FQHC Data Reporting and Program Monitoring

This FQHC data reporting article is a continuation of our Federally Qualified Health Centers (“FQHC”) series covering the requirements of the Health Center Program. All Federally Qualified Health Centers must accurately compile and report data and establish a system for program performance. This program is regulated by the Health Resources and Service Administration (“HRSA’).

I can remember my mother, a registered nurse who began her career back in the 1960s, growl to my father about the daily challenges she was encountering during her hospital’s conversion to an electronic health records system. It was a struggle for her, feeling as if the learning process sometimes took her attention away from caring for her patients. However she understood the importance, she foresaw the efficiency it would bring to healthcare and the tool it would become in monitoring the patient’s entire healthcare picture. She also saw another huge benefit, having immediate access to medical information of patients when timely and proper care is critical. 30+ years later we are reaping the benefits of this transition and taking it to higher levels of use as outlined in Chapter 18 of the Health Center Compliance Manual, Program Monitoring and Data Reporting Systems.

Before delving into the requirements of, and demonstrating compliance for Program Monitoring and Data Reporting Systems, here are a few interesting facts about the catalyst for this chapter.

The Electronic Health Record (EHR):

• The first version of an electronic health record dates back to the mid-1960s, created by Lockheed and known as “clinical information system”
• All healthcare providers, including FQHCs, were required to adopt and demonstrate meaningful use of electronic health records by January 1, 2014. As late as 2013 there were providers still using paper!
• Prior to January 1, 2014, Hospitals using EHR systems had a 3 to 4% lower mortality rate than those that didn’t. (Unusual but factual statement: Saving Lives By Switching From Paper.)
• Prior to January 1, 2014, the average doctor spent 8 hours a week on paperwork. This amounted to 336,336,000 hours per year in the USA spent on administration instead of patient care.

Not lost in all the detail of the data captured by EHR systems are the important messages the summarization provides to the healthcare industry. It enables management of a FQHC to monitor programs and their costs, review outcomes against performance expectations and discover important trends. These messages make up the foundation of Chapter 18, Program Monitoring and Data Reporting Systems.

What are the Requirements for FQHC Data Reporting and Program Monitoring?

A FQHC must establish a system for program performance to ensure the following:

• Oversight of the operations of the Federal award. Are healthcare activities monitored for compliance with the Federal requirements? Do you know the grant’s compliance requirements?
• Performance expectations are being achieved. Are the activities being monitored timely? The earlier an issue is caught, the less likely a FQHC falls short of its performance expectations.
• Areas for improvement in program outcomes and productivity.Develop a system where the objectives are to identify any possible efficiencies and highlight areas of effectiveness. Utilize that information as the program moves forward. Don’t let complacency be a part of the system.

A FQHC must also compile and report data as required by HRSA relating to:

• Costs of health center operations
• Patterns of health enter services utilization
• Availability, accessibility, and acceptability of FQHC services

(Note: The FQHC must also submit required data and information to HRSA in a timely manner and with such frequency as prescribed by HRSA. See Uniform Data System (UDS) and SFR 425 reports as examples.)

Demonstrating Compliance is key.

A FQHC can demonstrate compliance by:

• Maintaining a system in place for overseeing the operations of the Federal award-supported healthcare activities to ensure compliance. Does the FQHC have a system in place to collect and organize data related to the scope of project, including those data elements for the UDS reporting? Does the FQHC submit timely, accurate, and complete UDS reports in accordance with HRSA instructions? (Keep familiar with these instructions. Very important to review it annually.)
• Maintaining a system that produces data-based reports on patient service utilization, trends and patterns in patient population, and overall health center performance, as necessary to inform and support internal decision making and oversight by the FQHC’s key management staff and governing board. Does the FQHC have enough invested in its technology to ensure proper reporting?

It’s fair to say the implementation of EHR has made program monitoring and data reporting much easier. Imagine trying to achieve these tasks with only access to paper!