Questions & Answers

How do Providers in Tribal healthcare facilities receive REC services to support adoption of certified EHRs including training for facility staff?

The NIHB AI/AN National REC will issue a REC Provider Agreement Form.  Tribal health care facilities are requested to complete form entries for all Providers in the facility. Provider Agreement Form “sign-ups” approved by ONC will result in the allocation of direct support funds to our REC.  In turn, our REC will distribute these direct support funds through REC Sub-Recipient Awards to Tribal Organizations to support local certified EHR adoption and Meaningful Use support activities.

Can Providers or Tribal healthcare facilities directly receive funds to support certified EHR adoption including training for facility staff?

The NIHB AI/AN National REC cannot provide direct support funds to individual facilities or providers.  REC direct support funds will be made available for use through the following REC direct support funds strategies:

• Area Sub-Recipient Awards
• National RPMS  Certified EHR Adoption and Meaningful Use Support Strategy
• National Commercial Off-the-Shelf (COTS)  EHR Adoption and Meaningful Use Support Strategy

Is NIHB supporting RPMS  EHR sites?

Yes, each Area receiving a Sub-Recipient Award will support adoption of certified RPMS  EHR and Commercial Off-the-Shelf (COTS)  certified EHR and achieving Meaningful Use of  certified EHRs for facilities in their Area.

The NIHB AI/AN National REC will also provide direct support funds for a National RPMS certified EHR Adoption and Meaningful Use Support Strategy for facilities located in areas that do not receive Sub-Recipient Awards. This certified EHR adoption strategy will include the services of Clinical Consultants (Nurse, Pharmacy and Lab) experienced in RPMS EHR adoption.  The Clinical Consultants will provide technical training and assistance to facility staff subject to the availability of federal cooperative agreement funds.  

Is NIHB supporting non-RPMS  EHR sites?

Yes, each Area receiving a Sub Recipient Award will support adoption of certified RPMS  EHR and Commercial Off-the-Shelf (COTS)  EHRs and achieving Meaningful Use of  EHRs for facilities in their Area.

The AI/AN REC will also provide direct support funds for a National Commercial Off-the-Shelf (COTS) EHR Adoption Strategy and Meaningful Use Support Strategy for facilities located in areas that do not receive Sub-Recipient Awards. This EHR adoption strategy will include vendor selection support services and Meaningful Use training and technical assistance services.  Vendor costs associated with technical training and assistance for certified COTS EHR adoption will be the responsibility of the facility.    

Are federal IHS facilities allowed to sign up with the NIHB REC?

Yes, the NIHB AI/AN National REC is ready to begin enrollment of IHS Facility Providers.   The Agreement, which has been approved by the NIHB AI /AN National REC, the IHS Office of General Counsel, and the ONC, is available NOW. Enrollment is easy.  Only one Agreement form needs to be completed for each facility.

Do federal IHS facilities HAVE to sign up with the NIHB REC?

IHS management will issue a letter to Federal IHS facilities to encourage every Facility to sign-up as soon as possible with the NIHB AI/AN National REC. 

Are tribal health facilities allowed to sign up with the NIHB REC?

Yes, the NIHB AI/AN National REC will be ready to begin enrolling Tribal facilities during December 2010.  We will be announcing the Provider Agreement Form to sign-up Providers in Tribal healthcare facilities very soon.

Do tribal health facilities HAVE to sign up with the NIHB REC?

Tribal healthcare facilities have the option to sign up to work with the NIHB AI/AN Native REC or with their local State REC.  The AI/AN REC does not charge a fee for its services while many State RECs are assessing fees to Providers for their services. Most State RECs will not be knowledgeable about RPMS for those tribal facilities that have a certified RPMS EHR.  We also strongly recommend that Tribal facilities fully evaluate the type and level of certified COTS  EHR technical training and assistance services that will be provided by a State REC prior to signing their agreement.  And, of course, we hope that Tribal facilities will decide to support the NIHB AI/AN National REC and help the Indian Health System prove again how quickly our system adopts the highest quality standards of care, including EHR and Meaningful Use

Are urban Indian health facilities allowed to sign up with the NIHB REC?

Yes, the NIHB AI/AN National REC is ready NOW to begin enrollment of Urban Indian Organization Facility Providers.  The Agreement, which has been approved by the NIHB AI /AN National REC, the IHS Office of General Counsel, and the ONC, is available NOW.  Enrollment is easy.  Only one Agreement form needs to be completed for each facility.

Do urban Indian health facilities HAVE to sign up with the NIHB REC?

Urban Indian health facilities have the option to sign up to work with the NIHB AI/AN Native REC or with their local State REC.  The AI/AN REC does not charge a fee for its services, while many State RECs are assessing fees to Providers for their services.  Most State RECs will not be knowledgeable about RPMS for those urban Indian organization facilities that have a certified RPMS EHR. We also strongly recommend that Urban Indian health facilities fully evaluate the type and level of certified COTS  EHR technical training and assistance services that will be provided by a State REC prior to signing their agreement.  And, of course, we hope that Urban Indian Organizations will decide to support the NIHB AI/AN National REC and help the Indian Health System prove again how quickly our system  adopts the highest quality standards of care, including EHR and Meaningful Use

What is the responsibility of the NIHB REC for MU Support activities?

The NIHB AI/AN National REC will provide funds to adopt Meaningful Use Support activities through locally planned and adopted efforts. These funds will be made available for use through the following REC direct support funds strategies:

• Area Sub-Recipient Awards
• National RPMS  EHR Adoption and Meaningful Use Support Strategy
• National Commercial Off-the-Shelf (COTS)  EHR Adoption and Meaningful Use Strategy

What is REC providing that IHS Meaningful Use Team is not already providing?

The NIHB AI/AN National REC and the IHS Meaningful Use Team are collaborating to form an Indian Country Meaningful Use Initiative, to ensure a consistent approach and message, and to leverage all available resources for  I/T/U providers.  The National REC will supplement the IHS-funded efforts of the IHS Meaningful Use Support Team, and the IHS Meaningful Use Team will support the REC efforts in terms of knowledge-sharing, training materials, and expertise. Based on locally-determined priorities, REC  funds may be used to hire staff or support local Meaningful Use training services to work in tandem with the IHS MU Team.. Funds will be made available for use through the following REC direct support funds strategies:

• Area Sub-Recipient Awards
• National RPMS  EHR Adoption and Meaningful Use Support Strategy
• National Commercial Off-the-Shelf (COTS)  EHR Adoption and Meaningful Use Strategy

Why would a non-RPMS site want to sign up with NIHB REC? With whom should the non-RPMS sites sign up as a REC?

It is incumbent upon each and every provider and facility to conduct their own “due diligence” process to determine which REC will best meet their needs.  While Indian Country sites - - on-RPMS sites (Tribal and urban Indian facilities using certified COTS EHR Software) and RPMS EHR - - are encouraged to sign up with the NIHB AI/AN National REC, they  have the choice of using a State REC.  Each provider/facility must fully evaluate the depth, type and level of certified EHR technical training and assistance services that will be provided by each REC and which is most suited to their EHR and needs

Each Area Tribal Organization receiving an NIHB AI/AN National REC Sub Recipient Award must support adoption of certified Commercial Off-the-Shelf (COTS) EHR and achieving Meaningful Use of certified COTS EHRs for the facilities in their Area.

The NIHB AI/AN National REC will also fund a National Commercial Off-the-Shelf (COTS)  EHR Adoption  and Meaningful Use Support Strategy  to support COTS Vendor Selection and Meaningful Use support activities in Tribal facilities planning to adopt certified COTS  EHR.

Will the NIHB AI/AN National REC help provide the best solution for each particular practice?

The NIHB AI/AN National REC will provide technical support for the certified EHR selection process. However, the individual I/T/U facilities must make their own decisions on whether to use the certified RPMS EHR or purchase a certified COTS EHR system

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