Tennessee REC: 'We're now at a tipping point'

Most practices in Tennessee have adopted an electronic health record system, but smaller practices are faring better than larger ones at attesting to Meaningful Use, according to Jennifer McAnally Ride, director of the Volunteer State's regional extension center.

"The larger organizations with large Medicaid populations [are less likely to have met Meaningful Use]," Ride told FierceEMR in an exclusive interview. "They have more trouble moving, are more bureaucratic and have competing priorities. That's not what we expected,"

In addition, Ride talked about some of the challenges Tennessee providers have faced, what's in store for Stage 2, and how her REC will sustain itself after grant funding ends in 2014. 

FierceEMR: Describe the successes of your REC.

Ride: Tennessee has been very progressive in promoting health IT and health information exchange. We were initially contracted for 1,343 primary care physicians, and have signed up 1,800, so we're above the recruitment goal. Some of the participants are specialists. Sixty-two percent have successfully attested to Meaningful Use. We're now at a tipping point at adoption.

We also have a good relationship with our state agencies, including Tenncare [Tennessee's Medicaid program] to push health IT.

What was surprising is that we anticipated that physicians would want help with contracting, selecting an EHR and planning. But most people had an idea of what EHR to choose.

FierceEMR: What obstacles have Tennessee providers experienced in adopting EHRs?

Ride: Physicians have competing priorities--payment reform, ICD-10, PQRS. There's so much going on in healthcare and in these practices. It's very difficult for practices to be mindful of Meaningful Use.

Tennessee also does not always rank well in outcomes, so there's room for improvement.  

FierceEMR: What's on the horizon for your REC 2014?

Ride: We recently received a two-year contract from Tennessee to work with Medicaid-eligible providers. We're also working to support the Direct Project. And many providers are asking for our help after 2014.

At lot of RECs are looking at privacy and security to achieve sustainability and are doing vulnerability testing. It's such a big part of HIPAA and Meaningful Use. RECs are out there to help practices [with this]. We do have tools and resources to help them. We're dipping our toes in that, too.

Unfortunately so many physicians don't realize that they're violating [privacy and security] regulations.

FierceEMR: Any advice for providers?

Ride: Patient engagement is the next step in Meaningful Use Stage 2.  As patients, we'll really see a change to be part of the care team, not just observers.

This interview has been edited and condensed for clarity.