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RECs Won't Finish Mission Without More Funding

Scott Mace, for HealthLeaders Media, March 18, 2014

Gladd is more than just a blogger; until last year, he worked for the Nevada/Utah REC. And he recounted this story not just to me, but to the assembled press at the very conclusion of HIMSS, where new ONC chief Karen DeSalvo MD had agreed to take questions.

How did DeSalvo respond? The answer to that later. But first, a little more data to ponder.

According to Ryan Sandefer, chair of Duluth, MN-based College of St. Scholastica's department of healthcare informatics, as of last summer, only three percent of rural and critical access hospitals who could have performed their second year of Stage 1 attestation had done so. Sandefer had collected this data nationwide as part of his work with REACH, the Regional Extension Assistance Center for HIT, which serves Minnesota and North Dakota.

The same research found that only 20 percent of rural, non-critical access hospitals had only done 20 percent of second-year Stage 1 attestations.That's certainly better than 3 percent, but still nothing to celebrate.

Many of these hospitals are stuck in a queue waiting for vendors to upgrade to the 2014 certified version of their EHR software. Some of those providers are luckier than others, because their EHR software vendor does indeed have 2014 certified software to install, or even has the Stage 2-certified versions available to install.

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2 comments on "RECs Won't Finish Mission Without More Funding"


Sherry Reynolds (3/18/2014 at 4:11 PM)
The program was always set up with sustainability built in - in fact none of the REC's got any funding without a plan to survived. They were also supposed to be partially vs fully funded at 80/20 then 20/80 but ONC let them become dependent on govt funding. Providers can easily get a "free" EHR and get up to $64k over the first few years of using one and they could use that to pay for the consulting services. There are also many many rural health programs that provide additional funding for rural hospitals that ONC and rural health have put together. ONC and HITECH were supposed to be startup capital and the RECs had four years to figure out that they could have charged for their services.. Even if only at 20% it would have given them an extra year.

PJC (3/18/2014 at 3:49 PM)
The article notes an important point. The government's role in accelerating the adoption of EHR technology has been 3-fold, though almost all the press has been around incentives. The 3 elements have been: incentives (to help defray the cost of EHR acquisition and implementation), technical assistance (to provide low cost or even free expert technical consulting during the migration), and oversight (to establish standards through certification and to coordinate efforts among stakeholders). Because these were the three major obstacles raised by physicians when polled 5 years ago - a lack of working capital, knowhow and standardized EHR products. Now, with only about half of all providers having ever achieved MU at all, what's changed for those who haven't yet started? Not much. MU certification certainly helps, (and I'd even say, fewer vendors is actually advantageous), but the other two problems remain - and impending penalties make the capital pinch worse, while declining REC assistance leaves providers with huge challenges. But now that we've spent nearly $20B on incentives, how costly is it to lose a player who, having once achieve MU, decides to quit because they still can't afford the game? I'd say it's even worse to lose someone who has received incentives than it is to fail to help someone migrate in the first place. It's like a bridge halfway across the river. 2014 will be a watershed. ICD-10 will occupy all the "change agent" resources available form most practices. MU participation will fall off, before we can really prove whether the migration is working. And Congress will either wake up and realize the job isn't finished and needs more time, and yes, more money, or they will declare the whole thing a failure and waste precious time laying blame on this side or that side of the aisle. I hope fervently for the former.