For help with EHR implementation, use REC resources

Regional extension centers will provide EHR implementation assistance to many health care facilities. In this tip, two REC leaders identify 10 specific ways their groups can help.

ORLANDO, FLA. -- Regional extension centers (RECs) have a distinct target audience they are supposed to help with electronic health record (EHR) implementation and meaningful use compliance: publicly owned or nonprofit hospitals, federally qualified health centers, certain rural hospitals, and of course, individual and small group practices.

But all health care providers -- in particular, specialists and medium-sized hospitals, which might need assistance in tuning up their EHR systems for meaningful use but are outside that target audience -- can benefit from networking with their local REC, according to two presenters here at the annual convention of the American Health Information Management Association (AHIMA). Shirley Eichenwald Maki, from the REC and Assistance Center for Minnesota and North Dakota, and Karen van Caulil, from the Central Florida HIT Initiative at the University of Central Florida College of Medicine REC, offered some insights for health care providers struggling to comply with the federal government's incentive programs.

Here are the 10 things that regional extension centers can do to help you survive an EHR implementation:

1. Narrow the vendor selection. There are about 300 electronic medical records vendors out there. RECs are choosing preferred EHR vendors and filtering the information, essentially doing some of your homework for you.

2.  Negotiate volume discounts. An EHR system is expensive enough. One of the missions of your REC is to represent the thousands of physicians in its territory as a way to obtain software at lower costs.

3.  Expedite meaningful use compliance. Which vendors are meaningful use certified? Which are compatible with the local health information exchanges (HIEs), connections with which will be an eventual tenet of meaningful use and a prerequisite for earning federal incentive payments? That's more homework the REC is doing.

4.  Encourage HIE compatibility. Even if you already have an EHR system in place, how are you going to hook up to the local and state HIE? Your local REC has been in contact with local HIEs already, differentiating them by type; they can vary from simple services for locating medical records to sophisticated systems delivering detailed data, as well as the data standards they will use to facilitate exchange between providers.

5.  Offer technical support for implementation. Maki and van Caulil have been in contact with many EHR vendors, and have seen them struggle to keep up with demand for their software, not to mention the meaningful use regulations and EHR standards required to keep their certification. That means vendors will be spread very thin when it comes to assisting with EHR implementation. RECs will step in and offer to help.

You will have to look at your current paper workflow and fix broken processes before going from paper to an EHR system. The REC will have expertise in this specific kind of project management.

6.  Assess workflow management. You will have to look at your current paper workflow and fix broken processes before you embark on an EHR implementation. Having helped practices like yours get their EHR systems off the ground, your REC will have expertise in this specific kind of project management.

7.  Work with specialists, albeit for a fee. RECs will have to charge fees to health care providers not qualified for free services funded by federal grant money. The two RECs represented at this presentation said they were trying to keep those costs as low as possible for specialists and other solo or small group practices that might not be covered in the legislation but are in the same boat as solo physicians who are covered.

8.  Proselytize for patient records. Patients will have to give permission to share data over an HIE. They also will need to know about the benefits of personal health records, or PHRs. In all likelihood, you will not have to write materials explaining all this because your REC will be writing similar materials that can be freely distributed.

9.  Understand mandatory quality reporting requirements: Collecting quality data in a structured way, teaching doctors and nurses to build the relevant documentation at the point of care, and submitting it to the appropriate entities: These are all processes in development as the final rules trickle down from Washington. How this whole process will happen is a mystery to many providers. Your REC will know more about how it works in your neck of the woods than most any other entity you could consult.

10.  Talk you off the ledge: If you are an older physician considering drastic measures -- retiring, dropping Medicare patients or selling your practice to a younger physician -- to avoid EHR implementation, then you are not really helping patients in your area. RECs are working with hundreds, if not thousands of physicians with similar business models. They can help.

Ultimately, RECs might not make EHR implementation easy per se. They can, however, make the implementation process easier than it would be if solo and small providers opted to go it alone, Maki and van Caulil said.

Let us know what you think about the story; email Don Fluckinger, Features Writer.

This was first published in October 2010

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