The American Recovery and Reinvestment Act calls for the creation of regional health IT extension centers that help providers adopt and use health IT such as electronic health records. The Office of the National Coordinator for Health IT published a draft description of the program May 28, requesting comments by June 11.

While ONC’s draft description rightly stressed the delivery of IT assistance, the centers and their clients will require a wider range of expertise for the full preparation, deployment, and management of health information communications and technology. Different phases of EHR implementation and use require differing skills.

In its comments on the draft description, AHIMA recommended that the final program define core services that include a range of services to assist in EHR use throughout a system’s lifecycle.

This range of services includes workflow analysis, transition planning, data analysis, and training. The sample phases of an EHR lifecycle shown below illustrate the differing core services that users may require over the entire lifecycle.

In its proposal, ONC indicated it could begin requesting applications from potential regional centers as early as this summer, with grants awarded this fall.

 Sample EHR Lifecycle and Possible Core Services

Phases Description Core Services
Initiation and planning Assessments of current functions, vendor review and selection, resource planning Vendor analysis, system review analysis, identifies business needs, risk assessment, impact analysis
Requirements analysis Assessment and understanding of the business needs of the organization Data flow analysis, workflow analysis
Design and development Develop functional specifications of the vendor products to meet the needs of an organization Database support and development, business case analysis, reports analysis, IT design
Development and testing Modify systems according to the requirements and design; test software and functions Software testing, functional user testing, data flow analysis
Implement Move from testing to production of the system; users begin using products for daily clinical and business activities Training and awareness, system process support, IT support
Operations and maintenance Full scale release of the system and continued use in the live environment Follow up support, participation in learning community