More Clarity, Consideration Needed for HIT Extension Centers

AHIMA expressed support for a federal program establishing regional health IT extension centers that assist providers, but it registered concern that a program implemented ineffectively would cause confusion and contention and ultimately distract from the goal of EHR adoption and implementation.

AHIMA’s comments were in response to a draft description of the program published May 28 by the Office of the National Coordinator for Health IT. Specified under the American Recovery and Reinvestment Act, the program calls for a central Health IT Research Center with affiliated regional extension centers that provide direct assistance to providers. The centers will help providers meet requirements for receiving bonus Medicare and Medicaid payments under a separate ARRA provision.

AHIMA offered recommendations around four main comments:

Establish a clear and consistent set of goals:

  • Define what constitutes a “region” for the regional centers
  • Clarify the relationship among the regional centers and between the regional centers and the central Health IT Research Center
  • Reconsider the proposed plan to issue multiple, closely spaced requests for proposals from organizations seeking to become regional centers 
  • Consider mechanisms that ensure all providers are covered by qualified regional centers and that they are not penalized by any delay in accessing the services

Define a consistent set of core services delivered by an interdisciplinary team:

  • Further define the minimum level of services the regional centers must supply
  • Provide a consistent and uniform approach toward core services that addresses different functional components during each phase of an EHR implementation
  • Consider critical areas of health IT implementation that are not just technical in nature and require specialized skills, such as workflow analysis, transition planning, data analysis, training, and customization (see related story for sample core services)

Clarify the governance and management structure:

  • Define a clear and uniform structure for governance and management of the overall program, the regional centers, and the corresponding research center
  • Discuss a coordinated, consistent, and standard approach toward program planning and service delivery of the regional centers and their relationship to the resource center
  • Separate the research center’s research function from any management of the regional centers (the proposal seems to suggest that the research center will serve both roles)

Develop a sound program evaluation process that creates a learning community for sharing best practices with the resource center and among the regional centers:

  • Create a uniform and consistent approach toward evaluating the program
  • Develop a uniform measurement process that enables ONC to assess, evaluate, and make decision regarding future award programs, determining successful and unsuccessful regions, and defining areas that may need additional resources
  • Provide detail on the evaluation process

In the draft program proposal, the Office of the National Coordinator indicated it could begin requesting applications from potential regional centers this summer, with grants awarded as early as the fall.

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