*HITECH-LA and COREC are subsidiaries of county health plans. Their governing boards have committed funding beyond the federal subsidy for REC services for the initial years. As a free-standing entity, CalHIPSO is dependent on HITECH subsidies, provider fees and other fee-based services to be determined. To encourage early PPCP enrollment, CalHIPSO is waiving fees through December 2011 for any PPCP enrolling in by June 30, 2011. Subsidies for PPCPs who delay enrollment may be limited. (See www.calhipso.org/images/stories/pdf/CalHIPSOFeeSchedule.pdf for more information on CalHIPSO fees.) CONSIDERATIONS : Successful EHR implementation takes extensive involvement and preparation. Providers who desire to participate in the Medicare or Medi-Cal incentive programs are encouraged to get an early start. Providers who desire to qualify for Medicare incentive payments in 2011 should be ready for EHR go-live by April 1, 2011. Those starting later may experience unanticipated delays that result in delayed or forfeited eligibility for incentive payments. Since the federal subsidy for REC services may be more limited in the future, practices/clinics that delay may have to pay more for REC help. Service Partners and Vendors have finite capacity. Once capacity is filled, the best resources may no longer be available and waiting lists may result in delays that jeopardize meeting timelines for subsidies to the REC and incentive payments to clinicians.
Getting Started Are the clinicians of your practice/clinic ready to engage and willing to provide the leadership necessary to make needed changes in the organization? In addition to implementing a certified EHR, Stage 1 MU requires consistent collection and structured recording of specific clinical information. Most of this information now is collected episodically in primary care practices, but for MU, processes to collect and record the data may be more rigorous than current processes support. These data must be consistently collected, stored in a structured, retrievable manner and incorporated in treatment decisions. While details about Meaningful Use are beyond the scope of this guide, physicians are encouraged to familiarize themselves on these requirements8 and ascertain willingness to make changes necessary to achieve them. Physicians open to modifying workflow in ways that support efficient (and consistent) data capture and engagement of staff as part of the care team will have the advantage in implementing an EHR and achieving MU. But even highly motivated physicians will face substantial work on their part and the part of their staffs to make the necessary changes. Evidence indicates small practices tend not to have the internal resources to accomplish this work without expert assistance. Enrolling in a REC is not required to qualify for MU. Physicians are free to work solely with an EHR vendor without REC involvement or may directly secure the assistance of any consultant they choose. RECs were created as an additional resource to help. They will not replace the need for vendor involvement and subsidized services may not be sufficient for the practice’s specific needs, but they may offer valuable services that will make the process easier and less expensive. They also have a deep financial incentive to keep the practice on the right track.
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Please review the CAFP-developed Meaningful Use materials in our HIT Toolkit.
Guide to Working with RECs and LECs
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