Rejuvenating RECs
by Triona Guidry
Regional Extension Centers (RECs) grew out of the need to improve on-the-ground healthcare information technology (HIT) assistance for small practices. But many are dissatisfied with RECs, to the point the mention of them often causes a heated debate.
Why have RECs gotten such a bad reputation, and what can be done to improve them?
One of the greatest challenges facing RECs is buy-in from physicians. Some are concerned that most RECs remain in the planning stages, while others wonder how RECs will become self-sustaining after stimulus funding ends. Although physicians are increasingly interested in implementing electronic health records (EHRs) and using mobile devices to provide better care, they remain dubious about whether the end results will justify the cost of ownership.
Accordingly, it has been difficult for RECs to get providers to commit. A 2010 survey from the eHealth Initiative reported that most RECs have had less than 20 percent of providers sign contracts. The same survey showed that RECs are well aware of the need to provide affordable, meaningful functionality to small practices. However, RECs also predict that they may have to change their fee structure or service offerings to accommodate self-sustainability, which may further discourage providers from committing.
Another question is whether RECs can attract IT talent. The shortage in healthcare IT workers, especially those with the necessary skills, is particularly acute in the small towns and rural areas RECs were created to serve. With RECs predicting a hands-on approach to providing technology, this is a critical gap. If physicians lack confidence that help will be available, they will be reluctant to adopt new technologies, especially when they don't see much benefit to themselves and their patients.
Amid the controversy, the achievements of RECs often go overlooked. Outreach efforts continue to improve as RECs find their footing and place in the healthcare community. Some RECs are baking quality data into their offerings, using their bulk purchasing power to benefit primary care physicians who otherwise would not be able to afford the kind of top-tier information available from EHR vendors. One REC in New York jump-started progress by growing into the nation's largest EHR extension project after launching as the Primary Care Information Project (PCIP) in 2005 and moving providers toward the principles of meaningful use years before the term was defined in the American Recovery and Reinvestment Act of 2009. Slowly but surely, RECs are finding ways to make a difference.
How can RECs be improved? Building trust with physicians is one of the keys to REC success. RECs need to be able to demonstrate how physicians and patients will benefit from their services, turning skeptics into evangelists for the REC model. At the same time, RECs need to attract and retain qualified IT staff who not only have the technical know-how but also the customer service skills to help instill confidence in reluctant providers. Continued analysis of successes and failures will be critical in helping RECs achieve their goals.
