Funding: Support for this paper was provided by the Office of Rural Health Policy, Health Resources and Services Administration, PHS Grant No. 5U1CRH03717. The authors acknowledge Stratis Health, the North Carolina Area Health Education Center, Community Care of North Carolina, the North Dakota Health Care Review, the National Rural Health Resource Center and the University of North Dakota Center for Rural Health for sharing information about their experiences working with rural providers, and Caswell Family Medical Center, Dr. Karen Smith, Glacial Ridge Health System, and Midgarden Family Clinic for sharing information about their experiences implementing EHRs.
Rural Primary Care Practices and Meaningful Use of Electronic Health Records: The Role of Regional Extension Centers
Article first published online: 30 SEP 2013
© 2013 National Rural Health Association
The Journal of Rural Health
Volume 30, Issue 3, pages 244–251, Summer 2014
How to Cite
Casey, M. M., Moscovice, I. and McCullough, J. (2014), Rural Primary Care Practices and Meaningful Use of Electronic Health Records: The Role of Regional Extension Centers. The Journal of Rural Health, 30: 244–251. doi: 10.1111/jrh.12050
- Issue published online: 1 JUL 2014
- Article first published online: 30 SEP 2013
- Rural Health Policy, Health Resources and Services Administration. Grant Number: 5U1CRH03717
- National Rural Health Resource Center
- University of North Dakota Center for Rural Health
- electronic health records;
- qualitative research;
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 use.