Urban Health Plan, a network of federally qualified community health centers based in the South Bronx and Queens, is being recognized with a 2009 HIMSS Davies Awards for the way it has leveraged its EHR to improve outcomes for its underserved patients.

UHP is one of the largest providers of ambulatory care services in New York State, providing care for 31,000 patients from Hunts Point, Mott Haven and other surrounding communities of the Bronx.

In 2006 after moving away from a modular EHR that was first implemented in 2001, UHP became the first federally qualified health center in the country to use software from Westborough, Mass.-based eClinicalWorks. It was this move to a fully integrated EHR that positioned UHP to serve the state and federal government in a unique way, said its officials.

Alison Connelly-Flores, clinical systems administrator at UHP, was asked to participate in NYC Department of Health and Mental Hygiene’s eCW development team to create the “New York Build.” The project’s goal was to add sophisticated public health functionality to eCW by collecting data daily from its users within the city and using clinical decision support to improve the health and outcomes. UHP provided eCW with ideas for customizing their software to include registry functionality, the integration of data for improved ease of reporting, the creation of sliding fee scales, and billing enhancements to the practice management system to comply with New York State requirements.

Connelly-Flores and Chief Technology Officer Daniel Figueras say it is their work on this project that has placed them “ahead of the curve” and contributed to their recognition by HIMSS and others. 

“Urban is certainly an excellent example for the Davies program,” said David A. Collins, 
director, Healthcare Information Systems. “Their ability to learn from an initial failed implementation, and then apply those lessonslearned to their next effort really stood out for Urban.”

“The award validates all the work that we have done for years,” said Figueras.

Figueras says UHP has always had an eye for preventive care. Since the late ’90s UHP has been using health educators and case managers to help patients define and meet their goals. Now with an EHR they have taken that a step further, and case managers can query the data to produce lists of patients who need follow-up care.

Connelly-Flores says this “whole patient’ model is what set them up for being recognized by the National Committee for Quality Assurance for reaching Level III of the Patient Centered Medical Home in Sept. 2009.

Something she says would be impossible to achieve without the ability to capture and query data.

“We started out on a road to improve the health status of our community,” said Figueras. “And that was a road that was parallel to achieving these awards.”

Currently UHP is working on a pilot project that is testing the effectiveness of preventative text message alerts for cardiovascular health and pediatric immunizations, said Figueras.