Engaging providers in underserved areas to adopt electronic health records.

Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling, 200 Independence Ave, SW, Washington, DC 20201. E-mail: .
The American journal of managed care (Impact Factor: 2.17). 03/2013; 19(3):229-34.
Source: PubMed

ABSTRACT Objectives: To assess Regional Extension Centers' (RECs') health IT outreach and provider engagement efforts among primary care providers (PCPs) based in underserved areas. Study Design: A retrospective assessment of REC program enrollment. Methods: We computed REC program enrollment rates among PCPs for the entire United States and across census regions and compared enrollment in underserved areas relative to non-underserved areas. Measures of area-level underserved status included rural and health professional shortage area (HPSA) designations. Results: Of the estimated 302,689 ambulatory PCPs practicing in the United States, 120,783 (39.9%) were enrolled in an REC. REC enrollment rates among PCPs were higher in large rural (47.3%) and small rural (56.1%) areas relative to urban (37.9%) areas. REC enrollment rates among PCPs were also higher for single-county HPSAs (51.9%) relative to non-HPSAs (40.0%), geographic HPSAs (41.7%), and population group HPSAs (38.6%). The Northeast region exhibited the highest REC enrollment rates overall and across categories of underserved status relative to all other census regions. Conclusions: The REC program serves as a unique opportunity to address the health information technology needs of PCPs working in underserved areas. Over the course of 2 years, the program has exceeded its goal of enrolling 100,000 priority primary care providers. Provider engagement is the first step in a 3-step process aimed at getting providers to adopt and become meaningful users of electronic health records. Significant work remains for the RECs to meet these objectives, and future research should evaluate the success of the REC program in meeting subsequent milestones.

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    ABSTRACT: To identify area-level correlates of electronic health record (EHR) adoption and meaningful use (MU) among primary care providers (PCPs) enrolled in the Regional Extension Center (REC) Program. County-level data on 2013 EHR adoption and MU among REC-enrolled PCPs were obtained from the Office of the National Coordinator for Health Information Technology and linked with other county-level data sources including the Area Resource File, American Community Survey, and Federal Communications Commission's broadband availability database. Hierarchical models with random intercepts for RECs were employed to assess associations between a broad set of area-level factors and county-level rates of EHR adoption and MU. Among the 2715 counties examined, the average county-level EHR adoption and MU rates for REC-enrolled PCPs were 87.5% and 54.2%, respectively. Community health center presence and Medicaid enrollment concentration were positively associated with EHR adoption, while metropolitan status and Medicare Advantage enrollment concentration were positively associated with MU. Health professional shortage area status and minority concentration were negatively associated with EHR adoption and MU. Increased financial incentives in areas with greater concentrations of Medicaid and Medicare enrollees may be encouraging EHR adoption and MU among REC-enrolled PCPs. Disparities in EHR adoption and MU in some low-resource and underserved areas remain a concern. Federal efforts to spur EHR adoption and MU have demonstrated some early success; however, some geographic variations in EHR diffusion indicate that greater attention needs to be paid to ensuring equitable uptake and use of EHRs throughout the US.
    Journal of the American Medical Informatics Association 05/2014; 21(6). DOI:10.1136/amiajnl-2013-002347 · 3.93 Impact Factor
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    Health Services Research 06/2013; DOI:10.1111/1475-6773.12078 · 2.49 Impact Factor