Physician groups in rural parts of the country have greater challenges in adopting EHRs. The regional extension centers (RECs) are a new resource for them, but RECs serving rural areas, not surprisingly, also have challenges.
CentrEast, the REC designated for the 47 counties in central and east Texas, is looking to sign up 1,000 priority primary care providers. CentrEast is under the Rural and Community Health Institute (RCHI), a component of the Health Science Center at Texas A&M. RCHI was formed in 2003 to bridge healthcare disparities in the state and to improve quality of care and patient safety.
Robert Morrow, MD, medical director for the HSC, was part of a panel of providers who discussed best practices and lessons learned for RECs at the National Regional Extension Center and Health Information Exchange Summit West in San Francisco on Wednesday.
As the panelists revealed, even RECs need guidance as they help PPCPs with EHR implementation and adoption. Morrow reminded the audience that the federal funding for RECs is not a grant but a "small business loan for not-for-profit companies."
CentrEast is faced with an enormous challenge because providers in rural areas have so many barriers to overcome, including declining reimbursements, limited budgets and productivity, no or limited broadband and no buying power because health IT vendors tend not to support rural communities.
As a not-for-profit company with these challenges, CentrEast has had to be creative, efficient and smart with its resources. As with many of the RECs, CentrEast didn't get the amount it had requested from the Office of the National Coordinator for Health IT. In years one and two of its operations, the REC has to come up with 10 percent of funding to ONC's 90 percent. In years three and four, however, the tables turn and all RECs must pony up 90 percent of the funds.
Morrow said the challenge is to learn from the mistakes of others as everyone moves forward. One thing CentrEast plans to do once it has reached its goal of signing up 1,000 is reach out to non-PPCPs and specialists who are willing to implement and adopt EHRs. This strategy has been voiced by a few other REC representatives at the conference.
CentrEast formed a partnership with the Dwight Look College of Engineering at Texas A&M and worked with the college's industrial engineers to map out workflow and process re-engineering process for the physician office. Not all RECs have a connection to or are near a university with a strong engineering program, but it's a great idea to consider alternative disciplines to work out such issues as workflow analysis. Morrow noted that this is the domain of industrial engineers and they have the deep expertise, so it was natural for CentrEast to reach out to another department within the university.
Morrow suggested identifying local resources such as community colleges and physician champions to help the REC evangelize across the region. Keep strong communication lines open between your REC and the physician community. Morrow reminded the audience that what providers really need is support and access to "expertise."
Photo by bk1bennett via Creative Common license.
