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The Alliance was formed initially with Health Resources and Services Administration (HRSA) funding obtained in 1997 based upon a longstanding history of collaboration and a desire to pool resources to improve quality and lower cost to meet common objectives.

Early successes included completion of a network-level managed care assessment and training, integration of some hospital and after hours call, funding for network level clinical projects including diabetes, osteoporosis project and smoking cessation, access to subspecialty services, medical records assessment and review and update of patient educational materials.

The four founding member centers formally incorporated as a Low-Profit Limited Liability Corporation in 2002 with a strategic focus on Health Information Technology to improve quality.


Realizing the Vision for an Electronic Health Record System

To achieve its vision of leveraging health information technology (HIT) to impact quality, the Alliance designed the EQUIP project to implement an electronic health record (EHR) that would be:
• useful and practical at the point of care
• holistic – promoting multidisciplinary model of care
• integrated with other electronic health data bases to promote efficiency and continuity
• tool for incorporating evidence based recommendations into practice
• capable of providing data and reporting to support the care model

To support preparation for the EHRS, the Alliance launched the Learning and Empowerment project in 2002 to help staff develop technical skills. In 2003 the Alliance obtained Integrated Communication Technology (ICT) funding from the Bureau of Primary Health Care for the implementation of the EHRS, and subsequently obtained Agency for Health Research and Quality (AHRQ) funding to support, incorporation of point of care clinical decision support and a data warehouse tor reporting against national performance measures.

Over the subsequent three years, the Alliance successfully implemented a centrally hosted Electronic Health Record System across the four partner health centers.


Formation of a nationwide EHRS User Community

Having successfully implemented at the initial partner Centers, the Alliance is carrying out its plan to spread the benefit of HIT-enabled quality improvement to additional Health Centers nationwide. In 2006, the Alliance formed a strategic partnership with the Institute of Nursing Centers (INC). INC and the Alliance share a similar mission to support adoption of HIT for enhancing clinical care delivery and use of population level data. Through their partnership, the Alliance is providing the robust EHR and data reporting services to INC member Centers, and the two organizations are partnering on HIT research.

Some of the support for creating this nationwide EHRS User Community comes from HRSA High Impact EHRS Implementation grants, awarded to the Alliance in 2007, 2008 and 2009. Each Health Center contributes significant resources, and the Alliance partners with each Center to secure additional resources.


Health IT Enabled Quality Improvement

The shared vision of Health Centers participating in the Alliance is the use of Health Information Technology to support continuous improvement in health care delivery and outcomes. Use of advanced EHRS functionality to provide clinical decision support at point of care and reporting on National performance measures through a data warehouse support realization of this vision. Each month, the Alliance publishes a dashboard of Health Measures showing performance of each Center against the larger group and against National benchmarks.


The Future

Looking ahead, the Alliance strategic vision is to continue to support thoughtful use of HIT in the Safety Net. Current activities include optimization to meet emerging measures of Meaningful Use, pilot projects in new technology including patient portal, health information exchange and medical device integration, evaluation and research projects, and technical assistance to other Networks and Health Centers.