Dan Morreale, Board Member, NJ HIMSS William O'Byrne, Executive Director, NJ-HITEC Linda Reed, VP/CIO, Atlantic Health System Kevin Lanphear, DO,

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1 The Final Rule for Meaningful Use of Certified EMRs September 7, PM-1PM1PM

2 Panelists Dan Morreale, Board Member, NJ HIMSS William O'Byrne, Executive Director, NJ-HITEC Linda Reed, VP/CIO, Atlantic Health System Kevin Lanphear, DO, Newburyport Family Practice, Newburyport, MA, and President, Whittier Independent Physicians Association, a 200 physician IPA Tom Gregorio, SVP Administration and CIO, Meadowlands Hospital and Medical Center, and Executive Director of Health-e-cITi-NJ Raj Lakhanpal, MD, FRCS, FACEP, CEO, SpectraMD USA, LLC

3 Agenda 1. Welcome, Dan Morreale 2. Introduction, William O'Byrne 3. The Benefits, Opportunities, and Challenges for Health Systems in Demonstrating Meaningful Use, Linda Reed 4. The Benefits, Opportunities, and Challenges for Physicians in Demonstrating Meaningful Use, Kevin Lanphear 5. Meaningful Use and the New Jersey Regional Extension Center, Tom Gregorio 6. A Deep Dive into Meaningful Use Compliance for Physicians, Raj Lakhanpal 7. Attendee Q&A

4 Introduction and Opening Remarks William O'Byrne, Executive Director, NJ-HITEC

5 Meaningful Use for Health Systems Benefits, Opportunities and Challenges Linda Reed RN, MBA VP/CIO Atlantic Health System

6 Driving for Adoption and Clinical Outcomes + Technology (data, interoperability) + Quality (reporting& outcomes) + Adoption + Security and Privacy + Certification (provider and vendor) = Meaningful Use

7 Benefits of Meaningful Use Improving patient care and clinical outcomes Potential incentive payments Getting your HIT up to date Getting HIT vendors to finally do something about product gaps Getting more attention from senior leadership/board Getting others in your organization to participate in HIT Increased HIT spending

8 Challenges of Meaningful Use Staying informed of and ahead of the definitions and dates Preconceived expectations about the incentive payments Impact of MU on your HIT strategy Impact of MU on your current portfolio Impact on your existing resources Your ability to catch up and cost to do so Getting more attention from senior leadership/board Balancing health information access against ARRA & HIPAA Security and Privacy Regulations

9 Considerations and Opportunities Implementing and adopting core clinical systems, e.g. medication reconciliation, critical care automation, physician notes do we mandate CPOE adoption can you mandate Joining an health information exchange Ability to measure and report quality measures Balancing health information access against ARRA & HIPAA Security and Privacy Regulations What if vendors do not achieve certification

10 Recommendations Develop an Organization Wide strategy to address MU Proactively assess impact of ARRA on organizational priorities Understand what can be gained Review the impact of meaningful use What is it? What does it mean? What will it cost? Reinforce that meeting meaningful use is a multi departmental project and expectation

11 Remember to Assess the gap between your current state and MU Understand scope and value of meaningful use for your organization Understand the required changes to the IT Strategy and Project Portfolio Manage organizational expectations Monitor your vendor s certification process Continue to monitor meaningful use criteria

12 Meaningful Use for Physicians Benefits, Opportunities and Challenges Kevin Lanphear, DO, Newburyport Family Practice, Newburyport, MA, President, Whittier Independent Physicians Association

13 Opportunities for Physicians in Demonstrating Meaningful Use The Federal government is offering substantial financial incentives for demonstrating meaningful use compliance EMRs have matured, and vendors are providing a CCHIT certified product with the capability for physicians to demonstrate meaningful use Now is the time to implement: the Federal government, healthcare providers, and EMR vendors are all focused on adopting EMRs and demonstrating meaningful use EMR adoption leads to better practices at the point of care

14 Challenges Physicians Face in Demonstrating Meaningful Use Understanding meaningful use in terms of: The criteria Methods of reporting to CMS The timelines for reporting Allocating the time required for EMR installation, practice workflow redesign and learning to use the system An initial dip in productivity upon implementation of an EMR Maintaining the motivation and patience of providers during the implementation process

15 Meaningful Use Has Become Easier to Accomplish for Physicians Reduction in the number of the core set of criteria that physicians have to meet from 25 to 15 Physicians can choose to demonstrate compliance with any 5 of 10 menu set objectives Significant reductions in thresholds of measures for meaningful use compliance objectives (both core and menu set)

16 Meaningful Use and the New Jersey Regional Extension Center Tom Gregorio, SVP Administration and CIO, Meadowlands Hospital and Medical Center, and Executive Director of Health-e-cITi-NJ

17 NJ-HITEC New Jersey Health Information Technology Extension Center (NJ-HITEC) 211 Warren Street Newark, New Jersey

18 A Deep Dive into Meaningful Use Compliance for Physicians Raj Lakhanpal, MD, FRCS, FACEP CEO, SpectraMD USA, LLC

19 Medicare and Medicaid Incentives Physicians eligible for Medicaid incentives can receive up to $63,750 Physicians eligible for Medicare incentives can receive up to $44,000 Physicians can qualify for CMS incentives for EMR implementation from Medicare or Medicaid, but not both Hospital Based physicians are not eligible for the incentive program Physicians practicing in areas designated as HPSA (Health Professional Shortage Area) can receive an additional 10% incentive over the specified limits

20 Eligibility for Medicare and Medicaid Incentives Medicare eligibility Medicaid eligibility Physicians eligible for Medicare incentives will receive up to 75% of their annual Medicare billing, per year, up to the maximum incentive designated for that year. Non-hospital physicians who have over 30% of their total patients insured by Medicaid Pediatricians with 20-30% Medicaid patients. Physicians in Federally Qualified Health Clinics

21 Comparison of Medicare vs. Medicaid Incentives Criteria Medicare Medicaid Maximum Eligible incentive Qualifying for incentives Incentive payments Length of incentive program $44,000 $63,750 Medicare EP s must bemu compliant from the first participation year. Must demonstratecompliance over a period of consecutive years Beginning 2015 fee reductions occur for non compliance Medicaid EP s can adopt/implement/upgrade of certified EHR systems in the first participation year. Can demonstratecompliance in non-consecutive years No fee reductions apply but no payments will be made after 2021

22 Eligible Professionals Medicare Doctor of medicine or osteopathy Doctor of dental surgery or dental medicine Doctor of podiatric medicine Doctor of optometry Medicaid Physicians Dentists Certified Nurse Mid-Wives(CNMs) Nurse Practitioners (NPs) Chiropractor Physician Assistants (PAs) practicing in a: 1) Federally Qualified Health Center (FQHC) or 2) Rural Health Clinic (RHC)that is led by a physician assistant

23 Meaningful Use Use of an ONC certified EMR vendor Meaningful Use Compliance with meaningful use criteria

24 Stage 1 of Meaningful Use For Stage 1, providers must meet the following criteria to be meaningful users of EMR technology: The 15 Core required objectives 5 out of 10 Menu objectives Clinical Quality Measures 3 clinical quality measures from a set of 3 core and 3 alternate core measures 3 clinical quality measures from a set of 38 additional clinical quality measures

25 Goals for Meaningful Use Improving quality, safety, efficiency of care and reducing health disparities Engage patients and families in their healthcare Improve care coordination Ensure adequate privacy and security protections for personal health information Improve public and population health

26 Methods of Reporting to CMS In 2011 reporting to CMS will be by attestation Physicians need to attest to: Use of certified EHR technology Accuracy of the: Numerators, Denominators and Exclusions for each measure reported Beginning and end dates for which they apply From 2012, reporting to CMS will take place by means of ONC EMR certified technology, directly to a CMS designated portal.

27 Attendee Q&A

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