The federal government plans to establish a nationwide network of regional extension centers to help primary care physicians and other health care providers benefit from government programs that aim to promote the adoption and "meaningful use" of health information technology, or health IT, according to one government official. The centers primarily will help practices likely to face numerous challenges in meeting meaningful use requirements, including primary care practices, small physician practices, community and rural health centers, and public and critical-access hospitals.
According to Joshua Seidman, Ph.D., acting director of the Meaningful Use Division, Office of Provider Adoption Support, Office of the National Coordinator for Health Information Technology, practices that will face the greatest challenges also tend to provide more care to uninsured, underinsured and medically underserved patients and families. Seidman spoke during the eHealth Initiative's annual conference on health IT here in late January.
The regional extension centers will help about 1,000-2,000 physicians, focusing first on primary care practices, Seidman said. However, "ultimately, these regional extension centers will have many different roles," he noted.
"Obviously, they have an important role in helping to provide unbiased guidance. We are very clear about the need for them to explain their processes around better selection and group purchasing."
The regional extension centers also will help practices with workflow and redesign issues by, for example, providing guidance on project management and implementation. "We have a very clear mission of what we are doing over the next few years," said Seidman. "We are going to be responsible for getting 100,000 primary care providers to meaningful use by the end of 2012. Saying that represents a pretty ambitious goal."
The regional extension centers are part of a broader program enacted through the American Recovery and Reinvestment Act of 2009, or ARRA. Many of the components of the legislation are designed to help health care professionals and hospitals become "meaningful users" of certified electronic health records, or EHRs.
CMS issued a proposed rule in late December to implement the ARRA provisions that provide incentive payments for the meaningful use of EHRs through Medicare and Medicaid and to further define the term meaningful use. CMS is accepting public comments on the proposed rule now; a final rule will be released in the spring.
Seidman said three components will support the meaningful use agenda: a federally funded health IT research center, a beacon communities program and workforce development initiatives.
The health IT research center, funded at $50 million, will oversee the regional extension centers, serve as a national learning community for best practices, and provide expertise and, potentially, consulting support. It also will develop resources to help the meaningful use program, according to Seidman. The research center is expected to augment the existing National Resource Center on Health IT currently maintained by the Agency for Healthcare Research and Quality.
In addition, HHS will designate 15 beacon communities throughout the country to build and strengthen the health IT information exchange capabilities of these communities and to demonstrate how high-performing and successful meaningful use initiatives on a large scale can improve the quality, safety and efficiency of health care.
HHS also plans to create programs within community colleges, universities and medical schools to promote a paid increase in the number of health IT-trained technical workers to oversee the content of EHR systems and to ensure that newly minted medical graduates are adept at using the technology.
"We are moving toward advanced clinical processes and, ultimately, to improved outcomes," said Seidman. "That is really what this is all about. Meaningful use is so important that we really believe that it is a critical part of many other things in a reformed (health care) delivery system."