the wrong end of the healthcare system. Primary care can save dollars, but it gets the least amount of funding of any.

And health centers, they're dependent on whatever they can get from the 330 grant funding and from HRSA and other programs, and they need to be heard. Everyone again, just needs access to affordable healthcare, and it needs to grow over time and be more well-known out there in the country.

Sears: You've got to like the people that you work with too. And I feel very fortunate. I have a ton of respect for the OSIS team, and they just make it more fun to do the work that we do every day. And they're smart, they bring additional skills from leadership all the way down to how they work with their organizations. It takes a lot of passion and commitment to do what we do every day, doesn't it, Jeff?

Lowrance: Well, yes, we've both been doing this for 25 years.

Nelson: Wow.

Lowrance: We're both celebrating the 25th anniversary next year.

Sears: Yeah.

Nelson: That's amazing.

Sears: And that needs to be celebrated as well and leveraged. So again, you really want to like the people that you work with as well and respect them. And I have tremendous admiration for the OSIS team and Jeff.

Lowrance: Well, thank you. Same here.

Nelson: Wonderful. Well, thank you both for joining us today and talking about this important topic.

Sears: Thank you.

Lowrance: Thank you.

Nelson: And to all of our listeners, thanks for joining us. If you're interested in learning more about this topic, check out our site dedicated to health IT at techarget.com/Search HealthIT. If you have thoughts on this topic or if you have any healthcare-related stories that you'd like us to consider for coverage, you can reach out to me at [email protected]. That's H-N-E-L-S-O-N at TechTarget dot com. Follow us on Spotify to get more of these conversations and let us know what you think by rating and reviewing the show. See you next time!

Kelsey Waddill:
Music by Vice president of Editorial Kyle Murphy, and production by me, Kelsey Waddill. This is a TechTarget production.