Regional extension centers gain traction with small doc practices

Providers are finally starting to get on board with regional extension centers (RECs). Despite providing low- or no-cost IT consulting as part of the HITECH Act, RECs struggled for months to get buy-in from the small physician practices for which they are trying to implement electronic records and achieve Meaningful Use (MU).

As of this week, 100,000 small physician practices and rural hospitals have signed up for the REC program, according to HHS statements. Part of the reason: Some RECs, such as Telligen Health Information Technology in Iowa, have managed to help physician groups understand the services they offer and the significant subsidies or discounts that they can provide, according to an article in the Journal of AHIMA.

"The RECs are playing an integral role in helping providers on the path to EHR adoption," Dr. Farzad Mostashari, the Office of National Coordinator for Health Information Technology, said in a Health & Human Services (HHS) press release. "This compelling milestone demonstrates strong interest in adoption and meaningful use among community health centers, small practices, and rural providers that can lead to improvements in health and healthcare."

But it's still slow going. The RECs have always had an ambitious mandate. Within two years, they were expected to convince small practices--the average of which has only two doctors, little extra cash, and few IT resources--to install an EHR, figure out how to use it effectively, and demonstrate their Meaningful Use of the system to the government's satisfaction.

Still, HHS officials insist they've hit a tipping point, having signed up 90,000+ providers, with another 10,000 expected by year's end. The problem is that only 1 percent, or 1,000, of those practices have achieved Meaningful Use goals so far, and experts say they're likely the early adopters who would have pursued EMRs without government assistance anyway.

REC services run the gamut, officials say. Telligen has done everything from helping practices transform paper-based recordkeeping into an EHR to simply helping more IT-enabled practices to add on MU-critical modules like CPOE, the Journal reports.

Physician practices looking to take advantage of REC services might not all be so lucky. Many RECs are still in the planning stages themselves, according to a recent survey by industry group eHealthInitiative. There is some sense from respondents, though, that momentum is building for more implementations in 2012.

But HHS isn't letting up on the pressure for both RECs and providers to reach MU goals. For example, Mostashari is pushing the agency to get practices qualified for Medicaid incentive payments before next spring.

"Our challenge to extension centers is that every Medicaid provider that you're working with must get $22,000 in the next six months, not because of the money but because it's a concrete indicator of our commitment to them that this is real. Then take those who have adopted and keep moving toward meaningful use," Mostashari said.

One important note for physician practices taking a "wait-and-see" attitude: the $643 million in federal funds subsidizing the RECs low-cost services will run out in four years. And it's heavily front-loaded, with nearly $600 million to be handed out in the first two years, according to HealthcareITNews.

To learn more:
- check out the Journal of AHIMA report
- read the HHS press release
- visit the's blog
- dig into GovHealthIT's coverage
- read the HealthcareITNews article