The HITECH Act establishes the Health Information Technology Extension Program (Extension Program).

The Regional Extension Centers (RECs) will offer technical assistance, guidance, and information to support and accelerate health care providers’ efforts to become meaningful users of Electronic Health Records (EHRs). This list represents the final 60 awarded centers.

• Alaska – Alaska eHealth Network
• Alabama – University of South Alabama
• Arizona – Arizona Health-e Connection
• Arkansas – HITArkansas (Arkansas Foundation For Medical Care)
• California – CalHIPSO (Northern California Regional Extension Center)
• California – Southern California Regional Extension Center
• California – Local Initiative Health Authority for Los Angeles County, Los Angeles
• Colorado – CORHIO (Colorado Regional Health Information Organization
• Connecticut – eHealthConnecticut
• Delaware – Quality Insights of Delaware, Inc.
• Florida – South Florida REC (Health Choice Network, Inc.)
• Florida – University of Central Florida, Orlando
• Florida – Community Health Centers Alliance, Inc., St. Petersburg
• Florida – University of South Florida, Tampa
• Georgia – Morehouse School of Medicine, Inc.
• Hawaii – Hawaii Health Information Exchange
• Idaho – WIREC (Qualis Health), Idaho & Washington
• Illinois – IL-HITEC (Northern Illinois University)
• Illinois – CHITREC (Northwestern University)
• Indiana – I-HITEC (Purdue University)
• Iowa – Iowa Foundation for Medical Care
• Kanas – aHIT (Kansas Foundation for Medical Care Inc.)
• Kentucky – University of Kentucky Research Foundation
• Louisiana – Louisiana Health Care Quality Forum, Baton Rouge
• Louisiana – eQHealth Solutions, Inc, Baton Rouge
• Maine – HealthInfoNet
• Maryland – Chesapeake Regional Information System for our Patients
• Massachusetts – Massachusetts eHealth Institute (Massachusetts Technology Park Cooperation)
• Michigan – M-CEITA (Altarum Institute)
• Minnesota – REACH (Key Health Alliance – Stratis Health), Minnesota – North Dakota
• Missouri – The Curators of the University of Missouri
• Montana – Mountain-Pacific Quality Health Foundation
• Nebraska – Wide River Technology Extension Center (CIMRO of Nebraska)
• New Jersey – New Jersey Institute of Technology
• New Mexico – LCF Research
• New York – RHITEC New York eHealth Collaborative (NYeC)
• New York – Fund for Public Health in New York
• North Carolina – NCHICA (University of North Carolina, Chapel Hill)
• Ohio – Greater Cincinnati HealthBridge (Ohio-Kentucky-Indiana)
• Ohio – Ohio Health Information Partnership
• Oklahoma – Oklahoma Foundation for Medical Quality, Inc.
• Oregon – OCHIN Inc. (Primary)
• Pennsylvania – Quality Insights of Pennsylvania, Inc. (Eastern)
• Pennsylvania – Quality Insights of Pennsylvania, Inc. (Western)
• Puerto Rico – Ponce School of Medicine
• Rhode Island – Rhode Island Quality Institute
• South Carolina – South Carolina Research Foundation
• South Dakota – Dakota State University
• Tennessee – Qsource
• Texas – The TAMUS Health Science Center Research Foundation. College Station
• Texas – University of Texas Health Science Center at Houston, Houston
• Texas – Dallas-Fort Worth Hospital Council Education and Research Foundation, Irving
• Texas – Texas Tech University Health Sciences Center, Lubbock
• Utah – HealthInsight, Utah-Nevada
• Vermont – Vermont Information Technology Leaders, Inc.
• Virginia – VHQC and the Center for Innovative Technology, for The Virginia Consortium
• Washington, DC – DCREC – District of Columbia Primary Care Association
• Washington, DC – National Indian Health Board
• West Virginia – West Virginia Health Improvement Institute Inc.
• Wisconsin – WHITEC (MetaStar, Inc.)

Health Information Technology Regional Exchange Centers
Approximately $643 million dollars have been allocated to support the development of 70 or more HITRECs in the first three quarters of fiscal year 2010 (which started October 1, 2009). Each center will provide technical and other assistance to least 1,000 practitioners that will help them attain meaningful use of electronic health records. This includes the EHR selection process, contracting, project management, implementation, and support. (The certification process and the meaningful use requirements are being developed by the Office of the National Coordinator and are expected to be finalized any day now).

Regional Centers will target primary care physicians that work in small practices (1-10 providers) in underserved areas or those who work with u

nderserved patient populations. The HHS expects HITRECs to “…offer technical assistance, guidance and information on best practices to support and accelerate health care providers’ efforts to become meaningful users of Electronic Health Records (EHRs).”

The first 20 HITRECs, two from each of ten national regions, were schedule to be operational by January of 2010.  All HITRECs need to be fully operational by the end of 2011 and will eventually need to become self sustaining. Each Center will be required to support a minimum of 1,000 providers and in aggregate all centers are expected to help 100,000 providers attain meaningful use of EHRs in the first two years of the program.

Each center needs to be sponsored by a nonprofit organization and initial government funding for each center may vary from $1,000,000.00 to $30,000,000.00

Functions and Duties of the HITRECs
The Regional Centers will be fully operational value added centers that will provide on-site and other forms of technical assistance to providers, including;

• Selecting an EHR product – Each Regional Center will identify two or more certified EHR products that they have fully evaluated; Assist in indentifying the product that is a best match for the providers’ needs;
• Achieving effective implementation
• 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
• Observing and complying with applicable legal, regulatory, professional and ethical requirements to protect the integrity, privacy and security of patients’ health information
• Helping providers achieve, through appropriate available infrastructures, exchange of health information in compliance with applicable statutory and regulatory requirements, and patient preferences.
• Supporting priority primary-care providers who have existing EHR systems

Additional duties of the Regional Centers include:

• Educational outreach to Providers – Support their regions through educational programs and materials that focus on “effective strategies and practices to select, implement, and meaningfully use certified EHR technology.” Training events may be cosponsored by other organizations.

• National Learning Consortium – All Regional Centers will be required to participate in a National Learning Consortium and work closely with the Health Information Technology Research Center to develop materials and tools that foster EHR adoption.

• Vendor Selection & Group Purchasing – The Regional Centers will help providers select and negotiate contracts with EHR vendors, hardware vendors, and other IT service vendors. They are expected to design group purchasing plans that leverage volume discounts and service level agreements tied to volume. “The selection process for these vendors must be open and competitive; the selection committee must include representatives of the priority primary-care providers actively practicing within the Regional Center’s geographic service area.”

• Implementation and Project Management - Regional Centers must provide end-to-end project management support over the entire EHR implementation process, including:
o Individualized and on-site coaching
o Consultation
o Troubleshooting
o Other activities required to assure that the supported provider is able to:
› Assess and enhance organizational readiness for health IT
› Assess and remediate gaps in IT infrastructure
› Configure the software to meet practice needs and enable meaningful use
› Ensure adequate software training for all staff
› Track and adhere to implementation timelines

• Practice and Workflow Redesign - Regional Centers will must provide support for practice and workflow redesigns necessary to consistently achieve:
o Documentation of essential clinical information in a structured format
o Electronic administrative transactions
o Electronic prescribing
o Electronic laboratory ordering and resulting
o Sharing key clinical data across practice settings
o Providing patients with access to their health information
o Public health reporting
o Policies and practices that protect the privacy and security of personal health
information.

• Functional Interoperability and Health Information Exchange – Regional Centers will focus on meeting the functional interoperability needs of practices, including, but not limited to:
o The electronic exchange of administrative transactions
o Laboratory orders and results
o Medication prescriptions
o Quality and public health reports
o Patient summaries

• Privacy and Security Best Practices – Regional Centers will support providers with the implementation and maintenance of physical and network security, user-based access controls, disaster recovery, encryption and storage of backup media, human resources training and policies; and identification of state laws and regulatory requirements that impact privacy and security policies for electronic interoperable health information exchange.

• Progress Towards Meaningful Use – The Regional Centers’ personnel shall participate in program training and be able to provide their clients effective assistance in attaining meaningful use.

• Local Workforce Support - The Regional Centers will be expected to partner with local resources, such as community colleges, to promote integration of health IT into the initial and ongoing training of health professionals and supporting staff. Regional Centers may provide internship opportunities for local training programs, provide instructors for didactic programs, and use local training programs’ graduates to fulfill the workforce needs of their extension activities and the implementation, maintenance, and use needs of the centers’ participating providers.

Regional Center Selection Process
Proposals from organizations that wish to serve as Regional Centers will be received during fiscal year 2010. Regions may consist of area within a state, a single metropolitan area, several states, or contiguous portions of multiple states.

Health Information Technology Research Center (HITRC)
The Health Information Technology Research Center (HITRC) and the Regional Centers together are referred to as the Extension Program and form the National Learning Consortium. A single HITRC will be established to provide technical assistance and share information on best practices between the Regional Centers and other stakeholders. It will also provide technical assistance for the establishment and evaluation of regional and local health information networks to facilitate the electronic exchange of information across health care settings and improve the quality of health care. The HITRC will receive approximately $50 million in funding over a period of 4 years.

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