TheTimesTribune.com, Corbin, KY

April 8, 2013

Survey assesses region’s doctors’ preparedness for electronic records


The Times-Tribune

CORBIN — By Jeff Noble / Staff Writer

More than 280 doctors in southeastern Kentucky have not installed new electronic health records, or EHR, software. And if those healthcare providers in small and rural practices don’t have the new software in service by 2015, they could face penalties from Medicaid and Medicare.

That came from a survey released during a conference in London at the Kentucky Highlands Innovation Center. The survey was done by Richard Murch, an internationally-known Health Information Technology (HIT) consultant who specializes in electronic health records.

Murch’s survey was commissioned by Stronger Economies Together (SET), a USDA Rural Development program which helps regions like southeastern Kentucky enhance and strengthen their biomedical and life science fields. A total of 431 rural doctors were surveyed.

He found out nine hospitals and hospital systems in southeastern Kentucky were using EHR certified systems, including Baptist Health Corbin-hospital and Saint Joseph’s-Kentucky One Health at their locations, including Saint Joseph-London hospital. Other nearby hospitals included the ARH Hospitals in Middlesboro and Hazard, and Rockcastle Memorial Hospital in Mount Vernon.

Murch stated, “While the large hospitals in the region have successfully installed this software and are using it with quality results, seven hospitals surveyed have experienced difficulties finding an EHR IT (Information Techonlogy) staff that’s experienced and qualified. They’ve frequently resorted to supplementing staff by outsourcing or using outside consultants, which means jobs are being lost to outside sources. … These doctors in the rural communities are vital. Are they going to close?”

The survey also noted a good number of doctors — 73 percent of those questioned — asked for help. As a result, SET is working on a plan to provide training and education. Murch recommended four steps to help with the training, with one of them being an online course for doctors, surgeons, nurses and other staff members in hospitals, surgery centers and clinics who using the EHR technology, or will be soon.

Another step was to provide new courses for people who are already in the EHR field, or want to be, which will give them the chance to study and obtain a qualification, or help them receive additional training.

His third step was to provide online training for patients who use hospitals, clinics and doctors’ offices that will show patients how to access their medical records.

The final step recommended by Murch was to establish a center to develop new electronic health records and health information technology businesses in southeastern Kentucky. He named the center as the Health Information Technology Entrepreneurial Development Center.

The center Murch referred to ties in with the SET program, which has designated southeastern Kentucky as one of some 20 areas nationwide to get assistance through a new national program. That program is geared to developing a regional economic development plan.

SET noted Kentucky is behind the nation when it comes the number of doctors per 100,000 population. The program added the ratio’s worse in rural areas, due to two-thirds of the state’s population living in rural areas, while one-third of the doctors are outside Kentucky’s metro areas like Louisville, Lexington and northern Kentucky.

Input from SET also revealed many doctors in rural areas are nearing retirement, and considering whether to make personnel and money investments to comply with the federal mandates, or close down their practices.

The electronic healthcare records (EHR) software is mandated by the American Recovery and Reinvestment Act of 2009, and must be installed by 2015.

SET’s findings determined that healthcare and health-related businesses were the fastest growing segment of southeastern Kentucky’s economy, and hopes to create an additional 100 jobs during the next several years with the creation of an electronic health records and health information technology center.

As for the courses offered for EHR training, one panelist told Murch, “It’s going to come down to the educational institutions and their collaboration and cooperation.”

Another panelist noted, “What are the positions and what do they do? There’s got to be a need for doctors and nurses to be trained on that system.”

“The curriculum needs to be put in place, and are we training people for jobs that don’t exist now?” asked Lois McWhorter, the Associate Dean of Business and Professional Services at Somerset Community College’s Laurel Campus in London.

Of eight universities in Kentucky listed in Murch’s survey, only three offered Health Information Technology courses. The closest one to the Tri-County region was Eastern Kentucky University in Richmond, which offers Health Care Administration and Informatics (HCAI), but he noted “this will need substantial curriculum development and enhancement to include HIT planning, selection, training and deployment, networking, infrastructure management and many other skills.”

“We need to do a lot of work with the universities to improve these needs,” said Tom Fern, the State Director of USDA-Rural Development in Kentucky.

The survey also listed all 16 colleges in the Kentucky Community and Technical College System (KCTS), including Somerset Community College’s Laurel Campus in London, offer a Healthcare Information Technology course. Murch suggested enhancements to the curriculum are required to meet future needs, which is currently underway.

After the conference, Murch said of the survey’s findings and the discussion in London, “It’s a lot of work, a lot of data, it was a great presentation and we’re moving forward. That’s because there’s an urgent need for healthcare in rural Kentucky.”

He added the final report would be released at the end of this month.