A few days ago, I wrote a column for sister blog EMRandHIPAA dishing out scathing criticism of the Regional Extension Center (REC) program.
Not one to mince words, I confess I was a bit merciless in my critique, slamming the RECs as virtually useless. (Yes, I’m sure they’ve had the occasional success, but far too few to justify their existence — or so it seems from my vantage point.) The column smoked out a few REC defenders, but most people who commented seemed to share my frustration.
All that being said, it’s hard to argue that there’s a place for organizations that intelligently, efficiently offer EMR adoption help to smaller medical practices. It’s all well and good to push hospitals and other institutions to go digital, but doctors are where the rubber hits the road.
So after heaping abuse on the RECs — your call as to whether I’ve been fair — I thought it might be worthwhile to offer a few alternative approaches (which could be offered singly or as a package):
* Small practices usually can’t afford top-drawer IT consultants to guide them in EMR adoption. What if the REC program existed entirely to help practices assess their workflow and clinical needs? The consultants, which could be made available for free or for a small fee, would come on site and teach practices how to think about these problems.
* The RECs could offer a very rich Web resource, including checklists and forms, helping practices create lists of automatically-generated criteria and matching those results to EMR products. Once the matching process was complete, RECs could offer phone-based or live sessions helping doctors understand how to effectively research those vendors.
* What if RECs offered intense EMR education classes, as some professional societies are beginning to do, which physician leaders could attend to gain a broader view of both business problems and technology issues. Ideally, the classes would come with CME credits, which would definitely encourage more doctors to attend.
So, these are just a few ideas that popped into my head as I composed this article. I’d love to hear your thoughts. What services should a REC or similar organization offer to advance EMR adoption?
Hi Katherine,
I’m not surprised that the RECs have not been able to deliver on their promise. They are essentially a government ordained and paid for service. The government was better off giving the money to the physicians directly and let them purchase the services they needed. We would have seen much better segmentation of services than if RECs have to serve all physicians in their local area. I’m sure many physicians are getting excellent service, but many are getting sub-optimal services and many are getting none.
I actually don’t think any of your suggestions will work.
Costs and Consultants. I agree that the costs are too high and that physicians need consultants to help them. However, most physicians don’t have the time to spare to work with consultants. How are we going to make this work? I’m sure the RECs have faced the same constraints.
Rich web source of check-lists and forms. There are a ton of check-lists and forms out there. Why should the RECs replicate what is already there? What physicians need is a streamlined process of EHR selection and tools that will capture their comparative information and allow them to see which ones are most likely to meet their requirements. They also need to be able to see how others with similar practices are faring with their EHR.
Classes. I think this might work. Physicians do attend CME programs, but classes are not enough. Physicians need information that is customized to their own practices, not generic information. There is a ton of generic information out there, available easily through a google search.
Classes also don’t reach out to remote and rural physicians, who make up a very large number of physicians in the US.
We definitely need some new ideas, but we need to understand the demographics and the needs and constraints of the various physician segments out there before we start developing solutions.
Karim
Why not ask the Brits how to do it …
The NHS-contracted PCPs have sucessfully implemented one of a half dozen EHRs across ~80-85% of their own with no interference or “incentive” from the Brit socialized medicine bubbas in London.
How did that happen?
Actually, NHS-contracted PCPs did get a lot of incentive from the government. 25% of their income comes from meeting quality of care targets that require sophisticated information technology. If they didn’t use IT, they would be poor. That’s a really, really good incentive in my mind!