“Health centers historically … were incredibly underfunded,” said Serrago. FQHCs provide many of the same services as other primary care organizations but often operate with significantly fewer resources, she said. “We are extremely aware of every dollar we spend and every dollar we are charging our health centers.”

Creating scale for community health centers

CTC's approach allows participating health centers to benefit from the organization's collective purchasing power and shared infrastructure. That can make Epic available to organizations that otherwise might not be able to afford the platform.

“Health centers that would normally never be able to afford Epic because of just how expensive it is are able to join our already established instance and get it at a much lower rate,” Serrago said.

Nelson noted that the need for that type of model is particularly acute among FQHCs, which often operate with small IT teams and disparate technology environments.

The organizations are also trying to help health centers manage the growing number of technology choices. CTC evaluates new AI and other technology offerings on behalf of its members to determine whether a new product is necessary or whether Epic already provides similar functionality.

In some cases, CTC has brought capabilities in-house by purchasing additional Epic applications rather than having individual health centers manage multiple third-party vendors. The goal is to consolidate technology and reduce costs for member organizations.

Supporting the EHR transition

Moving to Epic, however, involves considerably more than purchasing access to the platform. CTC's first implementation involved 10 health centers going live within 10 months, while the organization also had to evaluate more than 20 vendors and complete the associated contracting and implementation work.

“It was crazy. It was bananas,” Serrago said, noting that the organization had significant support from Med Tech Solutions throughout the process.

Med Tech's role has included managed services, help desk support and hands-on assistance during implementations and go-lives. Nelson said her team typically provides support during the critical first weeks after a health center transitions to Epic, working with providers, front-office employees and other end users to translate their day-to-day workflows into the new system.

“We serve as an extension of CTC,” Nelson said. She added that support is tailored to each health center because clinics have different levels of Epic and IT experience.

For Serrago, that support lets CTC's internal team focus on the core elements of the implementation while Med Tech handles many of the operational details around go-live.

“The partnership with Med Tech Solutions allowed us to be able to really just focus on what we needed to do as far as build,” she said. Med Tech also worked directly with individual health centers to determine staffing needs, support requirements, and go-live plans.

Technology aimed at improving access

The organizations say the technology is not simply about giving FQHCs access to a more sophisticated EHR. Optimizing workflows can also help health centers remove barriers for patients and increase efficiency.

Serrago said CTC has implemented tools such as e-check-in and virtual check-ins, as well as workflows that allow health centers to accommodate urgent-care needs and patients on standby.

“We're able to roll out e-check-ins, virtual check-ins and things like that to make it faster and easier,” she said.

Nelson said many health centers previously operated with homegrown, outdated or poorly optimized systems. Moving to a more standardized, supported environment can make those systems more user-friendly, which can reduce patient wait times and allow providers to spend more time directly with patients.

The partnership also has provided support during crises. Serrago described an instance in which an FQHC experienced a ransomware attack, and CTC helped shut down the network and work through the recovery process. The health center couldn't see patients while its systems were inaccessible but reopened after about three days.

Change management is critical

While technology is an important component of the model, both Serrago and Nelson emphasized that successful EHR implementation ultimately depends on people and organizational change.

Nelson said organizations moving to Epic should view the project as an “operational and IT transformation,” with attention to change management, end-user adoption and communication across stakeholder groups.

Serrago agreed, particularly for health centers undertaking an EHR conversion with limited resources.

“Change management is extremely important,” she said. “My advice would be make sure you have buy-in from all levels.”

That means involving not only executive leadership but also board members, managers and employees. During a major EHR transition, employees may have to work across two systems temporarily, undergo retraining, and adapt workflows, reports, and dashboards to the new platform.

“You're going to want to make sure that you really have that buy-in, and everyone understands why you are making the decision and why it's in the best interest of your organization,” Serrago said.

Implementing Epic in an ambulatory health center is different from implementing the system in a large hospital system. FQHCs need an implementation strategy that accounts for their smaller size, resource limitations, and learning curve.

For CTC and Med Tech Solutions, the partnership is continuing to evolve as CTC adds health centers and expands the services available to its members. The organizations are exploring additional ways Med Tech can augment CTC's teams during implementations while allowing CTC staff to remain focused on mission-critical work.

The broader goal, Nelson said, is to support CTC as it continues to expand access to technology for FQHCs. Serrago similarly said the organizations are willing to share their experience with other health centers undertaking EHR conversions—even those outside the CTC network.

For organizations with limited resources, the experience illustrates that gaining access to an enterprise EHR is only part of the challenge. Building the shared infrastructure, implementation support, and organizational buy-in needed to make the technology work for clinicians and patients can be just as important.