ONC has recently put out a report evaluating the performance of the REC (Regional Extension Center) program. The report is only 124 pages, so you might want to save the light reading for the weekend. If you want something more consumable, you can read this blog post from Thomas A. Mason, MD which includes this nice summary:
Survey data included in the report released today indicates that 68 percent of the eligible professionals who received incentive payments under Stage 1 of the incentive program were assisted by an REC, compared to just 12 percent of those that did not work with a REC. The survey 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.
In the same blog post he also points out ONC’s numbers that “nearly all hospitals and approximately three-quarters of doctors reported using certified EHRs.”
That all sounds like a success to me. All these rosy numbers about people being helped. Lest we think this report doesn’t matter, HHS has already announced another $100 million over 5 years for what I’d call REC like support money for those participating in MACRA. I expect many of the RECs to get this money, but we’ll see.
What’s clear to me is that these REC organizations did indeed help many organizations get access to the meaningful use money. Only in the government could you spend money to get people to have you spend more money, but I digress. Most of the REC organizations that I met with really did a lot to help small practices with the meaningful use program. Some of their EHR selection efforts could be questioned, but not the MU help they provided. I can’t remember how many posts I’ve written about the random methodology that RECs seemed to use in their efforts to help their clients choose an EHR. It was a mess and full of weird influences (Note: There were some exceptions where certain RECs just supported everyone and every EHR or at least did a good job having their clients drive the process of which EHR to support).
When you look at the recent study be Deloitte that many doctors don’t know about MACRA, that could partially be because the RECs did a lot of the meaningful use education for doctors. We don’t have that yet for MACRA.
Personally, I’m torn on how valuable the RECs have been to the progression of health IT. Did they really help practices choose the right EHR and implement it in an effective way? What would have happened if they weren’t there? At the end of the day, the cost of the RECs is small potatoes next to the billions we spent on meaningful use. I’m sure some rural practices would have never considered participating in meaningful use if it weren’t for the RECs. No doubt that’s who the politicians are thinking about when they included the money for RECs and now for MACRA support.
The harder question to answer is if healthcare is better off with all these rural practices being “meaningful users” of EHR.