Dissertations & Theses (Open Access)

Date of Award

Spring 5-2020

Degree Name

Doctor of Philosophy (PhD)

Advisor(s)

Grethcen Gemeinhardt Phd Mba

Second Advisor

Cecilia Ganduglia Md Drph

Third Advisor

Linda Highfield Phd

Abstract

While Federally Qualified Health Centers (FQHCs) provide affordable, high quality, accessible and cost–effective primary health care to all individuals regardless of their inability to pay, patients continue to have difficulty accessing affordable primary care as well as broader specialty services that other patients may receive living near larger health systems and hospitals. Health information technology (HIT) serves as a cost-effective means to overcome barriers related to accessing care, particularly for individuals living in rural and remote areas. We examined if the key influencers of an FQHC’s structure, broadband access and/ or state and federal policies impacted the utilization of telehealth and electronic health records (EHRs). Methods: In this retrospective, observational study, 2018 UDS data and 2018 FCC data were used to examine key influencers on health information technology (HIT) adoption among FQHCs (n=1,356) by analyzing the extent of technology utilization by providers and patients at the census block code level using SPSS. ArcGIS and GeoDa was used to descriptively map adoption of HIT and broadband availability and to examine spatial clustering and correlation of EHR and Telehealth adoption with patient volume Results: While several characteristics, such as CMS grant incentives and meaningful use, were identified as significant factors influencing full utilization of health technology within health centers, only the variable related to patient volume, our indicator of clinic size, was found to impact both EHR and telehealth adoption by providers as well as patients within 2018 FQHCs using bivariate regression analysis. Spatially, there were no obvious associations with adoption of HIT with broadband characteristics of speed and provider density. There was significant clustering noted between patient volume and HIT adoption based on spatial analysis. Conclusion: The purpose of this research was not to evaluate the overall health of FQHC patients, but to instead evaluate the technological tools that have the potential to improve the health of this specific population of patients. This study addressed access to care in a period where an expanded population needs healthcare resources. FQHCs provide healthcare access to the underserved, and with more health information technology, these safety net clinics could better serve this population.

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