INDIVIDUAL HIM PROFESSIONALS and HIM departments
routinely work with RECs, either within them as employees
or as partners with them from within their organizations. In either role they help redesign documentation workflow, implement new systems, and help capture quality measures.
When Sarah Cottington of Telligen HITREC in Iowa enters a healthcare facility for REC work, she always checks
to see if an HIM representative is on the steering committee
or involved in the meaningful use efforts. If one is not, she
explains how privacy and security, documentation workflow,
and several stage 1 measures like electronic reporting of
health information all require HIM input.
“Even though a hospital may not think the HIM professional is needed or required—that it’s all IT—I try to make it very
clear from the beginning that the HIM professional needs to
be involved,” she says.
For example, when determining how to provide electronic copies to patients within three days, a stage 1 measure,
HIM staff need to help write the policies and procedures,
design workflow, and train staff on operations. As an RHIT
and CPHQ with extensive quality work in hospital HIM departments, Cottington knows the value of having HIM at the
Read an extended interview with Sarah Cottington and
HIM director Lori Cherrier in the story “The REC Connection” on the Journal of AHIMA Web site.
Listen to an interview with AHIMA director of federal
relations Allison Viola on the importance of HIM contributions to the REC effort by clicking here.
April. As of September, 90,650 physicians and hospitals had registered for the Medicare and Medicaid incentive programs. But
only about 2,100 physicians had received incentive payments.
During a September 14 meeting of the Health IT Policy Committee, Centers for Medicare and Medicaid Services staff said
that most of the early attesters had long-established experience
“The hardest group and the largest focus for RECs to sign up
are these one- or two-doc offices, and those are always going to
need the most resources because they are super busy caring for
their patients and don’t have a lot of other bandwidth,” Kendall
Ryan Bush is manager of government strategy, physician practice solutions, at McKesson, an EHR vendor and consultant firm.
He sees a similar difficulty convincing small physician practices
to invest in an EHR they may not believe they need or believe
they can implement.
“Those physicians are the ones that we vendors have been trying to reach out to forever, and [the RECs] are going to need to
be creative and very aggressive with their outreach teams,” Bush
says. “They call [it] outreach, but they are selling a package of
services to a very suspicious buyer.”
Early Challenges in Staffing
The expectations for the RECs are high, and the timetable to
meet goals accelerated. In their first year RECs were expected
to organize a business plan, hire staff, educate providers about
their services, and sign up thousands. Early challenges included
a shortage of qualified, experienced health IT staff and resources, Bush says.
“So if they were to go out and provide advice or education to
these providers in a certain area, they just didn’t have the experienced staff to really get their message out in a clear, credible,
and concise way,” he says.
When the RECs were first organized, industry experts feared
they would be unable to recruit enough health IT professionals to accomplish their goals. These skills are in high demand
in more lucrative areas of healthcare, like vendor organizations
and large providers.
Some RECs have hired and trained staff only to have them
hired off by vendors and providers, Kendall says. The RECs can
only promise employment for the four years of their contracts,
after which the success of their sustainability plans will determine their future. Some RECs are fully staffed, but many others
are still hiring. Senior management positions have been open
for months at several RECs, Bush notes.
ONC anticipated the hiring challenges. Its Community College Consortia program jumpstarted six-month health IT training programs in community colleges nationwide, developed in
part to supply the RECs with trained staff.
“[Awareness] is one of the
challenges they really faced.
They had to first educate
providers on who they were.”
RECs are hiring, but they will need to be at full staff very quickly in order to move from signing up physician practices to actually helping them select, implement, and optimize EHRs.
Another continuing challenge is getting clients software upgrades from vendors. The meaningful use program has put unprecedented demand on vendors to either update or implement
new government-certified EHR systems. Providers need to use a
meaningful-use certified EHR in order to successfully attest for
incentive payments. RECs and vendors are hard pressed to meet
“That same lack of resources may rear its ugly head as they go
out and try to do all these implementations,” Bush says. “
Because every vendor out there, regardless of what they say, is