REC Sharing or Lack Thereof

There was a pretty interesting thread posted to a LinkedIn group about the RECs. Here’s some comments that will make you think a little bit about the RECs and in particular the RECs working together (or not).

It is understandable that REC’s must adapt their programs to the communities they plan on serving….Healthcare is local. However, living in Florida, where there are 4 REC’s, I expect some things to be consistent…for example the implementation process should include the same pre-implementation workflow worksheet. Unfortunately, this may not happen.

We know that ONC is asking that the REC’s play nice and share best practices. However, as a consultant that is talking with 3 of the 4 REC’s about a role….one REC leader in Florida asked me…”Make no mistake, we are competing with the other RECs, so as a consultant, how will you keep our secrets from the other REC’s you are working with in the State? This was a valid question, which I will address in my agreements, however, it made me think. What are they competing for..additional funding that isn’t there yet? Reputation? Most innovative?

Well..I think its all of the above. I believe, the REC, that employs the right people, have the right vendor PARTNERS, and think outside the ONC box, will rise above the rest. However, best practices must be shared and that is where the ONC project lead/coordinators (in Florida its Kelly), must step up and do!

RECs competing is kind of a sad idea for me. Something doesn’t feel right about that. Now take a look at the compensation funding model for the RECs:

The REC’s do get 500k upfront for marketing the REC, initial staffing needs, etc. Then they get $ as they sign up the physcians, in my area its 5k for primary physicians with no EHR. I think they get 3k for primary physicians that have an EHR, but needs to get too MU. Primary Docs are the main targets though. In terms of competing for physicians….they do not. The REC’s are assigned Counties in their State. The only time they would compete is if a doctor has two offices in separate Counties.

With this followup clarification from another user:

In my state, it’s $1500 for sign up, $1500 upon implementation, $1500 for meaningful use. Perhaps the competitiveness referred to in your conversation with the REC in FL relates to future grant awards…

When you see the $ signs in the RECs eyes, now you’ll know why. I appreciate that the government wants to try and reward results. However, something tells me that this isn’t heading down the path the government intended.

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John Lynn

John Lynn

John Lynn is the Founder of, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

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  • Since REC work is federally funded, the tools and tactics developed within and deployed by RECs are public domain by definition, notwithstanding how much any REC may try to “brand” itself or demand “non-disclosure.”

  • Agreed with Bobby, this work is supposed to be a matter of public record. I have another question about “competition,” how long are the RECs supposed to be around? Won’t they go away after the duration of the HITECH program? Or is there the idea that if they do well enough, they’ll get to live on (funded by the ONC)?

    Perhaps it’s the opposite: if there’s only so much time to collect the money, best to get as much as possible while you can. I’m sure not all RECs are behaving this way (or even all employees within an REC), but this may be an example of unintended consequences.

  • The RECs will be competing for talent acquisition more than anything else.

    They are supposed to be around for the long haul after their initial grants are exhausted with minimal support from ONC (10% I believe). This brings up another competitive arena, since in order to ensure viability after ONC money runs out, they will have to acquire paying customers in the form of specialists, larger groups and ongoing revenue from MU support, or anything else they can think of.

  • I like to clarify few things. There are specific formulas for the REC funding. Every REC is funded the same way and every REC gets the funds “to draw” down from as each PPCP they assist as the PPCP meets the 3 define milestones. Disparity of dollar amounts being subsidized per PPCP and what PPCPs and non-PPCPs are charged for membership or whatever else they call it is not defined by the ONC. Each REC is doing it on their own. It’s important that the ONC money calculations are same for each of the 60 RECs but the actual distribution amounts differ b/c of the RECs different business models. As for RECS working together, from my personal experience with working with several, they tend to try to help each other. But, each won’t go out of their way to do so. With that said, each one of the Exec. Directors are human beings with egos and I am sure there are some competitiveness there. Two most common mis-understanding about the REC programs are: 1) money is given to PPCPs, which is not true and 2) as each milestone is met, 1/3 of the money is given to the REC from ONC – not true again. The money is essentially reserved for the RECs to drawdown from as they submit expenses against the drawdown amount.

  • I am not sure who can approach REC for help. I read in earlier blogs that REC is available for help tp PPCP ( providers) to get to Meaningful Use. However most of the providers use some IT staff / clinical champion to carry out the tasks of implementing EMR or get some professional help from Project Management people.

    I have contacted REC in my area but have not received any reply from them.
    I would like to hear other people’s expereinces as well.


  • Alefia,

    RECs are there to assist the PPCPs to meaningful use through delivering some services (free) but most with pre-negotiated fee terms with Service Partners (consultants and EHR companies). Essentially, REC is there to help PPCPs get the best deal and best EHR product per the provider requirements and help them along in the Meaningful Use process. If you like more info, contact me at I can probably give a quick overview to see what RECs can do for you (if you are a PPCP).

  • The RECs exist so that the government can hire more people with overinflated salaries. They will offer no real value to small and solo practice PPCPs…except that the PPCPs have to go theough the REC to get the stimiuls money.

  • Jack, RECs are far from perfect. However, I must respectfully disagree. If RECs do their job, they will provide something that most solos and smalls need above all else if they want to get on the road to EHR adoption (Let me be clear that before RECs get involved, each provider must have the right reasons to even look at adopting an EHR). To give trusted advice on what EHR to get and how to go about implementing it and ultimately use it in a meaningful way. Many solos and smalls can’t even get by the basic question of how do I even select an EHR and what should I expect once I select one? I think just giving PPCPs a starting point is hugely beneficial.

    Also, PPCPs do not have to go through the RECs to get the stimulus money. REC program and EHR incentive program are not tied in that way.

    With that said, I do understand your pessimistic view of the RECs. I am on the side that the RECs will contribute positively. I am very hopeful.

  • Sorry for my lack of participation in the discussion. I left town this week on a week long whitewater trip with the scouts. Good times!

    Alefia makes an interesting comment. I wonder how quickly the various RECs will be able to respond to providers needs. They’re going to have a real challenge trying to do the volume that’s required of them while still giving the service that’s needed.

    It will be interesting to see the long term business models that RECs will try to employ, after ARRA money. Here’s one business model I suggested:

  • The California RECs and now the New York will choose the “usual suspects” as their preferred EHRs.
    I predict that NextGen, Allscripts, and eClinicalWorks will be on the list. I also predict that with these choices, the small and solo practice PPCPs will either not sign up or will not be happy with the costly softwares and the lack of user friendly software choices. The RECs are being led around by these EHRs with some of the REC employees having previous relationships with these vendors.

  • “The RECs are being led around by these EHRs”

    I wonder what else might be going on. Although, maybe it’s better that I don’t know. Did anyone see the LA REC people at the NBA finals;-)

  • Very interesting discussion. I truly think that the points discussed out here regd. the REC’s are going to be point of contention looking ahead, towards a successful EMR deployment.
    On the issue of REC’s competing against each other, I feel this will result in a healthy competition, if they don’t get biased for a particular EHR vendor. I believe these REC’s should set their own unique business model, as discussed above within the guidelines set-forth in the HITECH act.
    This would result in each REC having a set of vendors with similar offering , yet maintaining their own unique selling point.
    Each EHR vendor should have their own interpretation of HITECH act, using which the REC’s can quote or compete for the jobs.

    Regarding the grants given, I believe the staggered form of funding does solve most of the confusion.

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