Federal EMR money starts flowing to states

Washington -- More than $750 million in federal grants have been doled out to selected state offices and regional assistance organizations, with roughly half of the money geared largely toward helping solo physicians and small primary care groups with meeting federal criteria for electronic medical records use.

Cooperative agreement awards were announced Feb. 12 by David Blumenthal, MD, the national health information technology coordinator. Dr. Blumenthal said the funding "marks a major milestone in our journey towards nationwide adoption and meaningful use of health information technology."

One set of awards provides $386 million to 40 states and qualified state-designated entities to build capacity rapidly for exchanging information across the health care system. Dr. Blumenthal said the State Health Information Exchange Cooperative Agreement Program will help doctors and hospitals become eligible for Medicare and Medicaid incentives. The government in January issued two sets of proposed regulations outlining the path to bonuses for implementing and utilizing EMRs.

The second set of awards provides $375 million to create 32 regional extension centers that will focus more specifically on helping physicians and other health professionals select, use and maintain appropriate EMR systems. On-site technical assistance will be a key service that the regional centers will provide to primary care physicians, according to officials overseeing the program.

"The entire office is dedicated to tackling the real difficult challenge of helping providers implement electronic health record systems, and then achieve meaningful use," said Mat Kendall, acting director of the Office of Provider Adoption Support, a new entity that launched in December 2009 as part of the national coordinator's office.

Prior to joining the office, Kendall was director of operations for the New York City Dept. of Health and Mental Hygiene's Primary Care Information Project, which helped primary care doctors in medically underserved communities adopt EMR systems.

"It's especially difficult for small provider practices because they don't have the resources that large hospitals might have," Kendall said. "So there's concern that they may not get the support and attention they need in order to be successful in this endeavor."

Helping "priority" practices

The adoption support office has designated "priority" primary care practices that particularly need assistance in EMR vendor selection, work-flow redesign and staff training. These practices include those with fewer than 10 physicians on staff who usually work in rural settings, Kendall said.

Regional extension centers are expected to provide outreach and support services to roughly 100,000 primary care physicians and hospitals within two years. Kendall said his office started working immediately with the health care community to ensure planned program goals and milestones are met.

The efforts have been noted by some stakeholder organizations, including the Healthcare Information and Management Systems Society, which represents more than 23,000 individual members, of which 73% work in patient care delivery settings.

"The RECs seem very open-minded about the process so far," said Tom Leary, HIMSS senior director of federal affairs. "We're hearing from our community that this should be helpful. The RECs in particular are meant to help providers on what to purchase, what to look for in those purchases, how to implement and install, and also help with work-flow issues -- the types of situations that need to happen in an office setting once they've made the purchase of the electronic health record."

The initial awards are part of a roughly $100 billion investment in science and technology in the economic stimulus package that President Obama signed into law one year ago. Over the coming months, the administration plans to announce additional health IT awards for RECs and the states.