Regional extension centers face a number of challenges as they begin to help providers ramp up their adoption of electronic health records (EHR) and comply with federal meaningful use mandates, REC representatives said in a recent eHealth Initiative webinar held to discuss their expectations and plans to work with providers.
Such issues as physician reluctance, inadequate staffing and uncertainty about meaningful use add to the difficulty of meeting the tight deadline given to RECs to boost IT adoption, according to the leaders of some organizations that have been designated as RECs.
The challenge is to get doctors involved with RECs and to make them see the value of RECs' assistance, said Micky Tripathi, president and chief executive officer of the Massachusetts eHealth Collaborative, during the webinar. The collaborative was designated the REC for the state.
Until now physicians have underappreciated the EHR adoption and the use of other IT services, Tripathi said. "We're not going to get them out of the pipeline until we get them into the pipeline."
For that involvement to happen, physicians need to know which meaningful use criteria they will be required to meet. Without that, doctors hesitate to move forward, said Sharon Donnelly, vice president of development for HealthInsight, which serves as the REC for Utah and Nevada. There is "an awful lot of ground to cover."
Under the HITECH Act, the Department of Health & Human Services has awarded more than $600 million to 60 organizations to become designated RECs. The organizations are charged with using those federal grants to offer education and technical assistance; the HHS's goal is to help 100,000 priority providers achieve meaningful use of certified EHR systems by 2012. Priority providers include primary care physicians, small group practices, public and critical-access hospitals, community health centers, and rural clinics.
The Office of the National Coordinator for Health Information Technology manages the REC program through its Office of Provider Adoption Support. In addition to working with providers, the RECs will be responsible for participating in the national Health IT Research Center (HITRC), which also is coordinated through ONC.
HITRC is being designed to act as a centralized learning center through which the RECs can learn and share best practices, and determine the best ways to create sustainable business models, said Mat Kendall, acting director of the adoption support office. "We're seeing a lot of different approaches by RECs across the country."
Each REC is hoping to reach out to roughly 1,000 providers to meet their objectives under the federal grant.
We're seeing a lot of different approaches by [regional extension centers] across the country.
Mat Kendall, Acting Director, Office of Provider Adoption Support
In Illinois, for example, where the EHR adoption rate is low and dial-up modem use is high, the REC is focusing on creating a high-speed network and establishing a rating for the best electronic records, along with access to hardware services, said Roger Holloway, executive director of Rural Health Resource Services at Northern Illinois University in DeKalb. The designated REC is considering charging an annual membership fee to providers, who then will have access to numerous services.
Meanwhile, the Fort Smith-based Arkansas Foundation for Medical Care -- the designated REC in Arkansas -- is considering a similar membership-based business model. Providers will pay an annual fee and get a suite of services, including technical help at their practice site and the opportunity to participate in group purchasing of IT products, according to Jonathan Fuchs, AFMC chief operating officer and project director for its HITArkansas division.
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