Over the past year, states across the country have begun to develop Regional Extension Centers (RECs) to help support the broad electronic health record (EHR) initiative passed as part of the economic stimulus package in 2009.
Why should physicians care? With benefit of a little background information, the answer is pretty clear.
The evidence suggests — and it is generally believed — that adoption of EHRs by physicians and other healthcare providers is a critical first step in enhancing the quality and value of healthcare in the U.S.
The Health Information Technology for Economic and Clinical Health (HITECH) Act was part of the stimulus designed to provide incentives for physicians and other healthcare providers to adopt and use EHRs in a meaningful way.
CMS has designated specific benchmarks and timelines under “meaningful use” in terms of improving the quality, safety, and efficiency of care, engaging patients and families, improving care coordination, improving population and public health, and ensuring privacy and security for personal health information.
By meeting HITECH criteria for “meaningful use,” physicians and other providers can qualify for up to $44,000 from Medicare and/or $63,750 from Medicaid to offset their EHR purchase costs.
There is a stick to go along with the carrot. Beginning in 2015, CMS will impose financial penalties on providers who do not engage in meaningful use of health information technology.
So, where — and how — do you start? The process of making the transition from paper records to electronic records is complex and time-consuming for busy healthcare providers.
First, you must devote time and effort toward evaluating the available systems and selecting one that meets the needs and budget of the practice.
Next comes the really hard part — re-engineering the way care is delivered in the practice to coincide with the new technology!
This is no small feat. It requires a detailed analysis of the practice work flow pre-and post-EHR implementation — understanding what each employee currently does, and what that employee will do post-implementation, from the moment a patient enters the office until the time he/she leaves.
Once the practice is up and running with the new technology in place, challenges remain. Providers must understand and comply with specific rules in order for the practice to qualify for incentive payments.
Recognizing that adopting and utilizing a new technology can be a daunting task, the HITECH act also established and partially funded RECs to act as consultants — that is, to support priority primary care providers and certain critical access hospitals in making choices, adopting, and “meaningfully using” EHRs.
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Although EHR system vendors are expected to supply basic instruction and support, the higher level functions required to achieve “meaningful use” of EHRs falls under the purview of the REC.
How will a REC operate? That will probably vary from region to region, but in our area of Pennsylvania the quality improvement organization (QIO) for the state, Quality Insights of Pennsylvania (QIP), was chosen to direct the REC in the eastern portion of the state.
A number of healthcare entities are working in cooperation with QIP to supply the necessary consulting services. These include:
- Crozer-Keystone Health System
- PMSCO Healthcare Consulting of the Pennsylvania Medical Society
- Public Health Management Corporation
- Lancaster General Hospital
- The Pennsylvania Academy of Family Physicians
- Jefferson School of Population Health
To promote awareness of the program, QIP has developed a website and is contacting eligible providers and organizations. In addition, a series of five presentations and informational meetings will be offered to healthcare providers in various locations throughout eastern Pennsylvania.
A list of RECs available nationwide and other information on RECs is available at the Department of Health and Human Services website:
http://www.healthit.hhs.gov/extensionprogram
Clearly, RECs should be on your radar screen. If all goes as planned, they may play an important role in helping you with the transition from paper-based to electronic systems.
However, even with the best-laid plans, there may be unanticipated roadblocks.
In addition to the difficult but necessary culture change within practices, money may continue to present a barrier to success.
Will the promise of reimbursement of costs be a sufficient inducement for providers to purchase EHRs?
Will the REC business model as outlined in the HITECH Act allow them to be sustained?
David B. Nash is Founding Dean of the Jefferson School of Population Health at Thomas Jefferson University and blogs at Nash on Health Policy.
Originally published in MedPage Today. Visit MedPageToday.com for more health policy news.
