Quarterly News from your WTxHITREC

In This Issue
Now Serving Specialists
Provider Spotlight
Challenges of Stage 2
Best Care at Lower Cost
Ask the Expert
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Issue: 1
Enjoy your 1st issue of Quarterly News from your West Texas Health IT Regional Extension Center (WTxHITREC) and please feel free to forward this email to any of your colleagues or interested parties. 
The WTxHITREC continues to support providers and hospitals in selecting, implementing, and achieving meaningful use of certified EHR products through technical on-site assistance, guidance, and education of best practices
Our aim is to help improve practice efficiency, patient care, maximize revenue, and increase the quality of work/life balance for health care providers and hospitals in West Texas through the adoption of EHR systems.


As always, please contact the WTxHITREC with any questions or service needs at 806-743-7960 or info@wtxhitrec.org
WTxHITREC Now Serving Specialists!
Call 806-743-7960 to Learn More Today

WTxHITREC will now be offering specialist services on a tier system based on EHR adoption status and the number of providers within each practice.  Each tier has been created to develop an effective project plan to provide technical assistance and support each practice as they achieve meaningful use.

Tier 1 - No Certified EHR Previously Adopted

Tier 2 - Certified EHR Previously Adopted but Not Implemented

Tier 3 - Certified EHR Previously Adopted and Implemented - Meaningful Use Gap Analysis

Follow the link or call WTxHITREC for futher details.

Provider Spotlight 

April Floyd, PA

Serving our most Rural Areas


Best practice in health information technology can be found in our most rural areas of Texas. An ideal example can be found at Crane Rural Health Clinic, characterized as a medically underserved rural health clinic, approximately 35 miles south of any nearby urban area and located in Crane, Texas. As do many cities in rural areas, Crane serves as a central health care location for many of its smaller surrounding communities.

The staff and administrators at Crane Rural Health Clinic believe in improving patient care by utilizing a certified electronic health record (EHR) system they adopted in December 2011. This is evident in one of their providers' accomplishment in meeting Meaningful Use in September.

April Floyd, a physician assistant of the clinic, began practicing medicine in September 2009. She was recently named a Meaningful Use Vanguard (MUVer) by the West Texas Health Information Technology Regional Extension Center (WTxHITREC) for her leadership in the national EHR transition.


Floyd's recognition is an initiative of the Office of the National Coordinator for Health Information Technology designed to honor, thank and bring together clinicians and hospitals that have successfully implemented EHRs. Floyd has earned the distinction as a leader in health information technology.


Floyd said she was eager to meet Meaningful Use because she said EHRs give her the capability to better manage her patients' care.

"It allows monitoring capabilities for specific diseases and conditions and it also allows us to provide educational tools to the patient so that the patient can be informed of their condition," Floyd said.   


Read More



Submitted by 

Joe Huerta, MSM

WTxHITREC Regional Coordinator 



Increased Challenges of Meaningful Use Stage 2

CMS released the final rule for Stage 2 of Meaningful Use on August 23rd. With two months to digest the expanded requirements as described in the nearly one-thousand pages filed with the federal register, several challenges have been identified by your Health IT team at the West Texas Health Information Technology Regional Extension Center (WTxHITREC). Today, we will take a look at some of these specific challenges and how your Regional Extension Center can help in resolving these barriers to Meaningful Use.


The Meaningful Use Stage 1 requirement for the use of CPOE for medication orders, with 30% of unique patients for at least one medication order, has been vastly increased.  In Stage 2, more than 60% of medication orders must go through CPOE; additionally 30% of laboratory orders and 30% of radiology orders created by the eligible provider must be recorded utilizing CPOE. 


The fallout from this requirement appears to be a requirement for an established interface with laboratory and radiology information systems.  For many providers in more urban areas, this threshold is already being met with partnering laboratory and radiology services providing the required digital infrastructure for this interface.  Unfortunately, with many of the providers in West Texas falling in rural areas void of the resources available in more urban areas, laboratory and radiology orders and results are still conducted through a manual process.  The West Texas HITREC has helped a number of providers in these areas identify what new workflows will look like as they begin to migrate from manual processes to a digital one, and the appropriate partners to call upon to jump start this process.  Additionally, in collaboration with the 61 Regional Extension Centers across the U.S., the WTxHITREC has identified best practices to onboard these technologies in an efficient and cost effective manner.



As expected by many Health IT experts and providers alike, nearly every core measure experienced a substantial increase in the reported requirement from a certified EHR technology (cERHT). The 'pain' threshold for many is minimal at best.  For example, in Stage 1, the eRx requirement of more than 40% of all permissible prescriptions be transmitted electronically using a cERHT. In Stage 2, more than 50% of all eRx are required to be transmited from a cEHRT with a comparison completed with at least one drug formulary.  For most this last caveat is a matter of flipping on a switch with the help of one or a number of accepted payer groups. In fact the WTxHITREC has helped many providers flip this switch on for many providers in Stage 1 trying to increase efficiencies in their use of an EHR.

Read More 


Submitted by

Mehdi Rais 

WTxHITREC Director of Clinical Informatics

Best Care at Lower Cost:

The Path to Continuously Learning Health Care in America


The latest report from the Institute of Medicine (IOM), released in September 2012, is the next phase of recommendations in response to widespread demand for an improved healthcare system.  Best Care at Lower Cost follows two decades of reports published by the IOM, including To Err is Human: Building a Safer Health System, and Crossing the Quality Chasm: A New Health System for the 21st Century.   The IOM recommends a transformed approach that includes increasing connectivity to allow information to be accessed in real time.  In addition to widespread EHR adoption, interconnectivity must improve between providers of care.  Data collected in digital formats provide resources to manage care, capture results, improve processes and generate knowledge.  EHRs further promote patient-centered care by providing more tools to connect patients to reliable clinical knowledge and increase patients' involvement in their own care. 

Read the Full IOM Report and  

View IOM Infographic 

Submitted by

Becky Jones, RN, MSN, CPHQ

WTxHITREC Regional Coordinator

Ask the Expert

 Meeting Meaningful Use Core Measure 14


From our experience, multiple questions have been raised regarding the capability to electronically exchange key clinical information. The Centers for Medicare and Medicaid Services (CMS) clarifies the measure requirements by stating "the exchange is defined as electronic transmission and acceptance of key clinical information using the capabilities and standards of the certified EHR technology".


Question: Can the exchange be among other physicians at the same location?  Can it be exchanged with my home email address? Or with someone who has the same EHR as ours?

Answer: The continuity of care document (CCD) must be generated from the certified EHR and then transmitted electronically to a different legal entity and not between organizations that share a certified EHR technology.


Question: Does it have to be on a real patient?

Answer: Simulated exchanges will not be considered as meeting the measure, but using test patient information, instead of real patient data, would satisfy the measure. If real patient information is used the privacy and security of patient information must be met.


Question: Can we just send a CD or flash drive with the patient information to another provider? Can we send a fax from the computer?

Answer: CMS states there are many means to satisfy the transmission of the measure, but the "use of USB, CD-ROM, or other physical media or electronic fax would not meet the measure".


Question: Can it just be an email?

Answer: CMS states the eligible professional "may use any means of electronic transmission according to any transport standard(s) (SMTP, FTP, REST, SOAP, etc.) regardless of whether it was included by an EHR technology developer as part of the certified EHR technology in the EP's possession". SMTP is standard email technology.


Question: We will just have to do this one time for Stage one, right?

Answer: CMS states that one test must be completed during each reporting period. One test for the 90-day reporting period and another test for each of the annual reporting periods. 


For more information, see the CMS Fact Sheet or the CMS Q&A specifics for Core 14.


Submitted by

Leta Cross-Gray, RN

WTxHITREC Regional Coordinator

Please feel free to contact our offices for further information. 


Carson Scott, MPA

Director Marketing, Outreach, Education & Communications
WTxHITREC - Texas Tech University Health Sciences Center

806-743-7960 ext.356