Thursday, September 15, 2011

Guest Commentary: RECs – Help for Ambulatory Care Physicians in Implementing EHRs

Richard Jacoby, MD
Clinical Associate Professor
Jefferson School of Population Health

Over the past year, states across the country have developed Regional Extension Centers (RECs) to support the electronic health record (EHR) initiative passed as part of the American Recovery and Reinvestment Act (ARRA) of 2009. Why is this important? 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 health care providers is a critical first step in enhancing the quality and value of health care delivered in the U. S. However, adoption of electronic health records by physicians has been painfully slow in this country. How many of you still have to fill out a paper form when you visit your doctor?

The Health Information Technology for Economic and Clinical Health (HITECH) Act was included as part of ARRA to provide incentives for physicians and other health care providers to adopt and use EHRs in a meaningful way. 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. However, 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.

But adopting and utilizing a new technology can be a daunting task – especially when the technology is implemented in the context of health care provider practices. Recognizing this, the HITECH act established and partially funded RECs to act as consultants – i.e. to support priority primary care providers and certain critical access hospitals in making choices, adopting, and “meaningfully using” EHRs.

RECs assist providers in evaluating the available EHR systems offered by different vendors and selecting one that meets the needs and budget of the practice. Next comes the really hard part – providers must re-engineer the way care is delivered in the practice to coincide with the new technology! It requires a detailed analysis of the practice workflow pre-and post-EHR implementation -- i.e., 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. If all goes as planned, RECs may play an important role in helping with the transition from paper-based to electronic systems.

The Jefferson School of Population Health is providing services to physicians as part of the REC effort in Pennsylvania. For more information, contact Richard Jacoby, M.D. at

No comments:

Post a Comment