The Office of the National Coordinator (ONC) for Health IT faces a huge task ahead – releasing Meaningful Use guidelines, determining what qualifies an Electronic Health Record (EHR) as a “certified” product, identifying multiple agencies to act as certification bodies, specifying exactly how an EHR reports its Meaningful Use data, and doing all this so that the 2011 timeline can be achieved. In addition, the ONC has spurred efforts at health data exchange, whether it be from State Health Information Exchange programs or from fleshing out the Health Internet, and has moved to create and deploy Regional Extension Centers to be “feet on the street” that help individual physicians implement EHR systems.
There is certainly a lot on their table. Notwithstanding, the timelines specified in ARRA/HITECH legislation are looming, and the ONC has been prompted by many parties to move ahead quickly.
In its December 7th blog entry in Health IT Buzz, ONC chair David Blumenthal outlined the progress being made by his office. On the matter of the Regional Extension Centers, the ONC announced plans to accelerate the roll-out of this project from 3 rounds to two. The first round of about 30 grants will be made on January 21, 2010, and the remaining 40-ish grants to be announced in March. The ONC decided to compress the timetable to “take advantage of the high quality applications” it had received, as well as to accelerate the process in hopes of meeting the timetables.
What will the impact of these Regional Centers be? On the positive side, it may represent an increase in local help agencies with individuals who can work directly with rank-and-file practices (presumably smaller practices) as they attempt to adopt EHRs into their practices. Besides acquisition of hardware and software, the biggest hurdles for medical practitioners has more to do with workflow re-design and learning how to use the tools – this has frequently resulted in a dip in productivity as much as 20%, and this can last for months (depending on the usability of the product selected). For ambulatory practices, all 7 workflows involved in daily work must be addressed.
A challenge for the newly-appointed Regional Centers will be for them to fully appreciate the breadth of technologies available to physicians. If a given Regional Center only sees legacy vendors with local client/server installations as the health IT “universe” – that the future will simply be a bigger version of the past, with proliferation of local systems and data silos spreading everywhere – then that Regional Center will do its physicians a disservice. Legacy EHR systems will require consideration of local servers, local networks, firewalls and LAN security, data backup, and perhaps a Citrix layer to allow remote access from machines using different platforms (PC’s and Mac’s). Often, IT consultants engaged by medical practices have their own income tied to deployment and maintenance of such networks, and may lean in this direction automatically.
Practice Fusion, as one example, offers a web-based EHR which only requires local computers (desktop or laptop, PC or Mac) with an internet connection (hard-wired or wireless). Servers, LAN and security, backup, firewalls, Citrix layers – all these are unnecessary when using this kind of web technology. Further, Practice Fusion makes its offer as a free service to physicians (if one allows in-product ads), or as a low-cost ($100/month) subscription service if the ads are to be turned off. This may well be the best value option for physicians (especially smaller practices), and it is important that Regional Centers be aware of this sort of technology option when alternatives are reviewed with the individual practices they will be contacting.
The accelerated time table for deployment of Regional Centers is welcome news, and a sign that the ONC is responding to the calls to move forward quickly. We await with interest progress in the other domains – selection of certifying agencies, finalization of a certification criteria-set, finalization of Meaningful Use for 2011, etc. These next few months will represent a historic turning point in health IT, and we will be watching with great interest.
Robert Rowley, MD – Chief Medical Officer, Practice Fusion, Inc.
There is certainly a lot on their table. Notwithstanding, the timelines specified in ARRA/HITECH legislation are looming, and the ONC has been prompted by many parties to move ahead quickly.In its December 7th blog entry in Health IT Buzz, ONC chair David Blumenthal outlined the progress being made by his office. On the matter of the Regional Extension Centers, the ONC announced plans to accelerate the roll-out of this project from 3 rounds to two. The first round of about 30 grants will be made on January 21, 2010, and the remaining 40-ish grants to be announced in March. The ONC decided to compress the timetable to “take advantage of the high quality applications” it had received, as well as to accelerate the process in hopes of meeting the timetables.
What will the impact of these Regional Centers be? On the positive side, it may represent an increase in local help agencies with individuals who can work directly with rank-and-file practices (presumably smaller practices) as they attempt to adopt EHRs into their practices. Besides acquisition of hardware and software, the biggest hurdles for medical practitioners has more to do with workflow re-design and learning how to use the tools – this has frequently resulted in a dip in productivity as much as 20%, and this can last for months (depending on the usability of the product selected). For ambulatory practices, all 7 workflows involved in daily work must be addressed.
A challenge for the newly-appointed Regional Centers will be for them to fully appreciate the breadth of technologies available to physicians. If a given Regional Center only sees legacy vendors with local client/server installations as the health IT “universe” – that the future will simply be a bigger version of the past, with proliferation of local systems and data silos spreading everywhere – then that Regional Center will do its physicians a disservice. Legacy EHR systems will require consideration of local servers, local networks, firewalls and LAN security, data backup, and perhaps a Citrix layer to allow remote access from machines using different platforms (PC’s and Mac’s). Often, IT consultants engaged by medical practices have their own income tied to deployment and maintenance of such networks, and may lean in this direction automatically.
Practice Fusion, as one example, offers a web-based EHR which only requires local computers (desktop or laptop, PC or Mac) with an internet connection (hard-wired or wireless). Servers, LAN and security, backup, firewalls, Citrix layers – all these are unnecessary when using this kind of web technology. Further, Practice Fusion makes its offer as a free service to physicians (if one allows in-product ads), or as a low-cost ($100/month) subscription service if the ads are to be turned off. This may well be the best value option for physicians (especially smaller practices), and it is important that Regional Centers be aware of this sort of technology option when alternatives are reviewed with the individual practices they will be contacting.
The accelerated time table for deployment of Regional Centers is welcome news, and a sign that the ONC is responding to the calls to move forward quickly. We await with interest progress in the other domains – selection of certifying agencies, finalization of a certification criteria-set, finalization of Meaningful Use for 2011, etc. These next few months will represent a historic turning point in health IT, and we will be watching with great interest.
Robert Rowley, MD – Chief Medical Officer, Practice Fusion, Inc.
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