RECs Role in Leaving No Community Behind

Strategies for Ensuring HIT Adoption in Underserved Communities
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The National Health IT Collaborative for the Underserved (NHIT) recognizes the audacious tasks and timelines that Regional Extension Centers (RECs) face in providing education, outreach and technical assistance to providers throughout the US, and preparing them for the adoption and meaningful use of electronic health records (EHRs).  As an organization committed to help ensure that, with respect to health information technology, no community is left behind; we totally endorse the aim of supporting 100,000 primary care physicians in becoming “meaningful users” of EHRs. We are aware of EHR benefits in terms of the “quality, safety and efficiency of health care”, particularly for those populations who experience health disparities and less than optimal health services. We at NHIT are in full agreement RECs can play a crucial role in achieving the goals of HHS, the Office of the National Coordinator (ONC), the Centers for Medicare and Medicaid Services (CMS), as well as the intent of Congress as expressed in the American Recovery and Reinvestment Act (ARRA).

There are certain realities, however, that impact on the ability of RECs to fulfill their potential. Reaching providers most in need of assistance – those caring for underserved populations, particularly communities of color -  requires an understanding of several key issues that impact their ability to benefit from REC services.  These providers are often working in small practices that struggle to make ends meet. They serve the poor and are often reimbursed at rates that do not cover their costs. In fact, in many communities most Medicaid beneficiaries are seen in small private practices.  It is clear that these providers will need special assistance in the form of financing in order to make the upfront investments in technology required.  In addition, making the transition to EHRs will require these providers to make major changes in their practices.  They will need assistance from knowledgeable consultants and trained HIT and health information management (HIM) workers to install and maintain new practices and systems, while minimizing “down-time” and lost revenues.

A major challenge faced by RECs in getting the word out to providers in underserved communities to inform them about REC services and the availability of CMS incentives. Our experience confirms the value of building strategic partnerships. In order to truly have the greatest impact, RECs must develop key partnerships with advocates and community organizations in their region. That requires innovative and culturally appropriate approaches to education and outreach that are tailored to each community’s needs. Whether those advocates are in the form of staff, health industry representatives, consultants, subcontractors, or committed community organizations such as ours, these partners must be welcomed or cultivated, trained and engaged to disseminate messages designed, with community inputs, to inform, guide and prepare providers for their next steps in EHR adoption.

Over the past year, ONC and CMS through the support of the ARRA have invested in health IT related projects and programs all over the country, including 60 Regional Extension Centers and the Medicaid/Medicare EHR Incentive Program, all supporting the larger goal of ensuring that every patient has an electronic health record (EHR).  While we support the Administration’s ambitious goal, we also would like to stress the importance for the Administration to finance an effective education and outreach strategy to communities – consumers and providers - so that they will be aware of these investments and will be able to benefit from them. NHIT adheres to this fundamental principle of effective communication with community stakeholders and advocates.

Failure to engage and introduce HIT to underserved populations, rural communities, communities with limited English proficiency, communities of color and other marginalized populations can exacerbate the health disparities that the nation can ill afford. Underserved communities will suffer the most if the healthcare facilities that they rely on for their care and treatment are inoperable or out of business. Investing in effective communications to these groups will go a long way to guarantee the RECs reputation as a trusted and reliable source for HIT adoption.  

We cannot emphasize enough the importance of charging RECs with the mandate to leave no community behind in their attempts to provide crucial support in the adoption and utilization of EHRs.  We realize that there is a lot of ground to cover, but engaging organizations like NHIT and incorporating an “all hands on deck” approach will yield the outcomes so urgently needed to counter health inequities and provide quality health care to those who need it most.
Author: Latoya Thomas

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Disclaimer: The views and opinions expressed in this blog are those of the author and commenter alone, and do not represent an official position of the National Health IT Collaborative for the Underserved or its funders.