By Rebekah Stone Hart

In mid-December, President Obama announced that he would allocate $88 million to boost electronic health record (EHR) adoption — part of nearly $600 million in federal funding targeted at community health centers in the $787 billion federal economic stimulus package approved by Congress earlier this year.

Meanwhile, Centers for Medicare & Medicaid Services (CMS) announced that California will receive an additional matching grant of about $2.48 million to lay the groundwork for the state’s administration of incentive payments for electronic health record usage by health care providers who participate in Medi-Cal, California’s Medicaid program.

And under the federal economic stimulus package, individual Medicaid providers will be eligible for $63,750 in incentive payments over six years if they demonstrate “meaningful use” of EHRs.

Yet even with the cash incentives to adopt electronic records, many health care providers are hesitant to convert, according to two recent studies published in the Journal of the American Medical Informatics Association.

According to a survey of more than 1,000 family practice and specialty physicians:

• 86 percent believe health data exchange can improve care quality;
• 75 percent believe it can improve efficiency;
• 70 percent believe the systems can help reduce costs and yet
• 71 percent of respondents described themselves as “somewhat” or “very concerned” about patient privacy and security issues associated with electronic records.

UC San Francisco was faced with just such a data breach this fall, when an external hacker may have obtained “temporary access to e-mails containing (patients’) personal information,” as a result of a late September phishing scam, though the breach wasn’t publicly disclosed by the university until mid-December.

Officials said there was “no indication that unauthorized access to the e-mails actually took place,” but as a precaution, more than 600 patients were alerted to the breach.

While the fear of an inability to adequately protect patient records is a concern many physicians share, 81 percent believe that EHR systems allow patients and health care providers to maintain open channels of communication, according to the Journal of the American Medical Informatics Association.

And opening those channels of communication is an explicit goal in delivering a high quality of care for Kaiser Permanente, the Oakland-based health organization that recently announced a partnership with the Department of Veterans Affairs to launch a pilot program that would link each organization’s EHR systems. Beginning in mid-December, physicians at Kaiser and VA hospitals in San Diego County had electronic access to patient records at both organizations, with hopes that the program will quickly spread throughout California, and then nationwide.

Practice Issues

With major health organizations converting to EHR en masse, funding incentives available, and Medicare reimbursement penalties looming, resistance to EHR adoption is quickly becoming obsolete. So how does your practice cash in on the incentives while they’re here?

The Office of the National Coordinator for Health Information Technology recently released key updates about available funding for EHR adoption, with two main initiatives seeking to improve the quality and efficiency of health care delivery.

The first, Regional Health IT Extension Centers (or RECs), is an incentive program to promote use of EHRs by health care providers that participate in Medicare and Medicaid. Funds were set aside to establish regional extension centers, envisioned as local support organizations that provide technical assistance to health care practitioners in a defined region during their transitions to EHR and beyond. Approximately 70 RECs nationwide will each support 100,000 primary care providers for four years, after which the entities are expected to be fully self-sustaining. The REC program includes the establishment of the Health IT Research Center, a national body that will collect and distribute best practices in health IT adoption to RECs. Awards average $8.5 million, with an award floor of $1 million and a ceiling of $30 million. The deadline for applications is Jan. 29, 2010.

The second, Health IT Beacon Communities, will fund 15 “beacon communities” nationwide, which must have EHR adoption rates of at least 30 percent of health care providers in urban areas and 25 percent of providers in rural communities and are expected to achieve measurable improvements in health care quality, safety, efficiency and population health. Award amounts are expected to range from $10 million to $20 million for three-year, cooperative agreements. Letters of intent are due Jan. 8, with full applications due Feb. 1.

Individual physicians can receive funding for EHR adoption from either of these two initiatives, once they are established in Northern California to dole out goodies. REC programs are intended to begin serving their communities in March 2010, and Beacon Communities should begin providing support to physicians in April.

Rebekah Stone Hart is the editor of the Healthcare Journal. She may be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .