Frequently Asked Questions

  1. What is PA REACH East?

  2. What does PA REACH East do?

  3. Who is served by the efforts and activities of PA REACH East?

  4. How many priority primary-care providers and critical access hospitals does PA REACH East serve?

  5. How is support prioritized across providers?

  6. How do the Regional Extension Centers specifically help providers implement health information exchange (HIE)?

  7. What are the benefits of being a PA REACH East member?

  8. How do Regional Extension Centers maintain vendor independence and avoid furnishing biased advice when helping providers select an HIT vendor?

  9. If a provider does not have a electronic health record system, how can PA REACH East help providers select a health information technology (HIT) vendor?

  10. What is Meaningful Use?

  11. What is this federal incentive program for the implementation of electronic health records?

  12. Which providers are eligible for the CMS health information technology meaningful use incentive payments?

  13. What types of activities should be expected to be are included in the detailed requirements for meaningful use, for purposes of a CMS provider?

  14. What are the first accomplishments of PA REACH East?

  15. How is PA REACH East provided with its funding?

  16. What should I do if I am a “primary care provider” and want to be helped as part of the PA REACH East activities?

 

  1. What is PA REACH East?
    PA REACH East is the Regional Extension and Assistance Center for HIT (REACH) in Eastern Pennsylvania.

    PA REACH East is one of the non-profit organizations across the nation that has been awarded federal American Recovery and Reinvestment Act (ARRA) dollars to support the development of Regional Extension Centers (RECs). These centers are being set up to aid health centers and medical professionals as they work to implement and use certified health information technology and achieve health improvement outcomes through “meaningful use.

    Regional Health Information Technology Extension Centers (RECs) were created out of the ARRA HITECH Action – Section 3012, and are under the U.S. DHHS Office of the National Coordinator for Health Information Technology (ONC).

    PA REACH East is a unique collaboration of several state organizations focused on improving health care quality and access.

    At the present time, PA REACH East is being operationalized and staffed to fulfill the HITECH Act objective of making health information technology accessible and assisting providers in using technology in a meaningful way to improve health outcomes.

  2. What does PA REACH East do?
    As a designated federal Regional Extension Center, PA REACH East will offer education, technical assistance, guidance, and information on best practices to support and accelerate health care centers’ and providers’ efforts to become meaningful users of certified electronic health record (EHR) systems. These services will be provided on a subsidized basis to eligible entities, with priority to be given to primary care providers and certain critical access hospitals. Services also will be available on a fee basis to all health care providers in the state.

    In particular, PA REACH East will use its HIT/EHR knowledge and experience to work one-on-one with small practices and offer technical expertise in managing relationships with vendors, share knowledge of software implementation, and provide an understanding of work-flow change and quality improvement methods.

    The Regional Extension Centers will focus their most intensive technical assistance on clinicians (physicians, physician assistants, and nurse practitioners) furnishing primary-care services, with a particular emphasis on individual and small group practices (fewer than 10 clinicians with prescriptive privileges). Clinicians in such practices deliver the majority of primary care services, but have the lowest rates of adoption of EHR systems, and the least access to resources to help them implement, use and maintain such systems.

    The consistent, nationwide adoption and use of secure EHRs will ultimately enhance the quality and value of health care. By assisting health care providers, these outreach, education, and technical assistance services will help to accelerate these outcomes.

    Among the services and benefits that will be provided by PA REACH East are:
    • Consultation and assistance with EHR implementation, effective use, upgrading, and ongoing maintenance
    • Guidance and training on achieving “meaningful use”
    • Information about Medicare/Medicaid incentive payments
    • Hosted EHR systems (certified)
    • Development of health data analysis, extraction and report applications
    • Integration of health information technology, including electronic health records, into the initial and ongoing training of health professionals
    • Training on privacy (HIPAA), security, data storage, etc.
    • Group purchasing opportunities
    • Support for participation in health information exchanges
    • Active dissemination of best practices
    • Access to expert advice and capabilities from federal agencies

    One-on-one technical assistance will be a key service PA REACH East makes available to priority primary care providers, and will represent a significant portion of the center’s activities. As a Regional Extension Center, PA REACH East will be expected to work with both priority primary care providers and critical access hospitals who have not yet adopted EHR systems, and with priority primary care providers and critical access hospitals that have existing EHR systems, to assist them in achieving meaningful use of certified EHR technology.

    Regional Extension Centers will also help providers achieve, through appropriate available infrastructures, exchange of health information in compliance with applicable statutory and regulatory requirements, and patient preferences. PA REACH East will work with the Pennsylvania eHealth Collaborative on these activities.

    Finally, this initiative will leverage the ongoing work to integrate the pateint centered medical home (PCMH) model activities already underway in Pennsylvania. These aim to transform our state’s health care delivery system and improve the health of our rural population.

  3. Who is served by the efforts and activities of PA REACH East?
    PA REACH East will be open to any health care center and provider, but the Regional Extension Center will focus and prioritize its efforts on “primary care providers” and primary care physicians working with critical access and rural hospitals. A “primary care provider” is defined as any doctor of medicine or osteopathy, any nurse practitioner, nurse midwife, or physician’s assistant with prescriptive privileges in the locality where s/he practices, who is actively practicing one of the following specialties:  family, internal, pediatric, or obstetrics and gynecology.

  4. How many priority primary care providers and critical access hospitals does PA REACH East serve?
    PA REACH East is now providing individualized technical assistance to over 3,400 priority primary care providers.  Nationally, the Regional Extension Center program is helping over 150,000 priority primary care professionals become meaningful users of certified EHR technology.

  5. How is support prioritized across providers?
    Following the completion of assessments, PA REACH East provides intensive, individualized technical assistance to primary care providers in individual and small-group practices (fewer than 10 clinicians with prescriptive privileges), community and rural health centers, rural and critical access hospitals, and other settings predominately serving uninsured, underinsured, or medically underserved patients.

    Some health care centers and primary care providers (as described above) may have already acquired and/or implemented EHR technology. Such providers remain priority providers, though the technical assistance required is anticipated to be focused on movement from having an EHR to achieving all aspects of meaningful use of certified EHR technology, including but not necessarily limited to electronic exchange of health information and reporting of quality measures using the EHR.

  6. How do the Regional Extension Centers specifically help providers implement health information exchange (HIE)?

    This program will offer member health centers and providers access to information and technical expertise and will assist them with selecting and implementing certified electronic health records (EHRs), integrating health information exchange (HIE), using those EHRs into provider care delivery and administrative workflows to enhance the quality and safety of care while protecting patients’ privacy.  The Pennsylvania eHealth Partnership Authority (formerly the PA eHealth Collaborative) has selected Truven Health Analytics to build and implement the Authority's community shared services (CSS). CSS is the key component that will enable the secure, confidential electronic exchange of medical records between state-certified organizations, Health Information Exchanges (HIEs) and Health Information Service Providers (HISPs). With Truven in place, the creation of the statewide network-of-networks can begin. The CSS will support the ability of unaffiliated health care providers in Pennsylvania to exchange information with one another. It will include a suite of registries, indexing services and security functions that will create a cost-effective pathway between certified HIEs and HISPs so they can exchange information. Medical providers will subscribe or contract with an HIE or HISP so they can exchange electronic medical records. Without the CSS, these various organizations would be unable to exchange and share information without building and maintaining multiple interfaces. For more information, visit the PA eHealth Partnership Authority's Web site.

  7. What are the benefits of being a PA REACH East client?
    PA REACH East clients receive access to a basic set of educational and Web-based resources as well as to the direct technical assistance and customized services that PA REACH East offers.

    PA REACH East will offer clients a number of key services and benefits:
    1. Clients receive access to information, services, support and training on how to implement and use certified health information technology and achieve health improvement outcomes through “meaningful use.” These services will include:
      • Evaluating and using certified EHR products that offer best value for a provider’s needs
      • Achieving effective implementation of a certified EHR product
      • Training support
      • Enhancing clinical and administrative workflows to optimally leverage an EHR system’s potential to improve quality and value of care, including patient experience as well as outcome of care
      • Sharing best practices to manage and protect the privacy, security and exchange of patients’ health information

      PA REACH East staff work one-on-one and share their HIT/EHR knowledge and experience and offer their technical expertise on how to manage relationships with vendors, how to extract and analyze health data, and how to negotiate work-flow change and implement quality improvement methods.

    2. PA REACH East clients also help providers effectively prepare to take advantage of federal EHR financial incentives. Eligible Medicare and Medicaid providers who are successful in implementing electronic health records and achieving federal “meaningful use” standards can apply to receive reimbursement payments for their electronic health record systems. These payments range between $44,000 and $63,750 in federal Medicare or Medicaid reimbursements. The Centers for Medicare & Medicaid Services (CMS) will provide these incentives through 2016. (NOTE: beginning in 2015 CMS will reduce Medicare reimbursement for providers who have not adopted EHRs.)
    3. PA REACH clients are given the opportunity to take advantage of group purchasing discounts and the use of a list of hosted, certified electronic health record solutions.

  8. How do Regional Extension Centers maintain vendor independence and avoid furnishing biased advice when helping providers select an HIT vendor?
    PA REACH East is required to avoid entering into business arrangements creating an actual or apparent conflict of interest with the center’s obligation to act solely on the best interest of advancing meaningful use of certified EHRs by the providers it serves. Any Regional Extension Center that chooses to offer group purchasing of EHR software, IT support services, and/or hardware must offer a choice of software, service, and/or hardware vendors and products.

  9. If a provider does not have a electronic health record system, how can PA REACH East help providers select a health information technology (HIT) vendor?
    PA REACH East has developed a list of recommended and certified EHR systems and vendors. As a Regional Extension Center, PA REACH East is required to offer health centers and providers in Pennsylvania unbiased advice about EHR systems and other HIT products that will enable achievement of the “meaningful use” requirements, as defined by the U.S. Secretary of Health and Human Services. PA REACH East is available to assist priority primary care providers to assess their practice patterns and needs in the context of applicable laws, regulations, and available HIE infrastructures, and help each provider to select and obtain the highest-value option for its circumstances.

  10. What is Meaningful Use?
    This is the term developed by the Office of the National Coordinator (ONC) and the Centers for Medicare & Medicaid Services (CMS) to describe the criteria eligible providers must meet to qualify for financial incentives for using electronic health records (EHRs) in a meaningful manner.

  11. What is this federal incentive program for the implementation of electronic health records?
    As part of the American Recovery and Reinvestment Act, the Centers for Medicare & Medicaid Services (CMS) is authorized to provide a reimbursement incentive for eligible Medicare and Medicaid providers (physician and hospital providers) who are successful in implementing electronic health records and achieving “meaningful use,” as defined by the U.S. DHHS. These incentive payments began in 2011 and will gradually phase down. Starting in 2015, providers are expected to have adopted and be actively utilizing an EHR in compliance with the “meaningful use” definition or they will be subject to financial penalties under Medicare.

    Stimulus funding for participating practices who implement EHRs will range from a maximum of $44,000 per eligible provider over five years under Medicare or $63,750 maximum under Medicaid. Again, these funds will be available to eligible providers who acquire a certified EHR and demonstrate they are using the technology to improve the health of patients through meaningful use of the EHR and its data. PA REACH West will be available to assist eligible providers in meeting these goals.

  12. Which providers are eligible for the CMS health information technology meaningful use incentive payments?
    For purposes of the Medicare incentive payments for meaningful use of certified EHR technology, eligible professionals are defined in the Meaningful Use final rule.

    For Medicare, an eligible provider (EP) is a doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of optometry, or a chiropractor, who is legally authorized to practice under state law. Eligible hospitals include acute care hospitals and critical access hospitals.

    For Medicaid, eligible professionals (EPs) are physicians, dentists, nurse practitioners, certified nurse midwives, and physician assistants practicing predominantly in a Federally Qualified Health Center or Rural Health Clinic (FQHC/RHC) that is directed by a physician assistant. Eligible hospitals that may participate are acute care hospitals and children’s hospitals.

    NOTE:  hospital-based eligible professionals who furnish substantially all their services in a “hospital inpatient or emergency room setting” are not eligible for incentive payments.

  13. What types of activities are included in the requirements for meaningful use, for purposes of a CMS provider?
    The meaningful use criteria includes three stages. The first stage criteria are include 25 objectives, each of which has a corresponding measure. These objectives address such topics as:
    • capturing health information electronically in a coded format
    • using that information to track key clinical conditions
    • communicating that information in order to help coordinate care
    • initiating the reporting of clinical quality measure and public health information

    “Meaningful Use” Stages:

    Stage 1 criteria for meaningful use focuses on electronically capturing health information in a coded format, using that information to track key clinical conditions, communicating that information for care coordination purposes, and initiating the reporting of clinical quality measures and public health information.

    Stage 2 criteria expands upon the Stage 1 criteria in the areas of disease management, clinical decision support, medication management, support for patient access to their health information, transitions in care, quality measurement and research, and bi-directional communication with public health agencies. CMS is considering applying the criteria more broadly to both the inpatient and outpatient hospital settings.

    Consistent with other provisions of Medicare and Medicaid, Stage 3 will focuses on achieving improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data, and improving population health outcomes.

    Provided is a link to the federal rule, which includes the definition of meaningful use along with other requirements for qualifying for incentive payments: http://healthit.hhs.gov/meaningfuluse.
  14. What are the first accomplishments of PA REACH East?
    PA REACH East is working with over 3,200 providers to assist them in implementing health information technology in their practices and moving toward meaningful use. Of those providers, over 2,000 have gone live on their EHR system and are using it to e-Prescribe and generate quality reports, and over 600 have achieved Stage 1 Meaningful Use.

  15. How is PA REACH East provided with its funding?
    PA REACH East is funded through a federal grant (via the HITECH Act) as providers reach defined milestones that include the following:
    • Milestone One is considered met when ONC receives a signed Provider Agreement between a health care practice and a Regional Extension Center. Please see below for Provider Agreement parameters.
    • Milestone Two is achieved when a practice and the associated providers have gone live on a certified EHR. “Go Live” has been achieved when e-Prescribing and quality reporting measures are actively being utilized.
    • Milestone Three is met when a practice and its associated providers have met the meaningful use criteria.

  16. What should I do if I am a “primary care provider” and want to be helped as part of the PA REACH East activities?
    Sign-up via this Web site by clicking on the Assistance tab in the menu.  Interested centers/providers will need to sign a participation agreement and agree to its terms and conditions.

    A participation agreement has four main components:
    1. Contact information for each location and eligible provider, including a provider’s unique identification number and the provider’s primary practice location
    2. Practice profile and demographic information---specialty, numbers of patients and payer mix
    3. Agreement to make reasonable efforts, in cooperation with PA REACH East, to implement certified EHR technology within 12 months and attain meaningful use as defined by U.S. DHHS
    4. Signature on a standard HIPAA business associate agreement