The Executive Director of the NC Health and Wellness Trust Fund (NCHWTF) convened a group of private foundations in NC to discuss the potential for a loan fund to assist NC healthcare providers with the up front costs of acquiring and implementing an EMR.  The ARRA legislation included the concept of a state loan fund; however, the Office of the National Coordinator for Health Information Technology (ONC) has not yet released details on how a state-based loan fund would operate. 

Since the timeline for ONC’s competitive grants to create electronic health record (EHR) loan funds is still unknown, the NCHWTF Commission has decided to use its own funds to develop a pilot program that provides low interest EHR loans specifically focusing on small rural/underserved and urban practices.  This pilot program will allow these practices access to the capital required to purchase an EHR prior to the onset of the ARRA-funded federal incentive program under Medicaid and Medicare.  The advantage of establishing the loan fund at this time would be that North Carolina would have a competitive advantage in applying for the ONC grant and would be able to use this investment as the State’s match.  Specifically, the program will provide loans to Tier One health care providers for the following purposes: 

• To facilitate the purchase of a certified EHR technology or upgrade existing EHR technology to meet certification criteria;
• To train personnel in the use of such technology; and/or
• To improve the secure electronic exchange of health information. 

NCHWTF is contracting with the following agencies to facilitate the loan program: 

1. North Carolina Medical Society Foundation (NCMSF) will select practices that are eligible for the loan funding based on both their readiness to adopt EHRs as well as their financial viability.  NCMSF staff will also provide ongoing technical assistance as well as evaluation of the effectiveness of the loan program on EHR implementation within the selected practices.  The pre-qualification process will ensure practices are able and ready to implement an EHR system to accomplish “meaningful use” including: 
   • Commit to interface with NC Health Information Exchange
   • Participate in ongoing technical assistance from the REC and NCMSF
   • Prepare a financial and business plan
   • Create a project plan for EHR implementation
   • Ensure “readiness” to begin EHR implementation including staff training and resulting changes to practice workflow
   • Select an approved EHR product from the “preferred vendor list” to ensure system ability to meet meaningful use standards  

 

2. The Center for Community Self Help (Self Help) will underwrite, originate and service loans made in the fund.  Self Help is a community development lender that provides financing to low-income, minority, and rural individuals, businesses and non profit organizations, assisting those borrowers and strengthening their communities.  Self Help will use commercially reasonable efforts to fully collateralize the loans and obtain third party guarantees when available.

A key component of the HITECH funding from ONC is the creation of Regional Extension Centers (REC) whose role is to provide technical assistance to health care providers to adopt or enhance EHRs.  The North Carolina Area Health Education Center (AHEC), the agency receiving funding for North Carolina, has agreed to partner with NCHWTF to ensure that loan recipient practices receive technical assistance to successfully implement EHRs so they can qualify and receive the Medicaid/Medicare incentive payment and repay the loan fund.  The loan fund will be a critical asset to foster early adoption of EHRs throughout North Carolina and will integrate well with ongoing health information technology efforts in the state.

NCHWTF has also partnered with the Golden LEAF Foundation to provide guarantees on the NCHWTF loan fund and hopes to partner with other health funders in the state.

If you would like more information, please contact Kristal Kingi-Shearin at the NC Health and Wellness Trust Fund  or Maggie Sauer at the North Carolina Medical Society Foundation-(919) 833-3836.