Regional Extension Centers (RECs) represent a range of organizations that serve local communities throughout the country. The focus is to provide on-the-ground technical assistance for individual and small provider practices, medical practices lacking resources to implement and maintain Electronic Health Records (EHRs), and those who provide primary care services in public and critical access hospitals, community health centers, and other settings that mostly serve those who lack adequate coverage or medical care. RECs have established themselves as trusted advisors for primary care and are helping providers face challenges to achieve meaningful use and leverage those criteria to support quality improvement and transform healthcare.
Due to a lack of resources and/or expertise, small provider practices historically have challenges optimizing health IT to improve the quality of care they provide to their patients. These providers play an essential role in the national health care delivery network by serving as the home-base for preventive care and linking to the broader health care system, such as hospitals and specialists. The REC program was designed to leverage local expertise to provide practical, customized support to meet the needs of local healthcare providers, and do so in a non-biased synergistic way with private sector organizations.
With the passage of the HITECH Act, The Office of the National Coordinator for Health Information Technology (ONC) has been charged with building a secure, interoperable nationwide health information system, as well as supporting the widespread meaningful use of health information technology. Through the American Recovery and Reinvestment Act (ARRA), ONC has established 62 RECs that assist primary care providers in the adoption and meaningful use of electronic health records. RECs work to optimize the use of EHRs so that providers can become meaningful users, engage in new health care transformation and quality initiatives, such as Million Hearts, and participate in payment delivery reform programs, such as Accountable Care Organizations, Comprehensive Primary Care Initiative, State Innovation Models, and others.
The REC program was a response to the challenge issued by President Obama to ensure that all Americans have access to an EHR by 2014. ONC used the cooperative agreement funding model, relying on knowledgeable professionals serving as objective reviewers, to select not-for-profit organizations that would commit to support a defined number of providers in a set geographic area to reach meaningful use. ONC was able to select qualified REC partners for 62 awards in an unprecedented 5 months.
To ensure accountability and mitigate the risks associated with implementing a national scale program in a very short period of time, ONC proposed using a milestone system to help monitor the success of each REC. To be able to access direct assistance funds, the REC had to assist a provider through key programmatic milestones:
- Enrolling in the program
- Implementing an EHR system
- Achieving stage 1 meaningful use
RECs receive one third of the direct assistance for each milestone a provider achieves. The milestone system also ensured consistent results across RECs while encouraging innovation in the methods and means employed by an REC to best support their provider population.
Some of the REC’s core service areas include
- EHR implementation and project management
- Health IT education and training
- Vendor selection and financial consultation
- Practice/workflow redesign
- Privacy and Security
- Partnering with state and national health information exchange
- Ongoing technical assistance
Because every primary care practice is different, REC representatives in each state gear their support to meet each individual practice’s needs. RECs stay involved with the practice to provide consistent long-term support, even after the system has been implemented.