EMR adoptions: What role will regional extension centers have?

Researchers say there needs to be more guidance on how the centers will help advance electronic medical records among small medical practices.

By Pamela Lewis Dolan, amednews staff. Posted April 28, 2010.

About $640 million has been made available, courtesy of the government's stimulus package, to establish regional extension centers intended to help small practices adopt and become meaningful users of health information technology.

But those centers might be too understaffed and underfunded to provide the help physicians need, according to a study in the April Health Affairs.

The study was published a few days before the Dept. of Health and Human Services released $267 million in funds from the Health Information Technology for Economic and Clinical Health Act for 28 regional centers, bringing the total number of centers to 60.

David Blumenthal, MD, the national coordinator for health information technology, in a statement announcing the new centers, said they are a "vital part of our overall efforts to improve the quality and efficiency of health care through the effective use of health IT."

Among the study's conclusions was that consultants working for extension centers should have direct experience with small practices, in addition to technical knowledge. The authors said a person with experience both in software implementation and work-flow adaptation in a practice is hard to find. The study, with funding from the Commonwealth Fund, reviewed 29 existing programs that assist physician practices with EMR adoption (content.healthaffairs.org/cgi/content/abstract/29/4/668/).

Phyllis Torda, vice president for strategy and the Quality Solutions Group with the National Committee for Quality Assurance and lead author of the study, said the Office of the National Coordinator for Health Information Technology is trying to address the work force shortage with initiatives to support training and work force development, "but I don't know how quickly that will pay off," she said.

Researchers found that many practices struggle most with choosing a system, but help in that area from the regional extension centers is lacking.

Study authors also questioned the sustainability of regional extension centers due to inadequate funding. Similar projects in Massachusetts and New York spent approximately $60,000 to $80,000 per targeted physician. Proposed federal funding of regional extension centers made available under the American Recovery and Reinvestment Act of 2009 averages to about $6,400 per targeted physician.

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