The Health IT Regional Extension Center Program: Evolution and Lessons for Health Care Transformation

Abstract

Objective. Assess the Regional Extension Center (REC) program's progress toward its goal of supporting over 100,000 providers in small, rural, and underserved practices to achieve meaningful use (MU) of an electronic health record (EHR). Data Sources/Study Setting. Data collected January 2010 through June 2013 via monitoring and evaluation of the 4-year REC program. Study Design. Descriptive study of 62 REC programs. Data Collection/Extraction Methods. Primary data collected from RECs were merged with nine other datasets, and descriptive statistics of progress by practice setting and penetration of targeted providers were calculated. Principal Findings. RECs recruited almost 134,000 primary care providers (PCPs), or 44 percent of the nation's PCPs; 86 percent of these were using an EHR with advanced functionality and almost half (48 percent) have demonstrated MU. Eightythree percent of Federally Qualified Health Centers and 78 percent of the nation's Critical Access Hospitals were participating with an REC. Conclusions. RECs have made substantial progress in assisting PCPs with adoption and MU of EHRs. This infrastructure supports small practices, community health centers, and rural and public hospitals to use technology for care delivery transformation and improvement. Key Words. Health information technology, electronic health records, meaningful use, practice transformation, primary care providers Health information technology (health IT) is foundational to the pursuit of the three-part aim of achieving better care, better health, and reducing costs (Berwick, Nolan, and Whittington 2008;Buntin, Jain, and Blumenthal 2010). Despite the potential benefits of health IT, adoption of electronic health records (EHRs) has been slow (Blumenthal 2010). In 2008, only 8 percent of

Area-level factors associated with electronic health record adoption and meaningful use in the Regional Extension Center Program

“…20 21 Information about the area-level correlates of EHR adoption and MU in the current HITECH era is beginning to emerge. One recent and noteworthy study reported substantial progress towards EHR adoption and MU among REC-enrolled PCPs based in underserved settings, assessing EHR adoption and MU patterns by practice setting, provider type, and geographic area; 22 however, this study focused on a limited set of area-level characteristics and did not assess the potential contributions of other HITECH initiatives to EHR adoption and MU.…”

Adoption And Use Of Electronic Health Records Among Federally Qualified Health Centers Grew Substantially During 2010–12

“…11 HITECH has also created programs to train health care providers and other staff to help implement health IT.…”

Progress And Challenges: Implementation And Use Of Health Information Technology Among Critical-Access Hospitals

“…These programs include the Medicare Rural Hospital Flexibility (Flex) Program, 4 the health IT Regional Extension Centers, 18 and the Workforce Development Program of the Office of the National Coordinator for Health Information Technology. 19 In addition, many federal programs offer financing or subsidies to extend access to health care through the use of such tools as teleradiology (the real-time transfer of highresolution images) and video consultations.…”