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Health IT Regional Extension Centers (HITRECs or RECs) help primary care providers install and use their electronic health record systems (EMR). Many providers lack the expertise and resources to purchase, install, and use EMRs. The REC Program was designed to leverage local expertise to provide practical, customized support to meed the needs of local healthcare providers. [1]

In 2009, the American Recovery and Reinvestment Act (ARRA) allocated almost $600 million to establish these centers. HITRECs help providers achieve meaningful use, including group purchasing of health IT solutions, implementation assistance, project management, vendor relations, and quality improvement. [2]

Grant funding for this program expired in January 2016. According to a report of the effect of Regional Extension Centers published in April 2016 [3], 36% of the 62 programs intended to continue functioning without grant funding.





Arizona's 39-person steering committee has developed a roadmap to take Arizonans' health care out of the paper form/manila folder era into one of digital records and electronic sharing. They're calling it a "shared patient history summary," a basic up-to-date record of patients' medications, conditions they've been diagnosed with, and tests that have been done. With their patients' permission, primary-care physicians could have access to it, along with any specialists the patients see and, in case of emergency, paramedics and emergency-room personnel. For more information see: Health files to go high-tech -- State weighs electronic records plan



With a 2010 population of 37,253,956 (US Census) California has more than one Regional Health IT Extension Center. The Health Information Technology for Economic and Clinical Health (HITECH) Act invested up to $3 billion in California (from 2009 to August 2012). Based on their study of RHITEC in California, Manatt Health Systems provided to the California Healthcare Foundation a detailed report on recommendations to improve health information technology in California.

Regional Centers in California

CalHIPSO California Health Information Partnership and Services Organization

CalHIPSO is a not-for-profit joint venture between: California Primary Care Association (CPCA), California Medical Association (CMA) and California Association of Public Hospitals and Health Systems (CAPH). As one of 62 federally designated Regional Extension Centers (REC), CalHIPSO helps providers in California navigate the complicated world of electronic health record adoption. As of spring 2012, more than 7,700 providers are members of CalHIPSO and are ready to adopt EHRs and demonstrate Meaningful Use of an EHR in order to qualify for federal incentive payments under the ARRA stimulus program. CalHIPSO is the largest REC in the country. Serving 56 of California’s 58 counties, CalHIPSO’s market stretches across the state in both urban and rural areas. Our target providers work in community clinics, rural hospitals and clinics, small and solo private practices and public hospitals. The path to Meaningful use is unique to every organization; an organized team of regional and community-based administrative and technical experts are required to meet this challenge.

Health Information Technology Extension Center for Los Angeles County (HITEC-LA)

Health Information Technology Extension Center for Los Angeles County (HITEC-LA) is dedicated to helping Los Angeles County health care providers implement and meaningfully use electronic health records (EHRs) by providing high quality, personalized technical assistance. HITEC-LA seeks to transform Los Angeles County's health care delivery system by helping providers implement and effectively use EHRs to provide high quality, efficient care for patients. HITEC-LA is an independent, non-profit organization working as a project of L.A. Care Health Plan, the nation’s largest public health plan, who is also dedicated to supporting safety net providers. Approximately two-thirds of L.A. County's primary care providers are contracted network providers of L.A. Care, so in working with HITEC-LA, both organizations can support providers and further improve the quality care for all patients in Los Angeles County.

CalOptima Regional Extension Center (COREC)

COREC is based in Orange County California, providing information, guidance and direct IT assistance services. COREC will facilitate the selection, implementation and achievement of meaningful use of electronic health records. It intends to be at the forefront of providing practices with integrated data analytics to achieve optimal patient health and disease management. [http:www.corecoc.org/ COREC] is administrated by CalOptima, an Orange county organized health system that administers health insurance programs for low-income families, children, seniors and persons with disabilities in Orange County. The CalOptima Foundation was initially awarded $4,662,426 in 2009 by the ONC (press release)

The National Indian Regional Extension Center for California Tribal and Urban Health Programs (National Indian REC-CA)

National Indian REC-CA is operated by California Rural Indian Health Board (CRIHB), in partnership with the Indian Health Service. The only national REC encompassing 35 states, NICREC-CA is one of four regional subcontractors to the National Indian Health Board Regional Extension Center. National Indian REC-CA provides resource assistance to clinics to help achieve your Meaningful Use goals. National Indian REC-CA supports both national EHR users of commercial off-the shelf software (COTS) and Resource Patient Management System (RPMS) users in California to adopt, implement, or upgrade to a certified EHR and provide supplemental resources and guidance to achieve Meaningful Use. National Indian REC-CA is housed at California Rural Indian Health Board (CRIHB) in Sacramento, California. CRIHB was formed in 1969 to provide a central focal point in the Indian health field in California for planning, advocacy, funding, training, technical assistance for the purpose of promoting unity and formulating common policy on Indian health care issues.

Submitted by Kate Fultz Hollis


The Colorado Regional Health Information Organization (CORHIO) is a non-profit public-private partnership, dedicated to improving health care for all Coloradoans through health information exchange. They develop and implement secure systems and processes for sharing clinical information.


To facilitate health information exchange to improve care for all Coloradans.


Shared health information for all individuals in every Colorado community, providing the right care at the right time and place.


  • Health information exchange deployed in every community by 2015
  • 85% of all primary care providers and safety-net providers are meaningful users of electronic health records (EHRs) by 2015
  • 85% of all providers statewide are meaningful users of EHRs by 2015

The Colorado Regional Extension Center (CO-REC), an initiative of CORHIO, assists primary care providers with technical assistance, implementation guidance, and information on best practices to support and accelerate efforts to become Meaningful Users of electronic health records to qualify for Federal Stimulus Funds. These are free to eligible primary care providers. For non-eligible providers, CO-REC provides educational resources and information via the Web and through various seminars and events throughout the state. The REC program has coverage throughout Colorado and created a model of community-based support. While the primary goal of CO-REC is to serve health care providers in Colorado, the ultimate goal is to improve the quality of health care for all Coloradans. Through federal American Recovery and Reinvestment Act (ARRA) funding, CO-REC services are designed to help more than 2,200 eligible primary care providers qualify for Medicaid and Medicare incentive payments through 2012. As of March 2012, CO-REC has reached its goal of enrolling 2,295 providers. [1] As of December 31, 2011 out of the $2,558,571,509 funds awarded, $3,908,330,183 funds have been received. [2] CO-REC services includes hands-on and in-practice consultations.


  1. http://www.corhio.org/
  2. http://www.recovery.gov/Transparency/RecipientReportedData/Pages/RecipientAwardSummarybyState.aspx

Submitted by Julie Belleza


eHealthConnecticut: Connecticut's HITREC

In April 2010, the Office of the National Coordinator for Health IT announced that eHealthConnecticut, a 501(c)3 non-profit organization established in January 2006, would become the State of Connecticut’s Health IT Regional Extension Center (REC) through a $5,749,309 grant (No. 90RC0053) and cooperative agreement[1]. The organization entered into an agreement with ONC to provide assistance to Connecticut’s providers to help them select, implement, and achieve meaningful use of Electronic Health Record (EHR) systems in order to enhance health care quality, safety and efficiency. [2]

According to the organizations’ website[2], the mission of the eHealthConnecticut Regional Extension Center is to:

"Help Connecticut's providers select, implement, and achieve meaningful use of Electronic Health Records (EHR) systems in order to enhance health care quality, safety and efficiency."

Its goal is to serve at least 2,300 of the state’s 8,000 practicing physicians during the next four years. The organization has set a long term goal of having 80% of Connecticut’s providers live with electronic health record (EHR) systems. Short term goals for the first two years include serving at least 1,338 “priority” providers, or those in small practices or caring for under served patient populations.

As the organization is largely volunteered based to date, they are in process of hiring an executive director. They are working with Independent Physician Practices, physician hospital organizations, the primary care association, and various medical societies to assist with recruiting physician customers. They have also partnered with other providers to provide a variety of services to assist eHealthConnecticut with its performance of its HIT Extension Center grant. Currently it has engaged 9 direct assistance contractors and is seeking applications from a third round of applicants. It has also contracted with the University of Connecticut Health Center to provide education, training, and outreach services.

The eHealthCT REC administers services through a Core Team, receives referrals and commitments of providers from various physician organizations called “Channel Partners” and contracts with a number of pre-selected Direct Assistance Contractors who are deployed to provide technical assistance to help the REC’s customers achieve the milestones of EHR selection, EHR implementation and achievement of meaningful use. The organization is encouraging providers and small practices to sign up and register to receive its services.

Kick Off Event

On September 29, 2010 eHealthConnecticut held its kickoff event and summit on Meaningful Use in Trumbull, CT.[3] The event included a vendor expo, presentations by ONC, the State of Connecticut Department of Public Health, eHealthConnecticut, and several physicians. Though the number of attendees is unknown, estimates have suggested approximately 300 individuals participated. Discussions were focused on the tremendous number of resources and the value proposition being offer by eHealthConnecticut REC, the support oversight being provided by the ONC-HIT to the REC, and first hand experiences of local primary care physicians that have been early adopters, sharing their motivations, challenges they encountered, and lessons-learned.


  1. Health Information Technology Extension Program – Available at http://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__rec_program/1495
  1. eHealthConnecticut website – Available at http://www.ehealthconnecticut.org
  1. Oravecz WT. CT REC MU Summit: HIT me with your best shot. 2010 Available: http://www.hitechanswers.net/ct-rec-mu-summit/

Submitted by Matthew J. Cook, MPH


Delaware Health Information Network (DHIN) project of the Delaware Health Care Commission


To facilitate the design and implementation of an integrated, statewide health data system to support the information needs of consumers, health plans, policymakers, providers, purchasers and research to improve the quality and efficiency of health care services in Delaware


Share real-time clinical information among all health care providers (office practices, hospitals, labs, diagnostic facilities, etc.) across the state to improve patient outcomes and patient-provider relationships, while reducing service duplication and the rate of increase in health care spending.

Guiding Principles

The DHIN and its partners believe that a statewide system by which clinical information can be shared among disparate providers and consumers can only succeed if it possesses analogous support among all stakeholders. Therefore, the following guiding principles are central to the DHIN:

  • The network design must be inclusive of all stakeholders (patients, providers, insurers, employers, etc)
  • The consumer/patient is in control of sharing his/her health information
  • All users must "belong" to the network
  • Patient health information remains where it originated (e.g. hospital, laboratory)
  • There is collaboration and coordination among all who will utilize and benefit from the Utility
  • The stakeholders have a shared vision of how the Utility will be developed, organized and administered.
  • The stakeholders will communicate often in an efficient and effective manner
  • Those who benefit from the network will share in its cost

District Of Columbia


In 2010, eHealthDC was established as the regional extension center for the District of Columbia (DC) to support adoption and meaningful use of electronic health records (EHRs) in DC. eHealthDC is affiliated with the DC Primary Care Association, a non-profit organization that is experienced supporting the early adoption of EHRs among local organizations in the DC area (ex. So Others Might Eat (SOME), Whitman-Walker Health). Between 2010-2011, the Office of the National Coordinator for Health Information Technology (ONC) awarded over $6.3 million to eHealthDC to be a neutral source for credible EHR and HIT information as well as offer direct, individualized, and on-site technical assistance to 850 providers as they work toward meaningful EHR use.


The goal of eHealthDC is to improve the quality of health care in DC while helping eligible providers qualify for incentive payments from the federal government.


eHealthDC commits to work with any health care provider in DC, regardless of specialty, affiliation, chosen EHR, or status of implementation. Through February 2012, free foundational services are offered to providers meeting “Priority Primary Care Providers” (PPCP) criteria. Additionally, technical assistance and tailored implementation services are available at a subsidized rate to PPCPs.

eHealthDC supports all EHRs on the Certified Health Information Technology Product List. A vendor affiliate program has been established to help DC providers receive negotiated pricing, service level agreements, and baseline contracts with select vendors. eHealthDC is officially vendor neutral, although five vendors were selected through a competitive RFI process to be part of the vendor affiliate program. These five vendors are: Allscripts, eClinicalWorks, Greenway Medical Technologies, Athena Health, and Amazing Charts.

Status of EHR Adoption in DC

As of March 1, 2012, eHealthDC was supporting 894 DC Primary Care Providers in EHR adoption and meaningful use. Of these, 642 eHealthDC registered primary care providers had adopted an EHR system, with 93 at Stage 1 of Meaningful Use.

By June 3, 2012, 735 eHealthDC members were live on EHRs and 152 members had established Stage 1 meaningful use.


1. http://www.ehealthdc.org/ 2. http://www.dcpca.org/news/ehealthdc-surpasses-goal-of-signing-up-primary-care-providers-to-improve-health-care-with-ehrs/ 3. http://healthit.hhs.gov/portal/server.pt?open=512&mode=2&objID=3519

Submitted by Aleen Saunders


In 2005, the Florida Legislature appropriated $1.5 million to fund the development of the Florida Health Information Network. This year, Governor Bush will request $5 million in recurring funding for additional grants to support the expansion of electronic health records, as well as a recommendation for two positions and an additional $200,000 to support the personnel to administer the grant program.

The FHIN grant program was developed by AHCA to facilitate the development of a statewide privacy-protected health information infrastructure network as recommended by the Governor’s Health Information Infrastructure Advisory Board in its 2005 interim report to the Governor. The program provides seed money to develop regional health information exchanges and to encourage practitioners to become active users of electronic health records.

For more information see: Florida's Health Information Infrastructure



The Hawai'i Health Information Exchange (HHIE) is a non-profit established in 2006 for the purpose of improving health care delivery through seamless, effective, and safe health information exchange. It is responsible for developing and implementing Strategic and Operational Plans to ensure that there is measurable progress within the state toward universal adoption of HIE. In September 2009, HHIE was designated to develop and implement a statewide health information exchange that will connect to the national information network. HHIE's stakeholders are determined to transform the state's health care system into one that coordinates care, reduces costs, addresses the needs of the aging population, and provides incentives for patients proactive in health. Funding from the American Reinvestment and Recovery Act of 2009 will help the state accelerate it's long-term health information exchange goals in less than five years. As of December 31, 2011 out of the $1,591,902,082 funds awarded, $1,000,354,324 funds have been received.[1]

The HHIE has also established the Hawaii Pacific Regional Extension Center (HPREC), which serves all of the Hawaiian Islands, as well as Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. The Hawaii Health Information Exchange was awarded the Regional Extension Center grant in April 2010. HHIE has subcontracted with the Telecommunications and Information Policy Group at the University of Hawai'i-Manoa to be the technology consultants to physicians. HPREC will assist physicians transferring from paper records to electronic health records to meet Meaningful Use criteria and access incentive funds. The fee for eligible providers is $500, per provider.[2]


Hawai‘i Health Information Exchange facilitates the exchange of health information that enables quality health care statewide.


Public health and health care in the state of Hawaii has been positively transformed by the exchange of critical health care information throughout the system of care and can be easily accessed, as appropriate, by all interested parties, including consumers and providers, with total confidence in the security and validity of the information.


  1. http://www.recovery.gov/Transparency/RecipientReportedData/Pages/RecipientAwardSummarybyState.aspx
  2. http://www.hawaiihie.org/

Submitted by Julie Belleza



The Illinois Health Information Technology Extension Center Collaborative (IL-HITEC) is a broad based, state-wide consortium working together to provide services throughout the State of Illinois as described in the Health Information Technology Extension Program through the U.S. Department of Health and Human Services. Following the guidelines of the Funding Opportunity Announcement (FOA), the I-HITEC will provide education, outreach, and technical assistance to providers in selecting, implementing, and achieving meaningful use of certified EHR technology to improve the quality and value of health care. The coverage area includes the state of Illinois excluding Chicago 606** zip codes. IL-HITEC plans on cooperating with the HITEC serving zip codes in 606** to assure consistency throughout the state.

NIU to lead move to electronic medical records Northern Illinois University's Division of Administration and University Outreach has received a grant for slightly more than $7.5 million, spread over two years, from the Department of Health and Human Services to create a Health Information Technology Regional Extension Center.

Organizations involved in IL-HITEC have a longstanding history of collaborations and partnerships toward addressing issues in health and electronic health records and involvement in early adoption of EHR, assistance with implementation, as well as state and national involvement in the development of ongoing standards and use. Members of IL-HITEC are leading Health Information Exchange (HIE) planning efforts, funded by the Illinois Department of Health Care and Family Services, in 9 of the 16 Medical Trading Areas in the state of Illinois. Additionally, IL-HITEC has secured the commitment of the Illinois Academy of Family Practitioners and the Illinois State Medical Society to garner participation with priority primary care providers and has received similar commitments from small and large physician groups, hospitals, community health centers, and other related organizations.

For more info:



Indiana applies for grant to boost HIT delivery by:Molly Merrill from: Health IT News

Indiana Health Information Technology, Inc., formed by the state's five health information exchanges and four other state organizations, has filed an application for federal stimulus funding for a statewide health information technology program.

The effort, which is being led by BioCrossroads, a public-private collaboration that supports Indiana's investment in life sciences, seeks a four-year grant of several million dollars under the American Recovery and Reinvestment Act's Cooperative Agreement Program (CAP). The grant will be used to further enhance the quality and reach of Indiana's HIT delivery system.

"To promote and advance health information technology as one of our state's true life sciences clusters, BioCrossroads assembled the coalition and orchestrated the effort to develop this extensive proposal and establish its governing organization," said David Johnson, president and CEO of BioCrossroads. "We look forward to the new organization leading the charge by facilitating the proposed plan for further connectivity and additional healthcare delivery improvements."

IHIT will promote alliances and innovation among the state's five independent exchanges: HealthBridge, HealthLINC, the Indiana Health Information Exchange (IHIE), MedWeb and the Michiana Health Information Network (MHIN), as well as the state's Family and Social Services Administration, Indiana Department of Health, Indiana Economic Development Corporation and Indiana Health Informatics Corporation.

"Indiana's leadership in life sciences spans over decades of time and is further cultivated by the state's significant advances in health information technology. By more effectively managing vital health information, we are creating synergies for the numerous providers and commercial partners in Indiana's healthcare landscape," said Mitch Roob, Indiana's secretary of commerce and chief executive officer of the Indiana Economic Development Corporation. "This important collaboration by the IHIT team leverages the best in Indiana's life sciences resources and solidifies our preeminent position in the industry."

The state will be notified of funding availability in mid-December. IHIT will then assume full responsibility, beginning as early as Jan. 15, 2010, to facilitate efforts with participating state organizations, HIEs, hospitals, physicians and the national grantors.

"With the help of operating health information exchanges, a roster of progressive hospitals and physicians complemented by innovative entrepreneurial organizations and a long history of groundbreaking HIT research at our universities, the state of Indiana is poised to continue leading the nation in healthcare IT," said Anne Murphy, secretary of the Indiana Family and Social Services Administration. "The CAP funding will help us continue this role by enhancing the existing infrastructure to positively impact healthcare at all levels."


IFMC Named Iowa’s HIT Regional Extension Center

West Des Moines, Iowa – IFMC was recently designated as Iowa’s Health Information Technology Regional Extension Center. As a HIT Regional Center IFMC will assist providers in adopting, implementing and achieving meaningful use with their electronic health records system.

Registration is currently open to eligible Iowa providers interested in participating in this opportunity, full operation begins March 31. The Regional Center will primarily provide assistance to priority primary care providers. Priority primary care providers are defined as physicians and health care professionals with prescriptive privileges (physician assistants, nurse practitioners, nurse midwives) in:

  • Individual and small group primary care practices (ten or fewer professionals with prescriptive privileges);
  • Public and Critical Access Hospitals;
  • Community health centers and rural health clinics; and
  • Other settings that predominantly serve uninsured, underinsured, and medically underserved populations.

Through the Regional Center, IFMC and our partner INConcertCare, Inc., will provide assistance to 1,200 priority providers (33 percent of Iowa’s primary care practitioners) during the first two years of the program. This includes assistance in vendor selection, group purchasing, implementation, project management, practice workflow redesign, interoperability, health information exchange, privacy and security best practices. The Regional Center will also provide education and outreach, support for local workforce development, and assessment of progress toward meaningful use. “We look forward to assisting Iowa providers in improving patient care through the use of information technology,” says Kim Downs, Senior Director at IFMC.

Recruitment and registration is currently underway. If you are interested in receiving services or learning more visit www.ifmc.org [4] or contact Susan Harr at sharr@ifmc.org or 515-440-8215.

IFMC Links

Homepage [5] FAQ [6] Program Snapshot [7]



HealthBridge and a network of partners will establish a Tri-State Regional Extension Center (Tri-State REC) for Southwest Ohio, Northern Kentucky, and Southeastern Indiana. The Tri-State REC will pursue a comprehensive strategy to support electronic health records (EHR) adoption, health information exchange (HIE), process redesign, local workforce support and quality improvement to assist health care providers in its service area to implement and meaningfully use technology and qualify for incentive payments from the federal government. [8]



The Maine Health Information Network Technology (MHINT) project is a statewide system being designed to:

  1. Improve patient safety and the quality of clinical care by providing clinicians with timely, accurate and secure patient-specific information at point-of-care;
  2. Create a virtual electronic health record of critical information accessible to all participating clinicians and consumers; and,
  3. Assure that clinicians caring for patients who may not have a single-source medical record, e.g. uninsured or underinsured patients who may not have a primary care provider, will have access to clinical information necessary for appropriate treatment planning.

This highly coordinated, statewide electronic clinical information-sharing system is being developed so that it can be fully integrated with efforts by individual providers and hospitals in Maine to develop electronic medical records (EMRs).

For more information see: Maine Health Information Network Technology (MHINT)


Maryland has joined a growing list of states that have established state work groups to explore the potential of electronic health records and other healthcare technologies to lower medical costs and improve care. Last month, Maryland, named about two dozen government and healthcare leaders to the Task Force to Study Electronic Health Records. Over the next two years, the task force will study EHRs and the infrastructure that connects them. The group, which was established through state legislation passed in 2005, also will evaluate barriers to establishing a regional health information organization in Maryland and develop related policies on privacy, security and authentication in health information exchange networks. The legislation calls for the task force to send its recommendations to state legislators before 2008.



The Michigan Health Information Network (MHIN) will eventually enable medical records to move electronically with patients statewide, improving quality of care. The Michigan Department of Community Health (MDCH) and the Michigan Department of Information Technology (MDIT) are providing guidance and leadership for this important gubernatorial initiative.

For more information see: Granholm, CyberMichigan Initiate Effort To Design And Implement Statewide Health Data Network



eQHealth Solutions: Mississippi Regional Extension Center (MS-REC)

Since April of 2010, eQHealth Solutions has served as The Mississippi Regional Extension Center (MS-REC) providing technical assistance and consultation to providers in electronic health record (EHR) adoption across the state of Mississippi. During this time, we have helped over 1,000 providers in achieving Stage 1 -Meaningful Use. This achievement is a direct reflection of Mississippi providers’ forward thinking and dedication to improve the quality of care through health information technology (HIT). As a result of their meaningful use achievements, our participating providers have received over $56 million in EHR Incentive payments.[1]

About eQHealth Solutions

eQHealth Solutions, established in 1986, is a non-profit population health management and healthcare IT solutions company that touches millions of lives every year. Our high-tech and high-touch offerings include innovative medical management systems, face to face community care coordination services, utilization review, clinical data integration and business intelligence analytical reporting – all focusing on increased quality outcomes and optimization of provider and payer networks. eQHealth serves a variety of entities across the US, including federal, state and commercial clients.[2]

Perspective: Tennessee HIE to provide EHR and e-prescribing to Mississippi Medicaid beneficiaries

From: Patty Enrado, NHINWatch.com

This December, Shared Health will begin rolling out a solution that will give Mississippi Medicaid providers a Web-based electronic health record (EHR) system and e-prescribing capability for the state’s nearly 600,000 Medicaid members.

The program, through a contract by the State of Mississippi’s Division of Medicaid, was designed to get physicians on the “road to EHRs,” said Bruce Taffel, MD, CMO of Shared Health, a health information exchange in Tennessee. “The big effort is to get something on the physician’s desktop,” he said, be it an EHR-Lite or a full-blown EHR.

Medicaid offers benefits and challenges, but because of the challenges there may be even greater benefits to computerized patient records, Taffel said. “This is an ideal environment because of the transitory nature of the population. You need greater liquidity of data across the geography,” he said.

With the main focus of Medicaid being women and children, the program will look at how the state can be assured that these groups are “getting the right care at the right time,” he said. EHRs will provide the infrastructure to support wellness care and care coordination.

Shared Health is also working with the Delta Health Alliance, which is assisting the approximately 900 physicians in the Mississippi Delta region with EHR technology. Busy rural and sub-rural practices are struggling with how EHRs apply to them, Taffel said. “Shared Health is trying to be the resource of information for doctors on why it’s important for them,” he said.

The $1.2 billion in additional funding for EHR adoption recently announced by Vice President Biden is a “positive thing,” he said. The funding of resource centers will enable support and dissemination of information for physicians.

“This is a fast-moving environment; everything’s happening at once,” he said. The Centers for Medicare and Medicaid Services (CMS) will be sending out a letter to state Medicaid directors on how they will administer and pay the reimbursements under the American Recovery and Reinvestment Act (ARRA) of 2009. Once those guidelines are released, states will be able to submit input for how to reward or incentivize physicians, he said.

With its expertise in HIPAA compliance and privacy and security issues, Shared Health has been involved in educating independent physician associations (IPAs) on the HIPAA ramifications in light of new responsibilities under ARRA.

“Many states have stepped up in a major way,” Taffel said. “This program is representative of where the states are pulling together and taking a leadership role.”

Down the road, these EHR systems will eventually feed into a health information exchange, “creating the door in every office for information to begin to flow,” Taffel said.

“States can do a lot through their Medicaid programs,” he said. “You are seeing other activities bubbling up under the state umbrella. Communities are coming together over how we deliver better care through the liquidity of data. There are all kinds of ways and uses for the liquidity of data to support community initiatives.”

“This is an important trend,” Taffel said. “States are a critical piece of this."



The govenor of Missouri created their Healthcare Information Technology task force, which he then charged with recommending better ways for state government and private organizations to better share healthcare information. The 14-member task force will be chaired by Missouri Department of Health and Senior Services Director Julie Eckstein and will be tasked with reviewing the current status of healthcare information technology adaptation in the state, addressing issues related to the delivery of healthcare information, analyzing the cost adoption of interoperable healthcare information technology by the healthcare delivery system in Missouri, identifying private resources and public/private partnerships to fund efforts to adopt interoperable health information technology, exploring the use of telemedicine and making recommendations to the governor for implementation.

Missouri Health Information Technology Assistance Center

The Missouri Health Information Technology (MO HIT) Assistance Center is a public-private partnership that brings together leading health care and information technology experts from health care organizations, academia, industry, and government and is focused on providing resources to promote meaningful use of health information technology.

The MO HIT Assistance Center was established in April 2010 as the federally designated Health Information Technology Regional Extension Center for the state of Missouri. It operates in collaboration with the University of Missouri and partnerships with the Hospital Industry Data Institute, Missouri Primary Care Association, Missouri Telehealth Network, and Primaris (a nonprofit health care consulting company in Columbia, MO). Missouri has been awarded $4,907,935,619 in funds, with $3,794,969,621 in funds received as of December 31, 2011.[1]


To support primary care providers and other health care professionals in the adoption of electronic health records and use of health information technology to effectively improve the quality of health care in Missouri.


To assist Missouri's health care providers in using electronic health records to improve the access and quality of health services; to reduce inefficiencies and avoidable costs; and to optimize the health outcomes of Missourians.


The MO HIT Assistance Center has three primary goals: Disseminating best practices and educational materials to all health care providers to accelerate efforts to adopt and utilize health information technology to improve the quality and value of health care. Providing comprehensive support and assistance for providers seeking to advance readiness, adopt and become meaningful users of health information technology, with a focus on priority primary care practices and other settings serving un- and underinsured, and medically underserved populations. Establishing relationships with partners to leverage and disseminate a broad array of technical assistance services and tools to help priority providers in the selection, implementation, and meaningful use of certified electronic health records.


Eligible professionals may purchase an annual membership for $750. The majority of the MO HIT Assistance Center's direct technical service costs for priority primary care providers are subsidized by the Regional Cooperative Agreement with the Office of the National Coordinator, Department of Health and Human Services for 2010 and 2011. Providers not eligible for the subsidy pay the full fee of $5,750 or may purchase services a la cart. [2]

Services include the following:

  • Practice Profile
  • Practice Readiness Assessment
  • Vendor Evaluation Tools
  • Group Purchasing Services
  • Referral to Vetted Loan Services
  • Project/Change Management
  • Workflow and Care Process Redesign
  • Installation and Go-Live Guidance
  • Privacy and Security Guidance
  • 10 Meaningful Use Seminars
  • 10 Advanced Meaningful Use Seminars
  • Meaningful Use Guidance


  1. http://www.recovery.gov/Transparency/RecipientReportedData/Pages/RecipientAwardSummarybyState.aspx
  2. http://ehrhelp.missouri.edu/

Submitted by Julie Belleza




New Hampshire

New Jersey

New Jersey’s Regional Extension Center (NJ-HITEC)

Background: The HITECH Act authorized the development of a Health Information Technology Extension Program. The extension program provides for local extension centers known as Health Information Technology Regional Extension Centers (RECs). A national Health Information Technology Research Center (HITRC) was also established to help the RECs work collaboratively to collect and share best practices in EHR adoption, meaningful use and provider support. The Office of the National Coordinator funded 62 RECs geographically dispersed across the country at a cost of $677 million. The REC’s focus is to provide assistance to:

  • Individual and small primary care practices
  • Medical practices lacking the resources to implement and maintain an EHR
  • Primary care services in public and critical access hospitals, community health centers and other settings that mostly provided services to those who lack adequate coverage or medical care.

The REC’s services include:

  • Outreach and education
  • EHR support (vendor selection and contracting)
  • Technical assistance with EHR implementation
  • Achieving meaningful use(2)

New Jersey’s REC (NJ-HITEC): On April 6, 2010 the Office of the National Coordinator announced that the New Jersey Institute of Technology (NJIT) was appointed the REC for New Jersey and would receive more than $23 million to provide assistance to primary care providers.

Their mission is to: 1. "Assist 5,000 NJ physicians to achieve “Meaningful Use” of an EHR within 2 years 2. Improve quality and access of healthcare delivery to NJ residents 3. Enable NJ’s 18,343 primary care providers to achieve online access to patient records 4. Reduce Healthcare Disparity 5. Organize local educational outreach activities and help desk service centers in each county 6. Partner with local and state agencies, community colleges to educate providers and consumers on the value of health IT 7. Create employment opportunities for qualified health IT personnel"(1)

The services to be provided are:

  • Education and training
  • Practice assessment
  • Workflow redesign
  • Implementation services
  • Meaningful use reporting

Vendors: NJ-HITEC has taken a different approach from many other states and has not determined a list of recommended vendors. Instead they have decided to work with vendors who meet the following criteria:

  • “Current ONC accreditation.
  • Interoperability with all local Health Information Exchanges (HIEs) and Independent Delivery Networks (IDNs) specifically revealing any additional added costs or fees.
  • Interoperability with the New Jersey Health Information Network (NJ-HIN) with a full statement of any additional costs or fees to achieve this connection.
  • Interoperability with laboratories, PBMs and public health registries with a specific statement of any additional fees, transactional charges or costs in order for a provider to obtain this information”(1)

NJ-HITEC has contracted with several private vendors - PatientPoint, Nit Health, Complete Systems Integration and SpectraMD to help provide REC services to eligible primary care practices over the next 2 years and as of this writing is in the early stages of implementation.

References: 1) www.njhitec.org New Jersey HITEC 2) www.healthit.hhs.gov: REC program

Submitted by Thomas McCarrick, MD

New Mexico

New York

The Rochester RHIO is a nonprofit organization chartered in 2006(2). It is charged with creating a health information exchange that allows hospitals, labs, radiology groups and other healthcare providers to access and share patient information in a secure environment (1). As of December 2011, there are over 1,250 physicians and nearly 4,000 total users, which includes midlevel providers and support staff.(1) It serves a 13-county area between Buffalo and Syracuse, including Rochester.


The RHIO is governed by a board of directors from the Greater Rochester community, representing area physicians, public health, businesses, health insurers and hospitals. (2) Funding comes from a combination of state funds and matching grants from community organizations. (2) Also, RHIO is supported by regional health plans and data providers. (4)


Patient information is organized with a hybrid model. The master Patient Index (MPI) is its only centralized data base, while the data from hospitals, labs, etc. is federated on a series of edge servers. (3)

As of December 2011, the Rochester RHIO receives about 1.5 million reports per month to its Virtual Health Record (VHR), which provides one windwo to patient information from area hospitals, labs, radiology practices, pharmaces, EMS providers, nursing homes, insurance companies and social services agenies. Other services from the RHIO include:

- eResults delivery--test results delivered directly to doctors' clinical inboxes if they have an EHR

- Hospital notifications--alerts on patient admission and discharge

- Image Exchange--instant access to radiology images from providers throughout the region

- RHIO Direct--referrals and clinical data delivered to physician colleagues and patients as easy as email, with or without an EHR

- Senior Services Summary--nonmedical health and human services data to inform treatment decisions (5)

In addition to information exchange, Rochester RHIO offers EHR integration with 14 popular EHR vendors. This allows information collected by the RHIO to integrate directly with the physician's EHR.(1)

Future projects

The state of New York has about 9 different RHIOs. There is a plan to combine them into a SHINY (Statewide Health Information Network of New York).(1)

Privacy considerations

Access is only granted to healthcare providers, not to insurance companies or employer groups. Providers are met in person before they are given access to the RHIO.(1)

Patients must grant consent to every practice or medical organization before their information can be accessed.(1) Patients can grant consent by signing a paper form at a doctor's office, or by creating an account on the RHIO's secure patient portal. Once an account has been created, patients can also upload healthcare proxies and living wills, and connect personal health records to send doctors information directly. (5)

External links



  1. J. Neri, Manager of Community HIE Services, Rochester RHIO, interview, April 15, 2010.
  2. http://www.grrhio.org/about/default.aspx
  3. J. Neri, Manager of Community HIE Services, Rochester RHIO, e-mail interview, September 22, 2010.
  4. J. Eisenstein, Associate Director, Rochester RHIO, e-mail interview, September 23, 2010.
  5. J. Eisenstein, Associate Director, Rochester RHIO, interview, December 28, 2011.

Introduction and Background: The American Recovery and Reinvestment Act (ARRA), through provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, provides nearly $2 billion in incentives for “meaningful use” of electronic health records (EHR’s) by physicians and hospitals, as well as the support infrastructure to achieve it [1]. More than $560 million in HITECH Act monies are being channeled to state governments to develop health information exchange capabilities [1]. According to the Centers for Medicare & Medicaid Services (CMS), this “meaningful use” is tied to five goals for the healthcare system: 1) Improving quality, safety, efficiency, and reducing health disparities, 2) Engaging patients in their care, 3) Improving coordination of care, 4) Improving population and public health, and 5) Ensuring privacy and security protections for personal health information [1].

“Information and data exchange is critical to the delivery of quality patient care services and effectiveness of healthcare organizations” [2]. Health Information Exchange (HIE) is the system of exchanging medical information from one EHR to another. A Regional Health Information Organization (RHIO) is a multistakeholder not-for-profit group that manages the HIE [3]. The RHIO is the essential element of the proposed National Health Information Network (NHIN) in the United States. Regional Extension Centers (REC’s) are funded by HITECH as a local or regional resource to help physicians, especially in small practices, to achieve meaningful use criteria [4].

New York eHealth Collaborative http://www.nyehealth.org/: The New York eHealth Collaborative (NYeC), supported by the New York State Department of Health, was founded as a public-private partnership. Key strategies and activities include: 1) Promoting and assisting with health IT adoption across New York state, 2) Developing health IT and HIE policies and standards, 3) Evaluating and establishing accountability measures for New York’s health IT strategy, and 4) Convening, educating, and engaging key constituencies [5]. NYeC works with a statewide network of highly qualified organizations, serving as outreach agents [6]. A practice is eligible for regional extension center services if an MD, DO, NP, or PA practicing as a primary care provider and the practice site is ten clinicians or fewer with prescriptive privileges, or the practice is a federally-qualified health center, public hospital, or critical access hospital, or primarily serves medically underserved populations [6].

The “purple line solution” includes nine steps: 1) Assess and plan, 2) Select an EHR, 3) Design infrastructure, 4) Purchase, 5) Prepare for launch, 6) Implement, 7) Use, 8) Achieve meaningful use, and 9) Receive federal incentives. The REC assists with each step, for example by providing a preferred vendor list and negotiating with them, by evaluating infrastructure and workflow and assisting with choice and design of IT infrastructure, and assisting with purchases of hardware and software and training of staff [6].

Southern Tier HealthLink (STHL) http://www.sthlny.com/: STHL is the RHIO and REC for five counties in the south central region of the state, encompassing about 470,000 residents, 5 hospitals, and over 800 physicians. It began with funding from New York State ($3.5M from HEAL 1 in 2006 and $7.8M from HEAL 5 in 2008), and was founded initially as a partnership between the two major healthcare systems and local physicians [7]. At this time it is the only RHIO in NY using a Central Data Repository model - patient data is deposited and sealed until the patient consents to have records shared or accessed [3]. STHL provides a wide variety of products, services, and emerging interoperability services.


1. Blumenthal, D. Launching HITECH. N Engl J Med. 2010 Feb 4;362(5):382-5.

2. HIMSS. RHIO/HIE. [cited 2010 Nov 21]. Available from: URL:http://www.himss.org/asp/topics_hie.asp

3. Galanis, C. HIE, RHIO’s and EHR interoperability. [cited 2010 Nov21]; Available from: URL: http://www.nyecrec.org/images/Summit/sthl%20nyec%20presentation.pdf

4. HIMSS. State HIT dashboard. [cited 2010 Nov21]; Available from: URL:http://www.himss.org/statedashboard/hitDefinitions.aspx#REC

5. New York eHealth Collaborative. Who we are. [cited 2010 Nov21]; Available from: URL: http://nyecrec.org/index.php/who-we-are

6. The New York eHealth Collaborative Purple Line Solution. [cited 2010 Nov21]. Available from: URL: http://www.nyecrec.org/images/Summit/purplelineslides9-14%20-%20print%20version.pdf

7. Southern Tier HealthLink New York. About us. [cited 2010 Nov21]. Available from: URL: http://www.sthlny.com/About-Us.asp

Submitted by: Wayne Teris, MD

North Carolina

N.C. pursues $100M for electronic records From [Triangle Business Journal - by Leo John]

North Carolina’s three-pronged fundraising effort includes a proposal to access up to $40 million to build a statewide IT network, called a Health Information Exchange; another effort to garner $20 million to $30 million to hire 40 to 45 employees at nine regional support centers; and a third effort to access $28.1 million in stimulus dollars for the broadband backbone necessary to zip medical images from one provider to another.

By placing medical records online and connecting physicians and hospitals in a vast secure network, policymakers hope to reduce duplicated tests and medical errors and improve the quality of health care by providing more medical information to physicians.

“This is going to be very important for North Carolina,” says Holt Anderson, executive director of the North Carolina Healthcare Information & Communications Alliance. “The evidence is quite clear that we do not run a high quality health care system – not for a lack of good quality professionals but because of the complexity of health care. Information is not flowing today; it’s mostly on paper and it’s mostly unavailable.”


Through a July executive order, Gov. Beverly Perdue charged the North Carolina Health & Wellness Trust Fund with leading the state’s proposal for a health information exchange.

Vandana Shah, executive director of the Health & Wellness Trust Fund, says a 12-member group of industry executives under the Health Information Technology Collaborative is also advising the effort.

States can seek between $4 million and $40 million for the four-year project to establish an exchange, and North Carolina plans to pursue the most available. “We’re going to apply closer to the maximum,” says Shah.

State proposals will be rated, among other factors, on their “sustainability” – the ability to pay for ongoing operations – and their “governance” – appropriate levels of access for insurance firms, patients and providers.

While North Carolina’s network is planned to be part of an interoperable national system, states have been given leeway in creating each system independently. “So far, it wasn’t clear who was going to lead the effort,” says Shah. “With (the American Recovery and Reinvestment Act), Obama has clearly put the monkey on the states’ backs.”


Some state matching funds will have to be deployed toward the effort, and maintenance of the system is likely to create new costs. Still, without specifying amounts, proponents say an electronic system, once it is embraced by enough health-care providers, can weed out many existing inefficiencies.

“This is a down payment on an important change,” says Steve Cline, deputy state health director, who authored a 70-page report outlining the goals of such a network. “I am cautious about predicting savings, but there are certainly a lot of inefficiencies that result in cost-ineffective treatments,”

Cline says that starting in 2011, physicians and hospitals will begin to receive supplemental money from Medicare and Medicaid if they install and share electronic medical records. He says the incentives could amount to about $40,000 per physician over four years.

To assist physician practices with installing and sharing electronic records, North Carolina is pursuing $20 million to $30 million to establish nine “regional extension centers.”

Tom Bacon, director of the North Carolina Area Health Education Centers program at UNC School of Medicine, says the funds would go toward hiring 40 to 45 employees to staff the centers, which would assist the state’s 10,000 or so physicians spread across 1,800 practices.

“Physician practices, mostly in rural parts of the state, don’t have the resources to install electronic medical records technology,” says Bacon, whose organization is leading the submission for the extension centers.

The funds would be used “to place consultants out in the field who can provide technical assistance to physician practices in assisting them in selecting, adopting and purchasing electronic health records,” he says.

By hiring workers statewide, the effort also would fulfill the stimulus legislation’s main goal: to create new jobs.


Unlike funds for the exchange and regional centers, expected to come from the U.S. Department of Health and Human Services, the broadband network would be funded by $7.2 billion in stimulus money allocated for broadband projects to the federal Commerce and Agriculture departments.

Joe Fredosso, CEO of MCNC, a nonprofit that operates the University of North Carolina System’s high-speed Internet network, says the organization has submitted a proposal to obtain $28.1 million from the federal government in what he described as a public-private partnership.

“We are the infrastructure piece (of the health-care proposal),” says Fredosso. “We’re the piece of the stimulus application that is foundational. It’s the piece that people actually take for granted.”

Despite growth in the availability of broadband statewide, Fredosso says several rural areas are underserved. Even in urban areas, the infrastructure cannot support projects such as remote diagnosis through high-definition video conferencing that demands large amounts of bandwidth.

Fredosso says the federal government was deluged by applications for grants, and there is no guarantee MCNC will get the money. Even so, he predicts the state will find a way to pay for the infrastructure. “We will have to find money,” he says.

North Dakota


The Ohio Information Partnership is a non-profit organization assisting physicians and providers with the adoption and implementation of health information technology (specifically electronic health records) in Ohio. They are also creating a technological infrastructure for Ohio physicians, hospitals and other healthcare professionals to electronically share patient health records across Ohio. The organization is currently funded through the Office of the National Coordinator of Health Information Technology within the U.S. Department of Health and Human Services. Ohio has been awarded $8,835,369,870 in funds, with $6,500,135,255 in funds received as of December 31, 2011 [1]. Per their website in March 2012, about 6,000 physicians have signed up for their services.


To advance the adoption, implementation and meaningful use of electronic health record systems among healthcare providers and to facilitate and develop a statewide electronic health information exchange. These two initiatives will improve the safety, quality, accessibility, availability and efficiency of health care for Ohioans.


To create a secure and sustainable health information exchange that:

  • Ensures protection of patient records
  • Enables providers to access patient-authorized health information
  • Improves overall level of health care provided throughout Ohio


To create a trusted health information exchange, offering a value-added, integrated and seamless structure for enabling health data exchange to improve measureable health outcomes for Ohioans using the following objectives:

  • Promote the ability for providers to reach meaningful use to improve the quality of health care delivered;
  • Provide a financially sustainable HIE that is not reliant on long-term public or grant support;
  • Provide a technical architecture that ensures private and secure exchange of health information with disparate electronic health records (EHR) systems, regional health information organizations and exchanges in other states, using federally-endorsed standards and integration protocols;
  • Develop a governance structure that operates fairly and efficiently for all stakeholder groups throughout the state;
  • Harmonize Ohio laws and regulations encompassing health information and exchange with national standards and requirements;
  • Provide de-identified and aggregate clinical health data to address population health issues in Ohio in an administratively efficient manner.

The Ohio Information Partnership consists of eight of the following regional extension centers/health information exchanges, each covering a group of specified counties:

  • Northwest Ohio Regional Extension Center (NWOREC)
  • Dayton-West Central Ohio Regional Extension Center
  • Central Ohio Health Information Exchange (COHIE)
  • HealthBridge
  • Case Western Reserve University Regional Extension Center
  • Northeast Central Ohio Regional Extension Center (NECO)
  • Northeast Ohio HealthConnect (NEOHC)
  • Ohio University/Appalachian Health Information Exchange (AHIE) REC

The goal of their RECs is to help prepare practices for EHR implementation. The Ohio Health Information Partnership and its partners will:

  • Prepare practices for the adoption of an EHR
  • Assess practice workflow
  • Assist practices in the selection of an EHR
  • Help achieve “Meaningful use” so the practices can receive federal incentive money.

CliniSync is Ohio’s statewide Health Information Exchange. This exchange allows medical statewide to share lab results, patient histories, medication lists and other information about a patient’s care. The Ohio Health Information Partnership’s began connecting hospital systems in the summer of 2011. They used a structured, phased-in approach to gradually expand connections to CliniSync. Vision: “to improve electronic communication among those who touch a patient’s care so we can improve health care for all Ohioans.”

Let the Ohio Health Information Partnership provide you with free services, preferred vendors, a loan program, and the opportunity to get federal financial incentives when you adopt electronic health records.”[2]


  1. http://www.recovery.gov/Transparency/RecipientReportedData/Pages/RecipientAwardSummarybyState.aspx
  2. http://www.clinisync.org

Submitted by Julie Belleza



OCHIN established Oregon’s Health Information Technology Extension Center (O-HITEC) to provide free and low-cost services to help Oregon’s primary care providers achieve Meaningful use. O-HITEC is funded by a federal grant from the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology. [3]

O-HITEC’s overarching goals are:

  • Bring EHR Technology to providers in small clinics still using paper.
  • Help those who have adopted EHR systems achieve true, Meaningful use.
  • Transform the delivery of primary care in Oregon. [3]

All subscribers of O-HITEC's free membership service receive consultation designed to help providers: review, select, configure and install an EHR product, achieve and attest to Meaningful use, and use their EHR technology to the fullest. This is accomplished through education, outreach and technical assistance. [3]


OCHIN is one of the nation’s largest health information networks with health IT solutions that cover a wide variety of practices with and emphasis on safety net clinics, small practices, critical access and rural hospitals. [4]


  • Innovation Generates new and creative ideas that shape new processes, cut costs, and improve the overall system in which we are working.
  • Inclusion Thoughtfully considers and incorporates the diversity of ideas, people, and members in daily decision making through honest and productive communications.
  • Excellence Thinks critically and thoughtfully in making appropriate decisions. By being present and listening, applies the right solution to the right problem. Keeps the focus on members and strives to meet their needs.
  • Stewardship Nurtures a fiduciary responsibility to use resources in a conscientious manner. Has a passion for supporting and bettering the environments and communities in which he or she works. Exhibits trust and honesty.
  • Collaboration Solves problems and works as a team player to meet member and organizational needs. Makes an effort to find solutions that work for everyone involved. Understands the value of “give and take.”
  • Leadership Demonstrates vision, courage, and respect, as well as accountability to both process and commitments. A leader is one who has followers. [5]

Inserted by Jennifer Wright --Wrijenn (talk) 15:08, 26 April 2015 (PDT)

Oregon REC History

OHII was a multi-stakeholder collaboration to demonstrate the application of healthcare information and communication technology to improve the quality, safety, cost-effectiveness and accessibility of healthcare for all Oregonians. The Oregon health care community has a rich history of collaboration on data and outcomes to support improved care. Historically, organizations in the Oregon healthcare marketplace have joined together in many public/private collaborations designed to improve care for Oregon citizens.

In 2009, then Governor Ted Kulongoski announced that he had appointed Jody Pettit, MD, to serve as Oregon’s Health Information Technology Coordinator, and that Oregon would seek $26.5 million from Congress to pay for installation of electronic health records systems in more than 4,000 doctors’ offices across the state.

On September 7, 2009, OCHIN submitted a preliminary application to the Health Information Technology Extension Program to develop an Oregon Health Information Technology Extension Center (OHITREC). The Oregon HITREC would make use of two lead partners: OCHIN and the Oregon Health & Sciences University (OHSU). [9]

On September 29, 2009, OCHIN was invited to submit the full application for first round funding for the Oregon HITREC. The application was submitted on November 3, 2009.

Inserted by Kathie Cox --Kcox 14:06, 19 November 2009 (CST)

Edited by Jennifer Wright --Wrijenn (talk) 15:03, 26 April 2015 (PDT)

  1. http://rec.eqhs.org/
  2. http://www.eqhs.org/About
  3. 3.0 3.1 3.2 https://ochin.org/offerings/o-hitec/
  4. https://ochin.org/about-us/about/
  5. https://ochin.org/about-us/values/


The Philadelphia Health Information Exchange links healthcare providers in one of the largest and most demanding US healthcare markets encompassing some 4 million patients, 55 hospitals and 30 competing health systems.

Launched in 2003 with an initial focus on diagnostic imaging, the network now provides secure access to over 200 million radiology images based on studies on over 300,000 patients. Based on a "federated" or "peer-to-peer" technology platform, the PHIE can be used to find, locate, and securely retrieve patient data at disparate, even competing facilities throughout the Philadelphia area. Current participating health systems include the University of Pennsylvania Health Systemand the Jefferson Health System. PHIE has entered clinical usage for virtual chart review and to access patient data from multiple facilities. Future uses may include radiology utilization management.

PHIE was funded through $2.3 million in SBIR grants from the National Institutes of Health (NIH) and is managed and maintained by Hx Technologies (HxTI), a private, for-profit corporation.

External Links

Pennsylvania RHIO to close

The board of the Northeastern Pennsylvania Regional Health Information Organization has decided to dissolve the organization because of a lack of start-up money and questions over its sustainability. The RHIO was launched in July 2006 with the intention of sharing patient data among health care providers and 22 hospitals in 13 counties. The plan called for a central database. Initial estimates called for $11 million in start-up costs and another $2 million a year in ongoing costs. The organization was in the process of seeking non-profit status with the IRS, but the $26,000 needed to cover that cost was too much.

Edited from: Harrisburg Health Information Exchange submits ARRA grant By Kelly Lewis 9/11/2009 - 1:14:30 PM

The Harrisburg Health Information Exchange (HHIE) was established in 2007 by the HHIE Advisory Board and TechQuest Pennsylvania. Its goal is to bring together health care and community leaders to improve health care quality, costs, access and patient safety through deployment of health information technologies within and between health care organizations in the greater Harrisburg medical referral region.

Through our collective efforts, we want to speed the deployment of electronic medical records, electronic prescription solutions and health information exchange technologies to improve health care quality at the most critical time: the point of care.

Because we are in the state capital region, we will also develop and showcase best practices to advance public policy awareness, legislative support and funding to help our region as well as other regions in the commonwealth.

The HHIE Advisory Board, chaired by Michael Fiaschetti of Highmark Blue Shield, and many volunteers have devoted thousands of hours to develop the HHIE strategy to help more than 1,000 primary care providers achieve meaningful use of electronic health records. Through the EMR adoption and use committee, chaired by Holy Spirit Hospital Chief Information Officer Edith Dees, and the HHIE Physicians Advisory Board, chaired by Dr. Joseph Cincotta of Heritage Medical Group, the HHIE is uniquely positioned to help physicians and health care providers achieve meaningful use of electronic health records.

The Harrisburg area is a national leader in the adoption of health information technology. Their hospitals are in the top 10 percent, according to the latest Healthcare Information and Management Systems Society's (HIMSS) electronic medical record (EMR) adoption model. Their physicians have an EMR adoption rate that is 25 percent higher than the national average. Their health insurance providers are nationally recognized for their use of technology and innovation to improve health care quality.

Puerto Rico

Rhode Island

South Carolina

The South Carolina Regional Extension Center program has been set up under the moniker CITIA-SC: The Center for Information Technology Implementation Assistance in South Carolina. Out of the American Recovery and Reinvestment Act (ARRA) of 2009, the Health Sciences South Carolina (HSSC) received a $5.6 million grant to establish and direct the creation of South Carolina’s Regional Extension Center. This amounted to one of the highest amounts per physician in the country. HSSC was established in April 2004 as a public-private 501(c)(3) entity. This organization is the nation’s only statewide biomedical research collaborative and is supported by South Carolina’s largest universities and hospitals. Partners of HSSC include Clemson University, Greenville Hospital System University Medical Center, Medical University of South Carolina, Medical University Hospital Authority, Palmetto Health, AnMed Health, McLeod Health, Self Regional, Spartanburg Regional Healthcare System, University of South Carolina and The Duke Endowment.

CITIA is a partnership program that includes the SC Office of Rural Health, the SC Primary Health Care Association, and The Carolinas Center for Medical Excellence. The mission of this program is: To improve the health and quality of life of South Carolinians through the use of electronic health information as a critical tool for achieving enhanced clinical effectiveness, improved overall performance of the healthcare system and better value and satisfaction for all patient consumers. This mission is born out of the initiative of the Health Information Technology Regional Extension Centers Program (program 93.718) as authorized by the Public Health Service Act of ARRA 2009. The statutory objectives of the regional centers are to enhance and promote health information technology as laid out in the Public Health Service Act. In late 2010, the Federal Health IT Coordinator completed the final selection of Regional Extension Centers forming a resource pool of 62 organizations that are tasked with helping physicians, clinics, and hospitals transition to electronic health records. A total of $677 million has been allocated from February to October of 2010. South Carolina received its grant award in April with the primary recipient listed as The South Carolina Research Foundation, which was further defined as CITIA. CITIA is offering a range of services from consulting on implementation and meaningful use, to information on security best practices and vendor selection. After application for assistance has been approved, services are being delivered by one of the three partners outlined above. The cost for services is free for those that join prior to April of 2011.

CITIA has also been promoted and supported by the PalmettoHIT network, which is a statewide initiative to advance the use of electronic health records. Additionally the South Carolina Health Information Exchange (SCHIEx) has been established as the health information exchange for the state. Together these organizations and the South Carolina Department of Health and Human Services have come together to provide comprehensive resources for the providers of South Carolina and have positioned the state to achieve the goals and objectives as outlined in their individual mission statements.

References and Resources:




Federal health IT coordinator completes nationwide system to assist doctors and hospitals in switching to electronic health records. HHS Press Office. 8.28.2010. http://www.hhs.gov/news/press/2010pres/09/20100928a.html






Submitted by Tripp Jennings

South Dakota



The Texas Regional Extension Centers are among of a select group of organizations throughout the U.S. designated as having the experience and capacity necessary to assist health care providers with the task of modernizing their practices with certified EHRs. We have been selected by the U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator (ONC) for Health Information Technology to serve providers, with a focus on primary care providers, in Texas.

Provider support throughout the EHR Implementation Process

The Texas Regional Extension Centers are a support and resource center making the implementation or upgrade of EHRs easier for providers throughout the process. Ultimately, our aim is to help increase quality of care for patients, overall productivity, and improve the quality of work/life balance for you by helping providers achieve meaningful use of EHR systems. We will not leave your practice until EHR implementation is successful.

We offer participating practices a wide range of valuable services. Some of our core service areas include:

  • EHR implementation and project management
  • HIT education and training
  • Vendor selection & financial consultation
  • Practice/workflow redesign
  • Privacy and security
  • Partnering with state and national health information exchange (HIE)
  • Ongoing technical assistance

Our priority is helping providers understand and take advantage of the full benefits of EHRs. We provide scalable solutions that will enable providers to:

  • Improve patient safety and quality of care while reducing costs associated with medical errors, duplicate tests, and administering paper records and claims
  • Easily navigate the EHR vendor marketplace by having supported access to recommended certified systems
  • Use EHRs in a meaningful way so that patient information is available when and where it is needed, and care is coordinated across provider teams
  • Achieve EHR meaningful use objectives from the very beginning, maximizing incentives and minimizing financial and administrative burdens associated with implementing new electronic systems



Virgin Islands


In April 2005, Virginia Governor Warner issued Executive Directive 6 creating the Governor’s Electronic Health Records Task Force. The Task Force was established to conduct a two-year study and advise the Governor and the General Assembly in a first-year report made by November 1, 2005. The primary objectives of the first year of study are to develop a clear picture of where Virginia currently is on EHR and where Virginia should go with EHR in the future, and to articulate those findings and recommendations.

The primary objectives of the second year of study are to identify specific ways to “close the gap” between where Virginia is on EHR and where it wants to be, and to articulate those findings and recommendations to the Governor and the Assembly in a second-year report made by November 1, 2006.

Since the appointment of the Task Force members, the Task Force has begun to actively educate itself through its committee work. The Task Force Board has begun an intensive planning process and will provide an opportunity for physicians, nurses, pharmacists, dentists, hospital administrators, health insurers, community groups, and many others to contribute their expertise.

The Task Force consists of 36 members including representatives of the provider community, information technology experts and health care policy experts. Gil Minor serves as Chair of the Task Force and Secretary Jane Woods as Vice-Chair.


The Washington and Idaho Regional Extension Center (WIREC) is funded by DHHS and led by Qualis Health, a Seattle-based nonprofit healthcare consulting and care management organization.

Mission: To assist primary care providers in rural and urban Washington and Idaho in the successful adoption and use of electronic health records (EHR).

Partners: WIREC partners include Community Choice Healthcare Network, Inland Northwest Health Services, PTSO of Washington, Idaho Health Data Exchange, and North Idaho Health Network.

Director: Peggy Evans, PhD, CPHIT

Medical Director: Jeff Hummel, MD

View the WIREC Director's July 2010 testimony to Congress regarding implementation of the Health Information Technology for Economic and Clinical Health (HITECH) act.

Services: WIREC provides a variety of services including:

  • Vendor-neutral health IT consulting services including education and assistance in the review and selection of EHR products.
  • Workflow redesign.
  • Onsite support during EHR implementation and upgrades, as well as guidance on optimizing the EHR after go-live.
  • Guidance for eligible healthcare professionals who choose to participate in the Centers for Medicare and Medicaid Services (CMS) incentive program by achieving meaningful use of their EHR.
  • Technical assistance with health information exchange
  • Privacy and security information and assistance including networks, disaster recovery, and policy development (1).
  • Opportunities to participate in region-wide group purchasing of EHR software
  • Webinars and workshops featuring regional and national leaders in EHR use
  • Monthly newsletters
  • Customizable tools and strategies used successfully at other practices
  • Vendor-specific user groups for some of the most commonly used EHR products in the region
  • Connections to other practices facing similar challenges with EHR adoption and implementation (2).

Results: As of January 7, 2013, WIREC has worked with more than 3600 enrolled providers and has helped many of them achieve meaningful use; more than $25 million dollars in incentive funding from the CMS has been awarded for achieving meaningful use or for the Medicaid Adopt, Implement, and Upgrade (AIU) program. Here is a breakdown of the dollars WIREC providers have received through 2012:

  • Idaho Medicare total: $1,227,918
  • Washington Medicare total: $5,428,154
  • Washington Medicaid total: $17,554,615 (3)

In July 2012 the Government Accountability Office (GAO) published a report showing that healthcare providers who partnered with a Regional Extension Center (REC) were more than twice as likely to receive an incentive payment under the Medicare EHR Incentive Program (4). WIREC’s work with primary care providers across the rural areas of Washington and Idaho has provided smaller practices with the tools they need for successful EHR implementation, as well as increasing the probability that they will achieve meaningful use and receive federal incentive payments. More importantly, their work has facilitated improvements in patient care. WIREC’s Stories from the Front Lines highlights some of the success stories from members including a 71% increase in immunization rates at one clinic (5).

Providers in Washington and Idaho who need guidance and advice regarding EHR selection, implementation, and optimization should contact WIREC for professional support that will help achieve outstanding results.


1) http://www.communitychoice.us/wirec.html

2) http://www.wirecqh.org/services.cfm

3) http://www.wirecqh.org/Results.cfm

4) http://www.gao.gov/products/GAO-12-778R

5) http://www.wirecqh.org/results/stories_from_the_front_lines/Mountamat.cfm

Submitted by Edith Rutledge

West Virginia


WHITEC Wisconsin Health Information Technology Extension Center

The Wisconsin Health Information Technology Extension Center (WHITEC), led by MetaStar, a nonprofit quality improvement organization, is the federally designated Regional Extension Center for the state of Wisconsin. WHITEC’s goal is to ensure all health care professionals practicing in Wisconsin are able to achieve meaningful use of electronic health records and improve health care quality and efficiency in their practices. Services include Meaningful Use, HIPAA Privacy & Security, PCMH, and EHR Adoption.