Austin/Travis County: Strengthening the Safety Net Through Health Information Technology

Communities in Charge

Field of Work: Helping community coalitions design and establish sustainable health care delivery systems.

Problem Synopsis: In 1998, 44.5 million people in America did not have health insurance, according to the federal Health Resources and Services Administration (HRSA). In the absence of comprehensive federal efforts to expand health coverage, the burden of caring for uninsured individuals falls on states and local communities. Often, local health care systems are not organized to promote prevention and early intervention, coordinate care and services or monitor access to and quality of care. When people do not receive the care they need, the costs are borne by providers, local governments and, ultimately, local taxpayers.

Synopsis of the Work: In July 1997, the Board of Directors of the Robert Wood Johnson Foundation (RWJF) authorized $16.8 million to support Communities in Charge: Financing and Delivering Health Care to the Uninsured (CIC). CIC was designed to help broad-based community coalitions design and establish sustainable health care delivery systems. The Austin/Travis County Health and Human Services Department used its InformationLinks grant to strengthen its ties to the Indigent Care Collaboration (ICC), an alliance of safety net providers serving a three-county region of central Texas.

Key Results: From 2000 to 2003, the ICC developed the I-Care system, with a $2-million Community Access Program grant from the federal Health Resources and Services Administration. I-Care is a repository for clinical data that allows safety net providers to build systems for sharing electronic medical records.

In 2004, I-Care included more than 300,000 patients in its data repository and was adding 10,000 encounters per week from more than 30 hospital, clinic, and physician network locations.