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Report: ONC’s Regional Extension Centers Program Boosted EHR Adoption

April 13, 2016
by Heather Landi
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The Office of the National Coordinator for Health IT’s (ONC) Regional Extension Centers (RECs) program had a significant impact on increasing meaningful use success among physicians and small providers, according to an ONC report.

The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009, was designed to spur widespread adoption of electronic health records and health information exchange across hospitals and doctors’ offices.

The Office of the National Coordinator for Health Information Technology (ONC) established the Regional Extension Center (REC) program, which set goals to support 100,000 providers with priority on providers working in small primary care practices, practices with a large proportion of patients with Medicaid or without insurance, community health centers, rural health clinics, and critical access hospitals.

In a Health IT Buzz blog post, Thomas Mason, M.D., chief medical officer for ONC, detailed the success of the $700 million Regional Extension Centers program. Through the REC program, ONC funded cooperative agreements with organizations across the nation to provide on-the-ground support to thousands of physicians working in solo and small practices, Federally Qualified Health Centers, and other provider organizations with a large number of underserved patients, Mason wrote. Many other organizations that received REC support, such as Critical Access Hospitals, were in rural settings.

This support included a wide array of services—selecting and implementing an EHR system and other certified health IT products; achieving the EHR Incentive Programs’ meaningful use requirements; providing assistance with privacy and security, including security risk assessments and practice workflow redesign.

In 2010 ONC contracted with the American Institutes for Research (AIR) to conduct a mixed method evaluation of the REC program’s implementation and impact. The goal of the evaluation was to estimate REC program impact by comparing outcomes for REC participants to nonparticipants, ONC said.

Survey data from the AIR evaluation indicates that REC participation was positively associated with receiving incentives through the Medicare and Medicaid EHR Incentive Program, as 68 percent of REC participants received incentives for achieving Stage 1 meaningful use, compared to just 12 percent of nonparticipants. And, according to the report, the current rate of receiving incentives among REC participants compared with nonparticipants is notable given some EHR systems’ limited capacity to achieve meaningful use as of only three years ago.

According to the report, REC participation was positively associated with EHR adoption among primary care physicians working in small practices or practices with a large underserved patient base. Further, RECs appeared to serve a wide range of early and late EHR adopters.

And in addition to assisting physicians and small providers with successful meaningful use attestation, RECs also helped these provides learn how to effectively use their EHRs. Significantly more REC participants used six EHR features routinely compared with nonparticipants. Five out of the six features were core objectives for Stage 1 meaningful use, and one was a menu objective, the report stated.

According to Mason in his blog post, the survey data also found that many providers working with RECs received frequent and tailored help—often face to face, for as long as it was needed.

“Many RECs also created both structured and informal opportunities for clinicians to learn from one another, creating economies of scale to reach more providers with limited resources and spread providers’ EHR product-specific knowledge. These findings build on those of a 2012 GAO report, which concluded that Medicare providers working with RECs were more than twice as likely to receive an incentive payment,” Mason wrote.

“In short, the hard work of thousands of people across the country engaging in and with RECs has contributed to a remarkable increase in the national health IT adoption rate among physicians, nurse practitioners and others. This success in digitizing the health care system is vital to creating a connected, interoperable learning health system that results in better care, smarter spending, and healthier people in all corners of the country,” he said.


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