Kingmaker Recs

ONC has granted many millions of dollars to Regional Extension Centers (RECs) to promote widespread adoption of EHRs, peculiarly alongside minor somebody practices of psyche tending physicians. The RECs are chartered to educate as well as assist physicians as well as security internet providers with pick as well as purchase of EHR technology. Much similar the Department of Agriculture stepped inwards to assist farming at the plough of the previous century, the RECs are creations of the HITECH deed as well as the goals are non much unlike – diffuse Government best practices to minor businesses (the controversial aspect of such activities is best discussed separately). It is possible that after the EHR force is completed, RECs volition evolve into helping physicians practise meliorate medicine every bit Atul Gawande envisioned. But correct now, RECs are inwards the procedure of defining the ambulatory EHR market.

The mutual noesis is that the ambulatory EHR marketplace set consists of “hundreds” of competing software products as well as services. Well, in that location may real good endure hundreds of products out there, with hundreds of flashy websites, but real few stimulate got a sizable client base, whith a dozen or then vendors servicing nigh electrical flow EHR customers. HITECH has brought us an influx of novel entrants as well as I am sure enough in that location are many to a greater extent than to come upwards betwixt instantly as well as 2011. At the same time, marketplace set consolidation through mergers as well as acquisitions is reducing the disclose of both vendors as well as products. Just similar the Misys/Allscripts merger displaced former Misys products, the Allscripts/Eclipsys merger volition definitely retire duplicate or unprofitable products. And in that location volition endure more, as well as in all likelihood larger M&As inwards this space. There volition also endure the inevitable demises.

So what should a REC do when it comes to helping physicians select an EHR? Should they introduce several hundred EHRs to the medico to await at? Perhaps they should boundary themselves to the i hundred or then CCHIT certified EHRs? Or meliorate yet post the physician out in that location to kind through the multitude with a laid of instructions on best practices for selection. Chances are the medico volition non fifty-fifty laid out to look, permit lone genuinely select something. It thence falls to the REC to prescreen vendors, at to the lowest degree to a sure enough degree. RECs are also directed yesteryear ONC to shape Group Purchasing Organizations (GPOs) as well as obtain the best possible pricing arrangements for their constituents. Such arrangements are solely possible if large numbers of physicians are all buying the same EHR, thus farther narrowing the playing field.

Just getting EHRs inwards physicians’ offices is non nearly enough. RECs are also supposed to facilitate connectivity of their physicians to HIEs as well as in that location is ample collaboration betwixt dry reason HIEs as well as RECs, with or then existence managed yesteryear the same organization. It would endure a nightmarish suggestion for HIEs as well as RECs to facilitate connectivity of hundreds of unlike EHR products. Just similar Hospitals earlier them, RECs as well as HIEs are probable to select a few EHRs as well as operate on connecting with those first. In an era of universal standards this would non endure a problem, but our standards are evolving inwards parallel with EHR adoption as well as nosotros stimulate got to start somewhere.

The source proclamation of short EHR lists came from the 2 New York State RECs as well as created much angst inwards the minor vendor community. New York narrowed it downwardly to the commons suspects – generally large good established EHR vendors. Are New York RECs brusk sighted? Do they non want to back upwards project design as well as minor novel products that may plough out to endure “the adjacent large thing”? Are they receiving kickbacks from the financially stable vendors? Most likely, none of the above. The RECs must discharge their duties inwards the hither as well as now. They cannot afford to bet coin (taxpayer money) on the “next large thing” as well as considering that the grants, every bit generous every bit they may seem, barely encompass the costs of operations, the RECs must mitigate risk. Contracting with a vendor that has “been there, done that”, a vendor that may non stimulate got the newest as well as shiniest technology, but has a boatload of fairly satisfied customers (and unhappy ones too), a vendor commanding an Earth forces of trainers as well as implementers, a vendor that is already connected to many large Hospitals inwards the State as well as a vendor with a residual canvass extending good into the yesteryear non simply into a projected future, is arguably the safest course of pedagogy of activeness a responsible REC tin privy take.

I would add together i to a greater extent than slice of advice to all RECs creating brusk lists as well as GPOs. Make sure enough all your vendors guarantee the mightiness to extract all information from their electrical flow systems. Technology is non standing withal as well as sooner or afterwards game changing software volition brand its appearance. It may real good endure from i of your established vendors, but if it’s not, you lot stimulate got a fiduciary responsibleness to your physicians to ensure they tin privy movement on to bigger (or smaller) as well as meliorate things.