Sustainability, Partnership, and Teamwork in Health IT Implementation

Chapter 2. Sustainability of Health IT Supported by
the THQIT Grants
KEY FINDINGS
“This project has taken on a life of its own.”
—A value grantee
● ● Eighty-five percent of implementation and value grantees sustained or expanded health IT
systems after the end of the grant.
● ● Sixty-five percent of the planning grantees that did not receive THQIT implementation funding
still implemented some of the health IT they planned.
● ● The most common reasons grantees reported they could sustain the health IT were ability to
demonstrate benefits (77 percent) and clinician support (69 percent).
● ● The most frequent problems that led to some of the 69 implementation and value grantees
discontinuing or not implementing health IT were cost of ongoing maintenance (6 grantees),
lack of business case for the health IT and availability of funds (5 grantees), suboptimal level of
participation across partners (5 grantees), and lack of enthusiasm among physicians (4 grantees).
● ● Projects that reported conducting intensive process redesign before implementation, and those
that developed a detailed implementation plan, were significantly more likely to implement all of
their planned health IT.
Final grant reports are limited to 20 pages and must be filed within 90 days of the completion of a
grant. These requirements reduce the depth of available contextual and longitudinal information
about each project and limit evaluation of its impact, as it is not possible to assess whether results
were sustained beyond the project period. To complement the end-of-project reports, a comprehensive
set of surveys was administered to the THQIT grantees about 5 years after the end of the planning
grants and 2 to 3 years after the end of the implementation and value grants. Based on the survey and
follow-up interviews, this section explores answers to three key questions:
● ● To what extent was the health IT that was the focus of the THQIT grants sustained or increased
after the grant period?
● ● Where health IT was sustained, what were the reasons for and funding sources or income
streams for sustaining it?
● ● Where health IT was not sustained, what were the reasons for nonsustainability?
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Chapter 2. Sustainability of Health IT Supported by the THQIT Grants