Unusually large number of Californian docs ask state's regional extension center, CalHIPSO, for help meeting Meaningful Use regulations, but few have actually achieved MU so far.
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More than 7,700 healthcare providers have enrolled in the California Health Information Partnership and Services Organization (CalHIPSO), the largest health IT regional extension center (REC) in the nation. This is significantly more than the 6,200 providers who were expected to participate when CalHIPSO started two years ago with $33.2 million in federal grants.
The target population for RECs includes rural and safety net providers, as well as primary care doctors in practices of 10 or fewer physicians. Currently, CalHIPSO's membership is divided about evenly among small private practices, community health centers, and public hospitals and rural providers, said CalHIPSO CEO Speranza Avram in an interview with InformationWeek Healthcare.
The REC's federally mandated mission is to help primary care providers adopt EHRs and guide them through the process of achieving Meaningful Use. Through the end of last year, nearly 34% of CalHIPSO's members had installed EHRs, according to the REC's biennial report for 2010-2011. Today, about 40% have EHRs, said Avram.
CalHIPSO's goal is to have about 6,200 of its providers achieve Meaningful Use by December 2013. Considering that only 210 providers have done so to date, that might seem challenging, and Avram admitted that it's an "ambitious goal." But she described some factors that throw a different light on the situation.
First, she noted, a large percentage of CalHIPSO's members plan to apply to the Medicaid program for EHR incentives. In the first year of that program in any state, providers need not attest to Meaningful Use to receive incentives; they only have to show that they have an EHR or have signed a contract for one. They must show Meaningful Use in the second year.
California's MediCal program did not open EHR incentive program registration until January 2012, she noted, so the only CalHIPSO providers who attested to Meaningful Use were those going through the Medicare program. Since then, she said, 2,900 CalHIPSO members have qualified for Medicaid incentives. Between MediCal and Medicare, REC participants have received or expect to receive a total of $65 million in government payments.
In addition, she noted, many providers who already had EHRs are waiting for upgrades to Meaningful Use-certified systems, and EHR vendors have a long backlog to work through because they haven't been able to keep up with the demand.
CalHIPSO gets discounts for its members from major EHR vendors; it also leverages its size to negotiate advantageous contracts for its members, Avram noted. Although the REC doesn't recommend any vendors, athenahealth, eClinicalWorks, e-MDs, GE, Greenway, McKesson, NextGen, and Health Alliance all are mentioned on the REC's website. CalHIPSO currently is expanding that group to include vendors that have affordable, easy-to-implement systems for small practices, Avram said.
CalHIPSO, which provides services in all California counties except for Los Angeles and Orange, works with providers through 10 local extension centers. Assisting in this effort are more than 100 service partners that include technology firms, provider associations, and consultants.
As part of a three-pronged sustainability initiative, CalHIPSO has launched a technical services unit to provide additional support and advice through its service partners. REC members will receive these services at a discounted rate, Avram said; other providers, including specialists who are barred from receiving federally subsidized services, will pay full freight.
In addition, CalHIPSO is in the process of creating a data analytics platform to help small practices become patient-centered medical homes and participate in accountable care organizations, she noted. With initial funding from the California Blue Shield Foundation, CalHIPSO is collaborating with MedeAnalytics "to modify their product to make it accessible and affordable to our target demographic, who are the safety-net providers." According to the CalHIPSO report, a pilot of this application is underway and will be completed by the summer. Widespread deployment is expected by the end of the year.
Finally, Avram pointed out, many organizations of various types have approached CalHIPSO about partnering with the REC to take advantage of its large provider base. "We're evaluating those opportunities, and where they make sense, will make those available to our service provider network and our local extension centers," she said.
All of these plans are necessary to outlast the end of federal funding, she added. Moreover, they can help providers navigate the health IT challenges ahead. "We recognize that EHR is just one part of a much more complicated e-health world."
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