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September 2012 Quality Improvement Grantee Spotlight

"Hunter Health Clinic, Inc Uses Electronic Medical Records to Improve Diabetes Care"

Hunter Health Clinic, Inc logo.


The Health Resources and Services Administration (HRSA) Quality Improvement Website is pleased to highlight the Hunter Health Clinic, Inc. and their use of an electronic health record (EHR) to support improved care for patients with diabetes.  Hunter is a grantee of both the Indian Health Services (IHS) and HRSA’s Bureau of Primary Health Care.  They are a community health center, Health Care for the Homeless center and the only Title V Urban Indian Health Organization in Kansas.

Hunter went live with their electronic health record (EHR) in October 2009 and has successfully been tracking quality measures to improve health care quality and patient outcomes. Hunter uses the Indian Health Services’ Resource and Patient Management System (RPMS), a decentralized, integrated solution for the management of both clinical and administrative information.  RPMS features four main components: hardware, software, a network, and a database, all of which work together to support facilities to provide the best and most effective healthcare for individual patients and the community as a whole.  Hunter has found RPMS to be especially useful in their efforts to support improved care for their diabetic patients.


Image of Hunter Health Clinic staff receiving IHS training on RPMS EHR prior to “go-live”.

 Prior to “go-live” Hunter Health Clinic staff receives IHS training on RPMS EHR at their Central facility.”


Hunter Health Clinic, Inc.

Hunter Health Clinic is a non-profit, comprehensive health center specializing in caring for those who are uninsured and under-insured.  Hunter provides medical care, dental services, optometry, mental health counseling and substance abuse services across five sites while also serving as a training center for over 180 students, interns, residents and volunteers.  In 2011, Hunter provided over 84,000 patient encounters and saw 33,840 patients, 70% whom were uninsured and 80% whose incomes were below the federal poverty level.

Healthcare Improvement through the use of RPMS

Hunter has used RPMS to support their government reporting requirements. Currently, Hunter routinely reports on 13 required measures.  By generating these indicators in real time, through their use of RPMS, Hunter can identify successful interventions that have resulted in measured improvement and rapidly identify areas for additional focus including opportunities for enhancing their preventive care.

Meaningful Use clinical quality measures can also be generated through RPMS.  The clinic has been able to improve their stage 1 Meaningful Use core measures through the use of RPMS to better capture the information reported in the EHR.


Screenshot is of a quality report for diabetes patients within a subpopulation from January first 2011 to December thirty-first 2011, January first 2012 to March thirtieth 2012, and April first 2012 to June thirtieth 2012. Quality Reports displays the percentage of patients with HbA1c levels below 7, between 7 and 9, and above 9.

Using an EHR in Diabetes Care

Hunter operates a free-standing diabetes specialty clinic as a complement to their primary care services. The diabetes team, consisting of two dedicated clinicians, a foot specialist, a dietician, diabetes educators, nurses, an optometrist, and an outreach coordinator, provides comprehensive diabetes management. The clinic also supports a diabetes-specific medication program, laboratory services, and preventive dental care for their patients with diabetes.

Hunter’s EHR allows a continuous and real-time view of the patient’s health status and is valuable in identifying necessary services to prevent adverse outcomes.  One example of this is Hunter’s coordination of vision care for their diabetic patients.  Through the use of the EHR, the optometrist is able to monitor the ocular health of the patient and schedule appointments when new symptoms are noted or if too much time has elapsed since the patient’s last visit.  In addition, when the optometrist suspects that a new patient may have diabetes, the patient can be referred and, generally seen, in the clinic the same day. Helping patients manage all elements of their disease results in better health outcomes.


Moving forward, Hunter plans to join the Wichita Health Information Exchange and Kansas Health Information Exchange to allow them to share data with other providers across the State. Hunter also continues to train its staff to improve their efficiency in using the EHR. Being able to see how the technology benefits the patients has helped improve staff’s confidence in the value of health information technology.

Susette M. Schwartz, J.D., Chief Executive Officer for Hunter illustrates a strong commitment to the National Health Services Corps. She shares, “In my role on the HHS Secretary Sebelius’s National Advisory Council (NAC) on the National Health Service Corps (NHSC), I see how HRSA truly wants to partner with IHS and see more Tribal and Urban Indian organizations participating.  This year alone, we have two new NHSC provider recipients; one PA scholar and one ARNP loan repayment recipient.”

For more information contact Olinda Harbaugh (RDLD, MPH, CDE), Director of Performance Improvement, to answer your question or direct you to the appropriate contact. 316.303.9595 ext 2202.