Successful pattern for health info tech regional extension center

In the Federal Register, May 28, 2009 (Volume 74, Number 101), the Department of Health & Human Services proposed the creation of Health Information Technology Regional Extension Centers.

HITRECs need not start with a blank slate, but can use the USDA Cooperative Extensive Service (CES) as a model for delivering immediately useful knowledge to people, um, "in the field."

A bit of history about the 95-year success of technology transfer by CES gives evidence of its viability as a model.The Morrill Act of 1862 established land-grant universities to educate citizens in agriculture, home economics, mechanical arts, and other practical professions.

Extension was formalized in 1914, with the Smith-Lever Act. It established the partnership between the agricultural colleges and the U.S. Department of Agriculture to provide for cooperative agricultural extension work.

At the heart of extension, according to the Morrill Act of 1862, was:

♦ developing practical applications of research knowledge
♦ giving instruction and practical demonstrations of existing or improved practices or technologies in agriculture.

By analogy, health information regional extension centers (HITRECs) assist health care providers gain "meaningful use" of IT to

♦ improve the safety and quality of health care
♦ better understand and manage valuable medical and health data
♦ reduce clinical workloads through workflow analysis and
♦ effect common-sense clinical process modification or redesign.

("Meaningful use" is not yet clearly defined and will affect the selection of HIT and the features sought.)

Using that model, the same principles in the context of health care form the heart of health information technology extension work. With this proven history of successful agriculture technology and expertise transfer [The U.S. didn't become "the breadbasket of the world" by accident] as guidance, HITRECs can tap, for technology and practices that are relevant to health care providers, resources such as the

♦ National Institutes of Health (27 different Institutes and Centers)
♦ Centers for Disease Control & Prevention Coordinating Centers/Offices
♦ National Institute of Standards & Technology (Information Technology Laboratory) and
♦ Federal Laboratory Consortium for Technology Transfer (more than 250 federal laboratories and centers) as well as
♦ schools from MIT to Stanford, from Lake Area Technical Institute to Caltech.

HITRECs have a "running start" with the Morrill Act principles and county extension web sites on how to deliver clinical, medical, and science research knowledge regarding

♦ ANSI 5010 and ICD-10 implementations
♦ electronic record systems (PHR, EHR, EMR)
♦ therapies (e.g. anodyne and proliferative injection)
♦ clinical trials
♦ pharmaceuticals
♦ aspects of evidence-based medicine
♦ medical devices and
♦ wellness.

"The journey of one thousand miles begins with but one step." Or, from a different persepective- "The cost of initially solving a problem is $1. Solving the same problem many times removed downstream is $400 or more." Choice and the consquences of choice.