Time to extend my extension idea

It's a little-known fact, but the health information technology regional extension program was really my idea.

I'm from Indiana, where we do corn and beans right. One reason is Purdue University, which runs our cooperative extension service. Purdue has helped farmers introduce new technology, best practices and workflow improvements for more than a century. Now, it's doing the same for healthcare providers, running Indiana's health IT extension service.

I also worked as a Peace Corps ag extension agent in Africa.

But the health IT extension idea didn't come to me until about 2003 or so, not until I'd visited with Dr. Lewis Coulson, a health IT evangelist and a contributor to the Veterans Affairs Department's VistA electronic health record, at the VA's West Side (now Jesse Brown) Hospital in Chicago. Coulson was so gung-ho, I think he would have run next door to Cook County Hospital and installed VistA there himself—if only the VA would have let him. That's when it occurred to me: We ought to create a health IT extension service to empower folks like Coulson.

In 2009, Congress stole my idea, passing the American Recovery and Reinvestment Act. It called for creation of a health IT regional extension service. The REC program turned two years old in March. For an update, I called Mat Kendall, director of the Office of Provider Adoption Support at the Office of the National Coordinator for Health Information Technology. He runs the REC program.

So far, the 62 RECs have been awarded $721 million in grants and been paid some $265 million, Kendall said. They've signed up more than 129,000 primary-care providers, while helping more than 70,000 become EHR users and nearly 10,100 become meaningful users. Kendall said the REC program's target is to have 30,000 primary-care meaningful users this year.

Representatives from about half of the RECs met in St. Louis last week to discuss the program's future, Kendall said. Under the stimulus law, federal money for the program dries up in just four years.

I asked Kendall whether HHS intends to ask Congress for ongoing funding of the REC program, since its model, the cooperative extension service, receives annual appropriations ($475 million this year). He said such a request was beyond his "scope." But it's not beyond mine. So, here goes:

To HHS Secretary Kathleen Sebelius and ONC Chief Dr. Farzad Mostashari:

There are more than 500,000 physicians in office-based practice in the U.S. And there are many thousands of dentists, federally qualified health centers, critical-access hospitals, nursing homes and home health programs that also need trusted information brokers and experienced educators to help them install EHRs, connect to each other, link to health information exchange organizations, and gather, share and adopt best practices. This is all extension work.

You should put together the success story of the health IT extension program and take it to Congress. Tell its members the country needs this program and should fund it going forward.


Joseph Conn

Former extension agent

Follow Joseph Conn on Twitter: @MHJConn.



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