eHealth Initiative CEO Jennifer Covich discusses Regional Extension Centers (transcript)

This is the transcript of my recent podcast interview with eHealth Initiative CEO Jennifer Covich Bordenick.David Williams: This is David E. Williams, co-founder of MedPharma Partners and author of the Health Business Blog.  I’m speaking today with Jennifer Covich, CEO of the eHealth Initiative.  Last month the organization released a benchmarking survey of Regional Extension Centers in partnership with MedPlus, the health IT subsidiary of Quest Diagnostics.Jen, thanks for joining me today.Jennifer Covich Bordenick:    Thanks so much David for having me.Williams:    Please start off by explaining what Regional Extension Centers are and what role they’re supposed to play.Covich:    The Regional Extension Centers --or RECs-- were created through the HITECH Act, which is designed to promote Meaningful Use of health information technology. The RECs are supposed to help doctors implement EHRs.  They are consultants to the providers in the field and are expected to accelerate adoption.Williams:    What were your objectives in conducting the recent survey?Covich:    Because the program is new, we wanted to take the temperature of these organizations.  The government has never done anything like this before and we wanted to conduct a baseline survey to understand how far along these groups were and what their plans were. We intend to repeat the survey later this year to assess how far the RECs have come.Williams:    You refer to it as a baseline survey, which is fair because the RECs are just getting started.  On the other hand they have a pretty short fuse and I’m curious about how much progress the RECs had made even after just a few months in operation.Covich:    We did the survey this summer, and honestly they were just in the planning stages.  It did not surprise us that they hadn’t made significant progress.  Many had just been formed and had not made a lot of progress getting out in the field; most had not signed on providers yet.  They were just organizing and figuring out their model.Williams:    Do you have a specific time frame in mind for the follow up?  Are you already starting to collect information?Covich:    We want to do it about every six months so plan another reading this year and then again in the spring.We just came back from a conference on the West Coast with a number of RECs. From the conversations and anecdotal evidence it sounds like they’ve made some more progress in the last three months.Williams:    The RECs have funding from the federal government for a while but then they fairly quickly have to get their own funding. How do RECs plan to sustain themselves once that initial funding dries up?Covich:    We asked the RECs what type of business model they were considering. About half said they were looking at subscription models or membership models.  So a physician would pay an annual fee to get services.  Others planned to serve as consultants and charge by the hour on an as-needed basis. Some others were looking to have a flat fee that a physician would pay just once to get assistance. Those were the three types of models we saw.Williams:    How viable are those sustainability models likely to be?Covich:    It’s going to be tough. There is a lot of competition in the market with many vendors and consultants out there.  The RECs are supposed to go out and help small practices get started, help them adopt and guide them.  So the RECs have a specific mission. It’s less of a business mission and more of a goal for them to get into the small offices with the rural providers and help those who lack the means to do this themselves.  They have a very specific population that they’re supposed to go after.It’s going to be tough to find a financially viable business model with these groups. There is so much competition and some of the clients they serve don’t have a significant amount of funding. It will be interesting to watch over the next couple of years how this rolls out.Williams:    There was another entity established under HITECH, called the Health Information Technology Resource Center –or HITRC. What is the HITRC and what role does it play with the RECs?Covich:    The HITRC is the clearinghouse to support the dozens of RECs around the country. The HITRC’s job is to disseminate materials and share best practices in EHR adoption, meaningful use, and provider support.  It’s a mechanism for the RECs to learn from each other. The HITRC is supposed to be a learning center where the RECs come together, share ideas and support each other.The HITRC is a group of contractors that ONC brought on board to provide educational services and technical assistance to the RECs.Williams:    Beyond the HITRC, how are the RECs working with other entities including other ARRA-funded groups such as statewide health information exchanges?Covich:    They’re going to have to work closely with the state designated entities (SDEs_ that are charged with doing health information exchange.  It’s going to be critical that the RECs coordinate closely with the SDEs.(I apologize for all the acronyms here!)A little bit further down the road Meaningful Use will require health information exchange.  Doctors will have to be set up in their offices to do some health information exchange and the RECs will have to help with that. This will tie directly to the work of the SDE. Therefore it’s critical that those groups work closely together, and that their goals and efforts are aligned.Williams:    All this talk is a bit wonkish. However, I know that the objective of the funding and also a role that your group plays is to try to make sure that patients see some benefit at some point.From the work the RECs are doing, what benefits are patients likely to see and when?Covich:    That’s a really important point, because this is ultimately about the patient. Once you get past all the policy, wonkishness, regulations, rules and acronyms, this is about helping the patient at the point of care and ensuring that patients and providers have the information they need.  It means when I take my daughter to the pediatrician they have the lab results, and that the immunization results are put into the system right away and show up across town at the clinic.  It’s about connecting organizations to help patients. We can’t lose sight of that.There is a tendency for folks to get all caught up in contracting and agreements and rules and stages, but we really need to focus on the fact that this about improving patient care.Williams:    I’ve been speaking today with Jennifer Covich, CEO of the eHealth Initiative. We’ve been talking about a recent benchmarking survey on Regional Extension Centers.  Jen, thanks so much for your time.Covich:    Sure, thanks David.