The health IT incentives in the federal stimulus package should be expanded to include specialists, small hospitals and safety-net providers, the Meaningful Use Workgroup of the Health Information Technology Policy Committee recommended to the Dept. of Health and Human Services last Friday.

In recommending such a move, the workgroup is addressing several critical gaps where safety-net providers are concerned: Gaps in the continuity of care, gaps in the quality of care for the lower-income population that sees safety-net providers and the digital divide gap.

If health IT is going to transform the healthcare industry, its reach needs to extend to these safety-net providers. Last year, L.A. Care Health Plan in Los Angeles awarded $2 million in grants through its HIT initiative to nine community clinics to implement health IT systems. One clinic implemented an electronic health record, while the rest either implemented or are in the process of implementing a population registry application.

The health IT grants of L.A. Care Health Plan, the largest U.S. public health plan, support its mission to aid safety-net providers, provide funding for their long-term needs and address HIT disparities, said Roland Palencia, director of community benefit programs.

"The end game is to improve quality of care, give providers the information they need and empower patients to make decisions even in the face of adversity," he said. High tech is enabling clinics to engage in high touch and driving patient-centered care, he said.

Saban Free Clinic, which operates four Los Angeles sites and one of the grantees, implemented its population registry tool to track interventions, follow-ups and treatment plans for patients with chronic conditions.

The clinic focused first on diabetes and asthma, and has already seen a 10 percent increase to 65 to 70 percent in the number of diabetics having completed eye and dental exams, said Jehni Robinson, MD, CMO. Automation enabled staff to work on other projects and resulted in fewer errors in some indicators and more efficient services, which allows the clinic to handle the increased patient load.

Robinson said, as has another grantee, that the next step is implementing an electronic health record. "We know we have to go there," she said. “But the big 'if' is funding. It’s the big barrier."

If the health IT incentives can reach safety-net providers, the big barrier would be lifted for clinics like the Saban Free Clinic.

The federal advisory committee is tasked with defining meaningful use, as well as determining how to align the health IT provisions with the federal stimulus law. The Meaningful Use Workgroup will be collecting public feedback on its proposals.