Station…

The down sides:
Managing updates
Security
Error messages

are being well managed through pushing updates. The down side of SQL errors if there is a disruption has happened, but rarley. We have left the terminal servers up so that any of the doctors that prefer the RDP connection to the server still can use it. Its been about a month and I am cautiously optimistic this may be a better approach for us. At the end of the day, the best solution depends on the quality of the network, the tolerance of the software and users to get the SQL errors and specific concerns of the physicians.

This can be done and there are resellers who do just that – they take the physician’s forms and customize the templates according to how the physician typically works thru a patient.

Approximately $598 million is being made available through the Health Information Technology Extension Program (Extension Program), to ensure that comprehensive support is available to health technology users.

Under the State Health Information Exchange Cooperative Agreement Program $564 million will be awarded to support efforts to achieve widespread and sustainable health information exchange (HIE) within and among States through the meaningful use of certified Electronic Health Records.

State Health Information Exchange Cooperative Agreement Program
The State Health Information Exchange Cooperative Agreement Program will help States and Qualified State Designated Entities (SDEs) to develop or align the necessary policies, procedures and network systems to assist electronic information exchange within and across states, and ultimately throughout the health care system. A key to this program’s overall success will be technical, legal and financial support for information exchanges across health care providers.

The Extension Program will provide grants for the establishment of Regional Health Information Technology Extension Centers (Regional Centers) that will offer technical assistance, guidance and information on Electronic Health Records best practices. These estimated 70 (or more) Regional Centers each will serve a defined geographic area. The Regional Centers will support at least 100,000 primary care providers, (and receive $5,000 for EACH PROVIDER that is successful at “meaningful use”) through participating non-profit organizations, in achieving meaningful use of EHRs and enabling nationwide health information exchange with direct, individualized and on-site technical assistance in:
Selecting a certified EHR product that offers best value for the providers’ needs;
Achieving effective implementation of a certified EHR product;
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; and,
Observing and complying with applicable legal, regulatory, professional and ethical requirements to protect the integrity, privacy and security of patients’ health information.

The Extension Program will also establish a national Health Information Technology Research Center (HITRC), funded separately, which will gather relevant information on effective practices from a wide variety of sources across the country and help the Regional Centers collaborate with one another and with relevant stakeholders to identify and share best practices in EHR adoption, effective use, and provider support.

Grants under the Extension Program will be awarded on a rolling basis with an expected 20 grants awarded in the first quarter of FY2010, another 25 in the third quarter and the remaining awards in the fourth quarter of FY2010. The initial funding includes approximately $598 million to ensure that comprehensive support is available to providers under the Extension Program beginning early in FY2010, with an additional $45 million available for years 3 and 4 of the program. Federal support continues for four years, after which the program is expected to be self-sustaining. Of the total federal investment in this program, about $50 million is dedicated to establishing the national HITRC, and $643 million is devoted to the Regional Centers.

The law requires that Regional Centers be affiliated with a U.S.-based, nonprofit institution or organization, or an entity thereof, that applies for and is awarded funding under the Extension Program. The program anticipates that potential applicants will represent various types of nonprofit organizations and institutions with established support and recognition within the local communities they propose to serve.

The performance of each Regional Center will be evaluated every two years by a HHS-appointed panel of private experts, none of whom are associated with the center being evaluated. Continued support for the Regional Center after the conclusion of the second year of performance will be contingent on the panel’s evaluation being, on the whole, positive and on HHS’ determination that such continued federal support for the center is in the best interest of the program.

The Regional 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. Regional Centers will also focus intensive technical assistance on clinicians providing primary care in public and critical access hospitals, community health centers, and in other settings that predominantly serve uninsured, underinsured, and medically underserved populations.

The Extension Program expects all Regional Centers to be operating at full capacity by the end of December 2010. In addition, it is expected that by the end of December 2012, the Regional Centers will be largely self-sustaining and their need for continued federal support in the remaining two years of the program will be minimal.

Additional information is available at http://healthit.hhs.gov/extensionprogram

Thanks, Brent