South Carolina REC: Fostering EHR Implementation across the State

Mat Kendall and Kellie Hawkins | June 2, 2011

More than 1,000 providers in South Carolina are now on the road to meaningful use, thanks to the efforts of the Center for Information Technology Implementation Assistance Exit Disclaimer (CITIA-SC), the Regional Extension Center (REC) for the state. CITIA-SC, a program of Health Sciences South Carolina, is the second REC in the country to meet its initial recruitment goal. 

Todd Thornburg, Ph.D., senior program manager, attributes the early success of the REC to the relationships CITIA-SC formed with organizations that already knew South Carolina’s providers.

A Model Based on Collaboration

CITIA-SC is based at Health Sciences South Carolina Exit Disclaimer (HSSC), a biomedical research nonprofit that aims to improve the state’s health care system through research and state-wide collaborative programs. Six of the state’s largest health systems and South Carolina’s three research-intensive universities work together to form HSSC.

Following the lead of HSSC, CITIA-SC is also built on a collaborative structure. Instead of staffing the REC directly with health IT consultants who could help providers through the transition to meaningful use of electronic health records (EHRs), CITIA-SC distributed the funds among three organizations, allowing each one to hire staff to work with their specific constituency. To reach rural providers, CITIA-SC partnered with the South Carolina Office of Rural Health Exit Disclaimer, which has a trusted relationship with rural health clinics. South Carolina Primary Health Care Association Exit Disclaimer contributed its knowledge of the state’s community health centers. The Carolinas Center for Medical Excellence Exit Disclaimer brought its experience with quality improvement in hospitals across the state and helped the REC reach out to the half of state’s primary care practices that are owned by hospitals.

“The idea was to increase the capacity of already existing organizations that were already working with health care providers in the state,” says Thornburg. With their allocation of the REC funds, each organization hired EHR implementation specialists who have experience helping that type of provider transition to EHRs. The central staff based at HSSC coordinates among the different organizations and oversees the marketing, recruitment, and application process.

Thornburg says this cooperative structure made all the difference. “Health Sciences South Carolina, because of our experience, knew the power of trust. The trust providers have for the partner organizations helped us side step skepticism or overcome hesitancy to participate in the program.”

Also, by distributing the resources among the different organizations, the REC was able to recruit successfully. Representatives of the four organizations presented “everywhere [they] could present” to get the message to physicians across the state about the free services the REC offers to priority primary care practices—those serving rural or underserved areas or those with 10 or fewer physicians.

Thornburg says they’ve reached out to physicians in multiple ways—and many of the methods they’ve used came directly from the experiences of other RECs. “We’ve sent out emails and postcards and written articles for South Carolina Medical Society journal and regional medical journals. We did everything we could think of and tried to reach people in different ways. A lot of those ideas came from other RECs.”

What Physicians Are Saying

Interested physicians apply online for free consulting services through the REC. The application comes in to CITIA staff for approval, then the practice is referred to the appropriate partner organization to get matched with a consultant. The practice agrees to upgrade or adopt and implement a certified EHR package within one year.

Mackey Family Practice was one of the first practices to sign up for the REC services. A rural health provider and certified patient-centered medical home serving more than 40,000 patients about an hour south of Charlotte, Dr. Shealy’s practice was ready to upgrade to a certified EHR. Dr. Shealy heard about the program through Jay Moskowitz, Ph.D., CEO of HSSC and signed up for services.

Dr. Shealy says, “Our move would have been much more difficult without the REC. HSSC was an excellent resource for information and manpower. They came to our office to help with [EHR] implementation and answered our questions.” The practice was recently voted “Best of the Best” by county residents, and Dr. Shealy believes this is a direct result of the EHR implementation. “The ease of recovery of data always at your finger tips, [the ability] to send prescriptions effortlessly, and also communicate between each other,” all contribute to higher quality patient care and higher patient satisfaction.

Another physician who has received REC services through CITIA is Dr. John M. Carroll of Children’s Choice Pediatrics in Columbia, who was one of the first South Carolina doctors to receive the $21,250 Medicaid incentive payment. “This has been a win-win for our practice and our patients,” said Dr. Carroll. “Our system was a big investment for us, but it’s been worth it.”

Though CITIA-SC has met its initial program enrollment goal, the REC continues to offer technical support to health care providers throughout the state on a fee-for-service basis to advance the adoption of EHRs and offer guidance and information on EHR best practices. Thornburg believes that the positive experiences of the first 1,000 providers will prove the value of working with the REC to achieve meaningful use.

As Dr. Shealy tells other physicians considering the transition to EHRs, “Change is hard, but there are people who can help.”