The federal government has issued its proposed plan for establishing regional centers that will help physicians and hospitals choose and install electronic health records (EHRs) and get the most out of them. The target time frame for rolling these centers out is intended to support healthcare providers in time for them to qualify for Medicare EHR adoption incentives in 2011 and 2012, when the dollar amounts are the highest. Both the incentives and the plan for regional support centers are part of the American Recovery and Reinvestment Act (ARRA).
The Office of National Coordinator for Health Information Technology (ONC), which is getting $2 billion to improve the nation’s capability to use EHRs effectively and exchange information between them, has proposed that the goals of the regional centers be to encourage adoption of EHRs by clinicians and hospitals, help them become “meaningful users” according to the definition being developed to qualify for the incentives, and increase the odds that providers will become meaningful users. A significant portion of the centers’ activities will be to furnish individualized, on-site assistance.
This effort underscores the importance of choosing the right EHR system and dedicating the proper time and attention to making the system serve goals of healthcare improvement in the way it’s used. CCHIT encourages physicians to review the ONC plan in the Federal Register, comment on it and stay attuned to its progress in the coming year.
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(The link is dead to the ONC plan in the Federal Register.)
I am very much in favor of having some sort of review or rating mechanism for their implementation of EHR (whether certified or not). Users (docs, nurses, lab techs, etc) would be able to rate their systems based on meaningful usability. By tracking based on implementation (say, by hospital), one can better determine the degree to which poor usability is due to deficiencies inherent in a particular EHR vs those resulting from poor implementation.
This would also be an incentive for EHR companies to do a better job of providing post-implementation support, which in turn would improve our ability to be a “Meaningful User” (sung to tune of “Beautiful Dreamer”).
@Steve Daviss Thanks for mentioning the broken link. We’ve pointed to a different resource for the information.
In concept the program idea has merit, implementing an EHR isn’t the same as installing a shrink wrapped product on your PC. There’s a great deal of prep, planning, and adjustment (of the technology and the clinical processes) that need to be made etc.
Healthcare (and the management of healthcare process) isn’t like going to McDonald’s. McD’s takes pride is the fact that the Big Mac is made the same where ever you go. You simply can’t make the “Medical Big Mac” the same way in every location, and this is what adds layers of complexity to the implementation of an EHR.
Maybe it’s the nurse in me, or the person who’s been in on my fair share of implementations, but there should be a few primary goals of these “Centers of Implementation Excellence” (CIE: hey why not everything else in HIT has an acronym).
1.) They should include a strong focus on education and planning assistance (most Doc’s don’t have the resources or the time). 2.) They should work with the Vendors to help them “get it” — meaning the vendors need someone to help be the liaison into the medical care processes the CIE serves. 3.) They need to be able to make sure the medical providers in their communities have a way to support their efforts post go-live, and that these medical providers have the resources to provide input into the implementation planning, and don’t have to “adapt and adopt” a different workflow just “because”
If we focus on (and sorry to steal an over used quote) “teaching them to fish” these centers have a strong change of survival.
Physicians and hospitals are having a difficult time understanding how an EHR should fit into their daily workflow. There are so many unanswered questions (including the endless discussions on “meaningful use”) that need to be addressed before most physicians can really understand the full implications of implementing an EHR. The vast majority of physicians are not familiar with some of the basic technical issues that surround EHR implementation and usage. Therefore, their heads are spinning. My hope is that more efforts will be made to educate, train, and equip physicians before they’re asked to understand all these proposals and make important decisions based on them.
I’m still disappointed that in the money for these training centers, there’s not also provisions that require a coordinated effort to put the findings online and leverage technology to educate people all over the country as opposed to just these centers.
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