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Health Information Technology Extension Program

Brian Ahier's Photo
Posted Nov 17 2009 06:35 PM

The HITECH Act creates 70 Regional Health Information Technology Extension Centers.

HHS Fact Sheet

Obviously to effectively assist with implementation of an national electronic health record system, they will need to maintain operations.

Since these centers are created with stimulus funds, what is the sustainability model for their ongoing operations?
Brian Ahier ~ seeing the future unfold early

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6 Replies

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  Anthony_Guerra's Photo
Posted Nov 18 2009 07:52 AM

Brian, here is some info from the FAQ section of the ONC web site. I hope this helps.

B5. How can Regional Centers generate program income to satisfy cost sharing requirements?
It is expected that each Regional Center will generate resources to support cost sharing in ways that demonstrate provider and community commitment to the regional center and its goals of supporting adoption and meaningful use of health IT. Such sources of funding to support the center’s cost share obligation under the cooperative agreement could include per-provider participation fees. This statement does not preclude recipients using other legal sources of cost sharing contributions as governed by applicable laws, including Part 215 of Title 2 of the Code of Federal Regulations (CFR).

B4. Are there any limitations on the ways that program income may be used by the Regional Centers?
Fees and other funds generated by the project are considered program income under Part 215 of Title 2 of the Code of Federal Regulations (CFR). Program income generated by the recipient shall be retained by the recipient and first used to finance the non-federal share of the project. To support sustainability, ONC places no limits on the accrual of program income. After the federal cost sharing requirement is met, program income generated shall be added to funds committed to the project by the federal government and used to further eligible project or program objectives. In other words, funds generated using federal funds, including fees for services, will be used to meet the cost sharing requirement of the program. All funds generated after that requirement is met can be retained by the recipient and used for the same purposes for which the project was funded
  Dave Marchand's Photo
Posted Nov 20 2009 03:42 AM


Anthony is correct with the specific wording of what the Regional Extension Centers are allowed to do, what they struggle with is what will generate the money. When you look at the RECs in isolation, the value added services they can provide is often around help or education. With the federal government subsidizing this for the first few years (until the physicians can prove meaningful use) the question becomes what happens after that?

The picture becomes more clear when you look at everything that needs to be in place before the RECs can qualify for their last payment (helping docs achieve meaningful use). This requires the physicians have an EMR (hopefully funded with the Medicare/Medicaid incentive payments) and an HIE. HIEs are supposed to be funded via grants directly to the state or state designated entity. For most states, the federal funds will not be sufficient to provide state wide HIE capability and need to attract additional funds (state match, private).

With the HIE in place, can the RECs now offer value added services to the community via the HIE. For example, can the RECs provide some sort of informatics capability that looks at data flowing through the HIE and provides guidance physicians on how to improve care or reduce costs/increase efficiency. By delivering these value-added services to the community via the HIE, hopefully the RECs can use this to generate additional revenue streams while continuing to provide value to the communities they support. Realize that I have over simplified things a little and there is much that is needed in order to build this framework for delivery of community based services, but it should illustrate the point.

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  chrisbryant's Photo
Posted Mar 12 2010 12:11 PM

This is an important topic. I can't speak for UCLA Health System, my current employer and one of the many medical centers planning to benefit from the HITECH Act over the next few years, but I can say that, from a planning standpoint, shouldn't budgeting really be thought of outside of the long-term operations support? Maybe I'm not clear on who the ownership and/or oversight of the RECs is, but at some point they must become self-sustaining. In the FAQ it seems to talk about cost-sharing, but isn't that misleading for some who may then not plan for 100% independence from the funds? I think the reason this is an important question is it seems how the RECs do affect those who have EMRs in implementation. I'll do more research, but I appreciate this post since it made me think along other avenues of our upcoming EMR project and what impact extension programs may have upon it.
Christian Bryant,
UCLA JUG Founder
IT Project Manager
  aarthihealth22info's Photo
Posted Nov 03 2012 09:55 AM

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  lennardgarnett's Photo
Posted Jul 26 2013 04:14 AM

The decision to create 70 Regional Health Information Technology Extension Centers is great, this project was discussed for a long time and now finally these centers are working. These centers will help collect more data about x-ray diffraction and make this more accessible for people from local communities.
  DietKart's Photo
Posted Sep 05 2013 05:05 AM

Obviously to effectively assist with implementation of an national electronic health record system,using various health devices