Small but mighty: Community clinic reflects on 20-year EHR partnership

Toby Matula, CIO, Heart of Texas Community Health Center -

The Waco-based Heart of Texas Community Health Center has been providing primary healthcare services to the neediest members of our community in McLennan County since 1970. We've come a long way since our inception — I remember installing early software with 3.5" floppy disks and 9-track tape — but we're still the same organization: a small clinic doing a lot with a little and taking immense pride in the care we provide to our patients.

As a safety-net organization and Federally Qualified Health Center, every moment and every dollar we're able to spend on patient care is precious. A large part of our ability to deliver the best outcomes for our patients while remaining financially solvent has been our use of technology to keep us lean and efficient. In fact, we were an early adopter of the EHR — technology that's now commonplace throughout healthcare.

In the 1980s, we were using our first set of electronic systems, which certainly left some room for improvement. There was some concern from physicians that the technological shift of the impending digital age would disrupt patient care. But as a self-identified "computer geek," I believed deeply in the capacity for new technology to improve our ability to provide the best care for our patients.

We first partnered with Epic in 1991 to bring our scheduling and billing systems off paper and into an electronic system. Five years later, while many clinics and hospitals were still keeping patient records in a filing cabinet, we expanded the use of our electronic system to include digitizing clinical records. Despite the initial hesitation from physicians, we found that documentation didn't take any longer in the system compared with paper charting.

Soon, Heart of Texas was the place in Texas for prospective hospitals to come for demos of the software. Our little clinic in Waco had become the de facto statewide "showroom" for how to improve care through technology. Today, Heart of Texas continues to focus on efficiency with our use of technology, even having physicians help with system configuration in order to keep our technical team lean and ensure that the system is easy to use.

For over 25 years, embracing new technology has helped us, a small community health center, stay ahead of the curve so we can continue providing the best care to our patients. MyChart, the patient portal, has become integral to getting our patients engaged in their own care. Using the portal online or via an app on their phone, they're able to schedule appointments, check their test results and interact directly with their providers.

Over the years, we have worked together with our software developer to build products that specifically meet our needs, but our partnership provides more than just material software. We share a commitment to prioritizing the patient experience and a desire to improve health outcomes across the board by giving special attention to clinics serving vulnerable populations.

Epic has kept its commitment to carve out a space for smaller organizations and to continue supporting FQHCs, even as they've grown to support many organizations that far outsize our clinic. Epic's support, as well as a technology infrastructure grant for nonprofit organizations that allowed us to upgrade our systems in the early 2000s, has been vital to keeping our clinics running. Other healthcare organizations are still always surprised that our little group has such a strong connection with our software company's leaders. It's a testament to the ethos of the company and the power of private-public partnerships as a vehicle to improve healthcare delivery.

As Congress continues to debate the value of funding community health centers, it's important now more than ever that clinics like us are able to stay afloat while providing the best care possible. In the 37 years I've worked with Heart of Texas, I've witnessed firsthand the seismic shift in our productivity, efficiency and quality of care as a result of adopting innovative technology. In years to come, we look forward to embracing even more cutting-edge technology that will allow us to do more for our patients just as much as we look forward to continuing our partnerships with groups that share our commitment to keeping patients at the center of it all.

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