Health Help Tech Recs – Considerations For Ehr Rfps

Section 3012 of the HITECH act establishes Health Information Technology Regional Extension Centers (REC) that volition offering technical assistance, guidance together with information on best practices to back upwards together with accelerate wellness aid providers’ efforts to boot the bucket meaningful users of Electronic Health Records (EHRs).  Each REC shall aim to supply assistance together with pedagogy to all providers inwards a region, but shall prioritize whatever direct assistance starting fourth dimension to the following:

• Public or not-for-profit hospitals or critical access hospitals.
• Federally qualified wellness centers (as defined inwards department 1861(aa)(4) of the Social Security Act).
• Entities that are located inwards rural together with other areas that serve uninsured, underinsured, together with medically underserved individuals (regardless of whether such surface area is urban or rural).
• Individual or modest grouping practices (or a consortium thereof) that are primarily focused on primary care.

So far, ONC has granted over one-half a billion dollars to threescore RECs to hand these goals. One of the starting fourth dimension steps the RECs involve to bring is the evaluation together with subsequent recommendation of EHR technologies to their constituents.  Whether the REC selects ane EHR to piece of work with, or a curt listing of preferred vendors, or simply a full general rating organization for multiple vendors, chances are an RFP, or at the really to the lowest degree an RFI, volition live on issued to EHR vendors.

Following the grant annunciation several RECs issued (Requests for Proposals) RFPs together with some completed the EHR alternative process, spell most are all the same inwards the procedure of creating RFPs. The few RFPs currently published are past times together with large based on the DOQ-IT EHR RFP.  While the DOQ-IT document is splendid for an private practice, it needs some of import adjustments inwards gild to serve a REC’s objectives together with stated priorities.

1. Facilitate EHR adoption for several hundreds, to several thousands of providers, inwards a curt amount of fourth dimension – This objective volition require that for an EHR vendor to live on considered, it must direct maintain the capacity to genuinely perform such large scale implementations, both inwards human resources (quantity together with quality) together with technical infrastructure scalability. The RFP should enquire virtually both aspects.
2. All REC providers must live on eligible for Meaningful Use incentives – Any EHR selected past times the REC must be, or readily become, ONC certified for Meaningful Use. Since in that place are currently no ONC approved certifying authorities, the closest an EHR tin come upwards to satisfying this requirement is past times already beingness CCHIT 2011 certified (comprehensive or Stage 1).
3. The starting fourth dimension priority for RECs is modest Primary Care practices amongst less than 10 providers – There are 2 concerns here. First, these practices are ordinarily non cash rich, hence the EHR licensing model, together with whatever additional fees, needs to live on thoroughly explored. Second, in that place are specific features that are to a greater extent than of import for Primary Care together with non ever available:
   
   a. Full ACOG documentation capabilities together with extensive prenatal pedagogy materials for OB
   b. Comprehensive Pediatrics module including immunizations schedules for children amongst exceptional needs together with catch-up schedules
4. The initial REC endeavor volition live on directed at providers serving large Medicaid populations, rural areas together with other medically underserved patients. Physicians together with clinics providing services inwards these areas direct maintain really specific needs, non necessarily found inwards most EHRs.
   
   a. Behavioral Health – Any EHR used for underserved populations must include extensive behavioral wellness modules or functionality.
   b. Comorbidities – The EHR must allow documentation together with handling of multiple problems inwards ane visit, i.e. loading of multiple templates simultaneously together with longitudinal tracking of multiple problems, including patient specific aid plans together with affliction management alerts.
   c. Outreach & Patient Education – In improver to the minimum requirements of MU, underserved populations would live on good served past times sophisticated outreach tools together with extensive, culturally adequate, patient pedagogy materials. Specific materials for people amongst disabilities are also desirable. Just having a PHR is in all likelihood non sufficient inwards areas where in that place are few computers together with wellness literacy is low.
   d. FQHC functionality – Any EHR used inwards these settings must direct maintain all the regulatory reporting (UDS) together with billing capabilities to back upwards federally qualified clinics.
   e. Substance Abuse, Smoking together with Obesity – It would live on beneficial if the EHR would include content together with tools to facilitate counseling along amongst mightiness to care grouping sessions.
   f. Home Care – Any functionality that allows integration of dwelling aid activities into a exercise EHR would live on beneficial.
   g. Medical Home – Functionality built to meliorate back upwards medical homes creation together with operations, such every bit full general aid coordination together with collaboration, reporting together with referral management should live on helpful. RECs should enquire if EHR vendor has sense amongst whatever PCMH deployment.
   h. Rural Health Connectivity – Considering that most REC implementations volition happen inwards rural settings where broadband together with Internet connectivity are non yet every bit reliable every bit inwards urban areas, EHRs should supply contingency plans for internet service provider outages or lengthy periods of impaired answer time.
   i. Patient Volume – Most clinics to live on served past times RECs direct maintain really large together with complex patient volumes. EHR relaxation of occupation together with usability features volition live on extremely of import for successful adoption. Other than testing together with evaluating recommended products, RECs should also obtain cognition of a vendor’s Quality Assurance procedure together with the number of Usability professionals straight involved inwards production development.
   j. Last, but non least, whatever EHR vendor selected past times a REC should live on willing together with able to integrate amongst existing State specific technology scientific discipline efforts to back upwards underserved populations. H5N1 goodness representative volition live on the Indian Health Services RPMS together with its Patient Care Component, or whatever other Medicaid sponsored networks such every bit MO HealthNet inwards Missouri.
5. RECs volition live on engaging inwards the largest long term EHR implementation endeavor to date.  It is to live on expected that despite best endeavor some implementations volition neglect together with some practices volition live on de-installing EHRs. H5N1 detailed excogitation of activeness for extracting EHR together with PMS information from recommended EHR systems is imperative. RECs should enquire about, together with contractually request, equitable information extraction processes.

Note 1: Regarding EHR Modules - Although ONC volition live on certifying EHR Modules, it volition live on prudent for RECs tol alone direct maintain RFP responses from consummate products or vendors aggregating modules into consummate products. It would non live on advisable for RECs to engage inwards EHR Module aggregation due to the aggressive timelines together with shortage of expertise.

Note 2: Regarding Meaningful Use – At the fourth dimension of this writing CMS has non finalized the minimum requirements for Stage 1 Meaningful Use. It is really probable that the currently proposed requirements volition live on reduced inwards scope. However, the 25 certification requirements for EHRs should rest unchanged. Guaranties notwithstanding, EHRs that autumn curt of those requirements today are less probable to live on able to come upwards up to speed together with certify inwards fourth dimension for the RECs to run across their aggressive schedules. RECs deciding to recommend such EHR products should, at the really least, position together with clearly explicate the hazard to their providers.