By Brita Van Fossen, Editorial Assistant
Since the passage of the HITECH Act in 2009, the focus throughout the health care industry has been compliance with meaningful use requirements and, consequently, EHR implementation. Recognizing the difficult nature of the implementation process, the government established regional extension centers (REC) to help health care providers cope with the intricacies and choices associated with the transition.
RECs are designed to help physicians with compliance regulations, technical assistance and EHR vendor selection to maximize governmental incentives. Each center is allotted government grants in return for aiding primary care physicians (PCP) — predominantly in practices comprising fewer than 10 clinicians.
Currently, 62 RECs operate in the United States. Although each REC’s end goal is the same, they are not uniform in their policies. A popular policy, which has recently been called into question, is the use of the “preferred vendor list.”
With over 300 EHR vendors on the market and a strict deadline to meet, some RECs have made the choice to narrow down the vendors that they are willing to work with and recommend to physicians. Based on their ability to fulfill meaningful use requirements, as well as a variable set of guidelines provided by each REC, the vendors are required to formally apply through the request for proposal (RFP) process. Once accepted, the REC will put the vendor on their list and recommend them to physicians. If denied, the vendor is essentially excluded from the market in an REC’s region.
Despite their benevolent and convenience-driven initial intentions, the regional extension centers inadvertently cornered the EHR vendor market — based on criteria they considered relevant — but overlooked vendors that might be preferable and more applicable to the physicians.
In an interview with ModernMedicine, Rhode Island-based and physician-led EHR vendor Amazing Charts Inc. discussed its struggle with RECs as a result of their preferred vendor lists. Based on its functionality and cost, Amazing Charts is recognized by physicians as a preferable choice, said company founder Jonathan Bertman, M.D. However, because the EHR doesn’t offer software as a service (SaaS), numerous RECs denied Amazing Charts a spot on their preferred EHR vendor list. Even after meeting with ONC to discuss the hindrance, the denial was upheld.
Initially, RECs struggled with the rates of adoption among their physicians. Although numerous other factors play a role, the journey for Amazing Charts serves as a viable explanation for the rate lag, because, at the end of the day, the most important voices in the process ended up making the difference. Physicians are aware of what they want in a vendor and the options on the REC lists weren’t compatible with those needs, so the physicians spoke out. These physician preferences, not the criteria that the regional extension centers compiled, were what ultimately granted Amazing Charts acceptance from the RECs.
As a result, some RECs — including the Massachusetts eHealth Collaborative (MAeHC), which is running the New Hampshire REC — have denounced the use of preferred vendor lists because of such unintended consequences. In the past year, rates of physician enrollment in RECs have increased, in part because of the newly increased emphasis placed on physician perspective.
With every step of the transition to EHRs thus far, there’s been a learning curve. The development of regional extension centers is no exception. As the meaningful use deadlines approach, it’s important to bear in mind the intended goal and the ultimate beneficiaries of regional extension centers.