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Thursday, February 20, 2014

ONC - REC Spin Cycle 101?

ONC: RECs have 'surpassed their goals'
February 14, 2014 | By Marla Durben Hirsch

The nation's 62 regional extension centers have outdone themselves in their efforts to increase electronic health record adoption among physicians, rural hospitals, federal qualified health centers (FQHCs) and others, according to the Office of the National Coordinator for Health IT...

"RECs have far exceeded their goal to support the adoption and use of health IT by 100,000 small practices, community health centers, and rural and public hospitals, and while continuing to support providers to reach meaningful use, are now focusing their efforts on helping these healthcare providers use the technology for care delivery transformation and improvement," they wrote...
From the ONC blog post cited in the article:

 "RECs have played a critical role in this transformation, working with over 136,000 (nearly half) of the nation’s primary care providers (PCPs), helping 90 percent (over 123,000) of those providers adopt an EHR system and 62 percent (over 85,000) demonstrate stage 1 meaningful use."
123,000+ have "adopted EHR" with REC help? And, all of these were using paper charts prior to the Meaningful Use initiative and REC engagement? Or, was it the case that many/most of them were already using HIT, just not ONC-CHPL certified EHRs? Not clear.

Maybe they'll clarify.

Why even question this? See, e.g., The AcademyHealth Listening Project: Improving the Evidence Base for Medicare Policymaking (pdf)
IV. The Politics of Evidence and Medicare Policymaking
The interviews underscore the importance of politics and ideology in shaping the perception and use of evidence in Medicare policymaking. Comments from respondents suggest that the political or ideological perspective underlying a piece of information affects whether and how it is used in the policy process. Grey literature – which in some forms can blur the lines between research and stakeholder self-promotion – is increasingly gaining the attention of policymakers and presenting new challenges for the analysts charged with separating evidence from opinion. Importantly, the interviews also suggest that health services researchers must consider the political feasibility of the policy options and ideas they explore if they wish for their research to be useful...

Respondents also pointed to political or ideological undercurrents in stakeholder reports and noted the skill of interest groups in getting their self-funded research in front of policymakers. For their part, policy analysts are spending more of their time trying to assess the value of stakeholder reports, as well as the other forms of grey literature described earlier in this report...

Finally, interviewees noted that traditional research studies, even those appearing in the peer-reviewed literature, can also reflect a particular political perspective or unacknowledged set of assumptions. According to one individual, many research funders have a worldview that influences the types of projects they support. This worldview may ultimately distort research findings, or whether and how those findings are received in the policy and political arena.
In other words, you will get called on "spin," so avoid it. It just gums up the works.

So, the RECs have "outdone themselves" and their reward is to be allowed to wither on the vine? RECs are said to be loosely modeled on the U.S. Agricultural Extension Centers.

Those are now 100 years old.

Divide the aggregate 62-REC four year funding allocation by the 136,000 PCPs assisted by RECs. It's about $1,200 a year. That will buy you maybe one week of low-end private consultant time.


From the folks at "Are Robot Doctors In Your Future?"

Click here for the full size image on their site.


My wife has a group of girlfriends I call "the Ya-Ya Sisterhood." They are all former colleagues who worked together for years in Vegas when Cheryl was head of QA for the Environmental Remediation Project at the Nevada Test Site. A dazzling power cohort of female smarts and executive management chops, they are now scattered all around the nation, but remain tight friends who gather several times a year to party hearty. A couple of years ago they all went to Scotland together. Next up on their schedule is a Rhine River cruise boat / biking trip this spring.

Several days ago, Margo, who'd been leading the cruise trip planning, was found unconscious and unresponsive at home in New Mexico.

Bacterial spinal meningitis. Apparently strep-caused, originating from a mundane prior sinus infection.

Massive irreversible brain damage. She died yesterday. We are all just stunned.

Hold your loved ones close every day. You just never know.

More to come...

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