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June 6, 2013 Texas Regional Extension Centers for Health IT
June 6, 2013
TexasRegional Extension Centers
for Health IT
Mission: To assist our 5,631 priority primary care providers adopt information technology to achieve meaningful use, resulting in improved patient care. Vision: To be recognized as a center of excellence by aligning
our services with the National Quality Strategy, providing support for Patient Centered Medical Homes and the goals of the Partnership for Patients through collaboration with primary care providers and health care specialists in Texas.
To remain a trusted partner and reference source to achieve current and future quality reporting measures.
Shared Mission and Vision
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In April 2010, Texas Regional Extension Centers (RECs) were awarded grants by the HHS Office of the National Coordinator for Health Information Technology. Total of $35.7 million awarded to the four Texas RECs
RECs are currently in year four of a four year grantRECs were contracted to support 5,631 priority primary
care providers adopt electronic health records (EHR).Priority primary care providers include the following
specialties: Family Practice Pediatrics Internal Medicine Obstetrics and Gynecology
RECs were contracted to enroll and support 111 critical access and rural hospitals of 50 beds or less
Background
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Texas Regional Extension Centers
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West Texas RECTX Tech Health Science
Center933 providers
Gulf Coast RECUT Health Science Center,
Houston2,200 providers
North Texas RECDFW Hospital
Council1,498 providers
CentrEast RECTexas A&M Health Science Center1,000 providers
REC Finder @ WWW.CENTREASTREC.ORG/REC_FINDER
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WWW.TXREC.ORG
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Service Area Service DescriptionsOutreach and Education
Conduct general awareness campaigns on: Achieving Meaningful Use EHR Incentive Program Benefits of EHRs
Recruit priority primary care providersVendor Selection Arrange EHR demonstrations
Provide vendor selection materials Share vendor survey information
Practice Workflow Redesign
Assist providers with workflow redesign process Design practice workflow redesign tool for PPCPs Provider staff education Optimize use of existing EHR
Interoperability and Health Information Exchange (HIE)
Support service level agreements Collaboration with State HIE effort Assist with HIE integration
REC Goals and Services
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Service Area Service DescriptionsImplementation Support
Train provider staff Assist with practice implementation as needed
Privacy and Security
Develop privacy and security materials Incorporate privacy and security best practices into work
flowMeaningfulUse
Create meaningful use education and assessment tools Conduct Meaningful Use evaluation service Assist with EHR Incentive Program enrollment and
attestationWorkforce Recruit
Provide opportunities for staff training and internships Establish relationships with community colleges and
other educational programs
REC Goals and Services(continued)
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Working with the Health and Human Services Commission Medicaid and CHIP Division Office of e-Health Coordination
Collaboration with professional associations, health information exchange (HIE) organizations, and other key stakeholders as part of a statewide integration strategy
Maintain a TxREC website and offeringsDeveloped white papers and other resources for our
clients: Developed and posted on ONC’s Health IT Resource
Center Assessment tool developed for private practices and
hospitalsWorking with the TMF REC Learning and Action Network
REC Best Practices
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A core REC service is to help providers enroll and obtain their EHR Incentive payment
The purpose of incentive funds is to help providers offset the cost of buying and installing an EHR in their practice
The Centers for Medicare and Medicaid Services (CMS) has paid Texas providers more incentive monies than any other state
As of 5/2013 the WTxHITREC has assisted providers in collecting $10,233,502 in incentive monies
REC support also helps Medicare providers avoid CMS penalties for not achieving meaningful use by 201510
Medicare and MedicaidEHR Incentive Program
Stakeholder Participation Kathy Mechler, Vice Chair of the Texas Health Services
Authority (THSA) Board REC work with “white space” HIE contractors
West Texas REC has contracted with THSA to assist providers in the White Space sign up to the THSA voucher program, select a Qualified HISP, and to send an initial HIE Direct Secure Message
West Texas REC is currently negotiating a contract with SETHS HIE (SOPHIE) to assist their efforts in the TX Panhandle and beyond
REC work with regional HIEs North Texas REC has a cooperative agreement with the North
Texas Accountable Healthcare Partnership (HIE for DFW area) CentrEast and Gulf Coast RECs works collaboratively with HIE
organizations that serve providers within their service area
RECs and Health Information Exchange
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RECs participate in the Texas HIT Workforce Executive Committee
RECs host interns from the HIT certification training programs to provide real world experience; to date: 30 interns have been hosted by the RECs 7 interns have been hired by the RECs after completing
their internship
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RECs and theTexas HIT Workforce
Texas RECs are vendor neutral RECs work with providers to help them select the EHR
that best fits their practice environmentRECs work with the vendors to advocate for their clientsApproximately 76 ambulatory EHR vendors have
products installed statewideApproximately 9 hospital EHR vendors have products
installed statewide
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RECs and EHR Vendors
Continue providing EHR implementation support services to: Priority primary care providers Specialists
Support providers as they transition from Stage 1 Stage 2 Stage 3 Meaningful Use
Support other quality data reporting and analytic servicesAssist with privacy and security risk assessmentsProvide Patient Centered Medical Homes training and
support to Texas providers
Next Step Sustainability
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Texas RECs compared with the national average:
In July 2012, the US Government Accountability Office (GAO) reported that Medicare providers who partnered with a REC were twice as likely to receive Medicare EHR incentive payments as those who did not. [Source: Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011]
In December 2012, GAO reported that 47% of Medicaid providers had partnered with a REC[Source: Electronic Health Records: Number and Characteristics of Providers Awarded Medicaid Incentive Payments for 2011]
RECs by the Numbers …
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Average for All RECs
Average for TX RECs
Milestone 1: Enrollment 100% 100%Milestone 2: Live on EHR 98% 85%Milestone 3: Demonstrate Meaningful Use
44% 45%
Priority PCPs by REC and Milestone Achievement
(as of June, 2013)
M1: Enrollment M2: Live on EHR M3: Demonstrate MU
-
500
1,000
1,500
2,000
35% 35% 57% 48%
N = 5,631
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100% 100% 99% 100% 100% 90% 99% 100%
Hospitals by REC and Milestone Achievement
(as of June, 2013)
M1: Enrollment M2: Live on EHR M3: Demonstrate MU -
10
20
30
40
50
60
70
11 7 6
10 8
5
3
53
47
39
CentrEast Gulf Coast North TX West TX17
N = 111
Priority PCPs by REC and Practice Type
0
300
600
900
1,200
1,500
1,800
2,100
2,400
2,700
3,000
3,300
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REC Providers by Specialty
Family
and G
enera
l
Medicin
e Intern
al
Medicin
e
Pedia
trics
Obstetr
ics an
d
Gyneco
logy
Other
Speci
alties
0
500
1,000
1,500
2,000
2,500
3,000
3,500
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On Track
Practice Issues
Vendor Issues
Attestation Process
MU Measures
0 50 100 150 200 250 300 350 400
380
365
135
61
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Barriers Reported by REC Providers
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Physician81%
PhysicianAssistant
6%Nurse
Practitioner13%
Nurse Midwife
1%
RECs support all categories of providers that are eligible for the EHR Incentive Programs
REC Providers by Type of Practitioner
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New EHR44%Existing EHR
56%
REC Providers by New and Existing EHR Users
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RECs support providers as they: Adopt EHRs for the first
time Upgrade from non-certified
to certified EHRs Maximize use of their
certified EHR by working with them to improve their clinical processes and workflow
Medicare39%
Medicaid40%
Undecided19%
Other2%
According to CMS:
■ 6,918 Texas providers (i.e., el-igible professionals) have reg-istered for the Medicaid EHR Incentive Program
■ 84% (5,791) have been paid
■ 15,400 Texas providers have registered for the Medicare EHR Incentive Program
■ 53% (11,898) have been paid
* CMS data as of November 2012
REC Providers by EHR Incentive Program
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Urban89%
North Texas: 54
Gulf Coast: 86
CentrEast: 253West Texas: 259
REC Providers by Rural and Urban Counties
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As part of our charge, RECs are encouraged to support rural providers
MUA17%
Partial MUA82%
Not MUA1%
Medically Underserved Areas (MUA)
REC Providers by CountiesListed as MUA and HPSA
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HPSA7%
Partial HPSA86%
Not HPSA7%
Health Professional Shortage Area (HPSA)
CentrEast RECYvonne Sanchez, MPAProgram ManagerTexas A&M Health Science CenterRural & Community Health Institute8441 State Hwy 47, Suite 3200Bryan, Texas 77807(979) 436-0402 [email protected]
Gulf Coast RECSam Liong, RN, MBA, MA Executive DirectorUniversity of Texas Health Science Center7000 Fannin Street , Suite 1870Houston, Texas 77030(713) [email protected] www.uthouston.edu/gcrec
North Texas RECRichard Howe, PhDExecutive Director250 Decker DriveIrving, Texas [email protected] www.ntrec.org
West Texas Health IT RECTravis Hanson, Esq., JD, MS Executive DirectorTexas Tech University Health Sciences Center4430 South Loop 289, Suite 300Lubbock, TX 79414(806) [email protected]
REC Points of Contact
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