With the looming deadlines resulting from the HITECH Act, physicians are scrambling to choose and implement technology that will meet meaningful use guidelines certified by the Dept. of Health and Human Services.
To help physicians, especially those in small practices with limited technological resources, migrate toward a paperless practice, the federal government awarded nearly $1 billion in grants to 60 Regional Extension Centers (RECs) to help physicians choose and implement technology, which will hopefully improve the quality and efficiency of health care in the United States. However, what looks good on paper doesn’t always translate into the real world.
Consider what is happening in New York. Two RECs in the state, NYC REACH and New York eHealth Collaborative (NYeC) received $48.2 million in federal grants. The charter of these organizations is to serve the physicians which should include providing them an opportunity to discover all the EMR solutions available.
Unfortunately, in this particular case, the RECs made a decision to provide a short list of vendors limited to the big players. All of these companies offer solutions designed for hospitals or large physician groups rather than one or two internists operating out of a small practice. Not to mention, the price tags for these products can run extremely high for the 1-10 physician practice.
Unfortunately, this short list of vendors may not be the best option for the large class of physician practices operating in ambulatory settings of 10 physicians or less. What small practices really need are easy-to-install, easy-to-maintain solutions.
According to a recent survey by KLAS Research of 370 ambulatory-care physicians or practice leaders, one-third want a SaaS-based EMR system. SaaS-based EMRs are perfect for this market segment because SaaS requires little technological expertise, a big advantage for smaller physician groups with limited resources. RECs should spend more time acquainting themselves with what SaaS technology is and translating the benefits of SaaS to the physician.
Little to no emphasis has been placed on this technology, preferring rather to label it as hosted or ASP technologies. It is neither, yet it is perfect for the smaller physician groups that do not want to sacrifice functionality for price.
State medical societies like the Virginia Medical Society have adopted standard approaches from selection to implementation, including pricing, contracting, certifications and implementation while garnering the ears of vendors and physicians in more of a collaborative approach. Not every system is the right system for any given physician practice, just as there are not only three solutions that will work for all practices.
If the REC program is designed to truly help physicians, a few things need to happen:
- Uniformed Approach – Currently, RECs are operating as autonomous units with no uniformed approach. RECs need to develop a consistent strategy that encompasses how they engage with physicians, program goals and metrics for success.
- Focus on Physicians – Rather than cutting deals and negotiating prices with EMR vendors, RECs should focus on the physicians to better understand their needs, concerns and available resources, so they can help them choose an EMR solution tailored to their practice, size just being one of many variables.
- Long-term Support – RECs need to clearly communicate how they plan to support physicians in the long term as dependence on technology continues to grow in the healthcare industry.
One REC doing things differently is the Washington-Idaho Regional Extension Center (WIREC). They have a vendor-neutral process, but still require vendors to submit participation letters while paying close attention to the necessary certifications required for meaningful use. They are focusing on ways to narrow the technology services gap between physicians and vendors.
Some RECs have formed unique and potentially highly influential relationships around managed service organizations (MSOs) focusing on the technologies intrinsic in the offerings and accepting responsibility for technical implementation. This, too, seems like a win-win scenario. The value of this program is to engage and maintain long-term meaningful relationships to help physicians and vendors drive greater success through implementation engineering, not shortening the list of vendors to a select few without knowing what the physician practice needs. They need more technical assistance after selection than they do prior to selection. RECs should be in it for the long haul and not for quick wins.
With this level of funding and commitment from the federal government, we really have the opportunity to make a difference in healthcare, but we have to take an approach that will be the most beneficial for the physicians we are all trying to serve.
My vote is to give physicians the ability to participate to a greater extent in the selection process. In my opinion the value that the RECs can play is to develop comparative matrices and allow the physicians to shop for the solution that best fits their needs. It’s similar to the established mini-mall concept for buying cars. Evaluating vendor capabilities, strengths and weaknesses might best be done when comparing each vendor’s approach, side by side.
Gary Ferguson is president and CEO of ClearPractice.
