To examine the role of Regional Extension Centers (RECs)
in helping rural physician practices adopt electronic
health records (EHRs) and achieve meaningful use.
Using data from the Office of the National Coordinator
for Health Information Technology, we conducted a
county-level regression analysis using ordinary least
squares to better understand rural-urban differences in
REC participation, EHR implementation, and meaningful
use, controlling for counties' economic conditions. We
prepared case studies of 2 RECs that are serving a large
number of rural practices, based on interviews with key
individuals at the RECs, their partner organizations, and
rural primary care practices that received assistance
from the RECs.
RECs are largely achieving their objective of targeting
providers in communities that face barriers to EHRs. REC
participants are disproportionately rural and more likely
to come from high poverty and low employment communities.
The case study RECs had long-standing relationships with
rural providers, as well as extensive staff expertise in
quality improvement and EHR implementation, and employed
a variety of strategies to successfully assist rural
providers. Rural providers report that REC assistance was
invaluable in helping them implement EHRs and achieve
meaningful use status.
Modifying the criteria for Medicare and Medicaid EHR
incentives could help additional rural providers pay for
EHRs. REC federal funding is scheduled to end in 2014,
but practices that have not yet adopted EHRs may need
significant, ongoing assistance to receive meaningful