Show Me the Value of

Health Information Exchange (HIE)

Karen E. Edison, M.D.Chair, Department of DermatologyDirector, Center for Health Policy

University of Missouri Health System

Evolution ?

Natural Selection never saw this coming!

Objectives

Understand the federal HITECH Act and how it impacts Missouri

Recognize the role of the Missouri Health Information Organization (HIO) in facilitating the electronic exchange of health information

Identify ways to impact the development of the statewide health information organization

The Health Information Technology for Economic & Clinical Health Act (HITECH Act)

HITECH Act 2009 ($20B) part of the American Recovery and Reinvestment Act (ARRA)

▪ “The Stimulus Bill - $787B”

Goal: Improve the health of Americans and the performance

of their health care system by encouraging health care providers to leverage health IT tools to achieve quality and efficiency goals

▪ David Blumenthal, “Launching HITECH”, New England Journal of Medicine, December 30, 2009

History repeats itself!

• In 1901, there were 2,000,000 phone users in the US

• Cumulative public and private investment was $500M, or $13B in 2009 dollars (about $6500 per user)

• Networks were operated by:

AT&T: ~1.3m

Independent networks: ~700k

• Number of independent networks: 2,811

HITECH Act: Federal Legislative Intent & Goals

Establish HIT and HIE as the cornerstone and primary tool driving health care reform

Adopt and deploy certified EHRs

Develop infrastructure to exchange health information safely, securely and efficiently

Level the playing field for all states to finance and expand states’ roles in EHR adoption and HIE development

What did HITECH fund?

Incentives for providers to adopt – Medicare & Medicaid

Grants to States – Health Information Exchange (Missouri HIO)

Regional Extension Centers to help providers (Missouri HIT Assistance Center)

Workforce development – HIT expertise Research and Development

What the HITECH Act Means for Missouri

Program National Missouri

Statewide HIE56 awards

(states & SDEs) Department of Social Services – $13.8 M

Regional Extension Center 60 awards University of Missouri – $6.8 M

Workforce 45 awards

Full Employment Council (KC) – $5 M Crowder College (Neosho) – $3.6 M Marysville University (St. Louis) – $4.7 M

Health Center Networks 45 awards St. Louis Integrated Health Network – $1 M Missouri Primary Care Association – $1 M

Medicaid NA MO HealthNet – $1.7 M

Broadband NA To Private Organizations – $275 M

Total Funding to Date - More Than $300 M8

Missouri State Goals

1. Improve the quality of medical decision-making and the coordination of care

2. Provide accountability in safeguarding the privacy and security of medical information

3. Reduce preventable medical errors and avoid duplication of treatment

4. Improve the public health

5. Enhance the affordability and value of health care

6. Empower Missourians to take a more active role in their own health care

10

MO-HITECH

Advisory Board

Governance

Workgroup

Technical Infrastruct

ure Workgroup

Finance Workgrou

p

Business &

Technical Operation

s Workgrou

p

Consumer Engageme

nt Workgrou

p

Legal/ Policy

Workgroup

Manatt & State Employees to Staff & Facilitate Workgroups

Strategic and Operational Plans

Draft Sections of Strategic and Operational Plans

Str

ate

gic

an

d

Op

era

tion

al P

lan

sHIE Planning & Development

Missouri has elected to be an “Opt In” state

Missouri’s Action Plan and Deliverables

12

6 Coordinated Planning Tracks

Establish governance and decision-making process

Develop privacy and security plan

Develop technology plan

Develop financing plan

Develop EHR adoption plan

Develop consumer engagement plan

3 Key Deliverables State HIE Plan

Strategic Operational

State Medicaid Plan Regional Extension

Center EHR adoption plan

Health IT is the enabler, not the result

There will be no health information exchange without involving the physicians……

What is the Value of Health Information (HI) Exchange?

Benefits for Providers

• Quick access to patient records from inpatient and remote locations for more coordinated, efficient care

• Enhanced decision support, clinical alerts, reminders, and medical information

• Performance-improving tools, real-time quality reporting

• Legible, complete documentation that facilitates accurate coding and billing

• Interfaces with labs, registries, other EHRs and HIEs

• Safer, more reliable prescribing 15

Benefits for Patients

• Reduced need to fill out the same forms at each office visit

• Reliable point-of-care information and reminders notifying providers of important health interventions

• Convenience of e-prescriptions electronically sent to the pharmacy

• Patient portals for online interaction with providers

• Electronic referrals allow for easier access to follow-up care with specialists

Providers Report Positive Influence of EHRs on their Practices

17DesRoches, C., et al, “Electronic Health Records in Ambulatory Care - A National Survey of Physicians” New England Journal of Medicine, 2008;359:50-60. (http://www.nejm.org/doi/pdf/10.1056/NEJMsa0802005)

, DesRoches, C., et al, “Electronic Health Records in Ambulatory Care - A National Survey of Physicians” New England Journal of Medicine, 2008;359:50-60 C., et al, “Electronic Health Records in Ambulatory Care - A National Survey of Physicians” New England Journal of Medicine, 2008;359:50-60. (http://www.nejm.org/doi/pdf/10.1056/NEJMsa0802005)

What is the new Missouri Health Information Organization (HIO) doing?

Missouri HIO

A public-private, collaborative process to inform the strategic approach to Missouri’s health information exchange infrastructure, with a particular focus on: Consumer engagement Privacy and security and compliance with state and

federal law Sustainable financing Transparent governance Technical infrastructure to support statewide HIE Business and technical operations to support

widespread HIT adoption and use

19

Provide leadership for a statewide health information exchange strategy that will lead to improvements in health care quality, affordability, and outcomes for all Missourians

Mission

To leave no physician behind!

Missouri HIO Board John Bluford, President and CEO, Truman Medical Center Kim Day, Senior VP, Regional Markets, Sisters of Mercy Health

System Margaret Donnelly, Director, Missouri Dept. of Health & Senior

Services (ex-officio, voting) Karen Edison, M.D., Co-PI, Missouri HIT Assistance Center (ex-

officio, non-voting) Laura Fitzmaurice, M.D., Chief Medical Information Office,

Children’s Mercy Hospital Craig Glover, Chief Information Officer, Grace Hill Health Centers Tracy Godfrey, M.D., Family Physician, Family Health Center of

Joplin* Melissa Johnsen, Private Citizen and Former Business Executive

Sandra H. Johnson, J.D., Interim Dean and Professor Emerita of

Law and Health Care* Ethics, Saint Louis University School of Law Herb Kuhn, President and CEO, Missouri Hospital Association Ronald Levy, Director, Missouri Dept. Social Services (ex-officio,

voting)* Ian McCaslin, M.D., Director, MO HealthNet Division (ex-officio,

non-voting) Steve Roling, President and CEO, Healthcare Foundation of

Greater Kansas City* Andrea Routh, Executive Director, Missouri Health Advocacy

Alliance Steve Walli, President and CEO, United HealthCare David Weiss, Senior VP and CIO, BJC Healthcare* Karl Wilson, President and CEO, Crider Health Center

*Officers of the Board

Governance

17 member public-private Board meets the first Wednesday of every month - incorporated on July 13, 2010

Executive search is underway for the Missouri HIO President & CEO

24

Activities

Two Workgroups meet monthly to tackle critical issues and make recommendations to the Board

Technology & Operations Workgroup ▪ Co-Chairs: Melissa Johnsen, Private Citizen &▪ Mitzi Cardenas, Truman Medical Center

Legal & Policy Workgroup ▪ Co-Chairs: Karl Wilson, Crider Health Center &▪ Jerry Sill, Missouri Hospital Association

HIO Board

Consumer Advisory Council is in its formative stages and is anticipated to begin meeting in late 2010 Chair: Andrea Routh, MO Health Advocacy Alliance

Finance and Sustainability Committee Chair: David Weiss, BJC

RFP for technical services partner was released yesterday

Technical Implementation – Phased Rollout Approach

Phase 1 (by June 2011) Implement foundational technologies that will support

robust, sustainable HIE across the state

Phase 2 (by October 2012) Expands technologies to meet key use cases that

support meaningful use requirements & robust HIE

Future Implementation (2013 – ongoing) Will be based on adding technologies to support use

cases that will further promote sustainability and meet market demands

Use Case – Patient Care Summary Exchange

2010 Workflow 2011 Workflow

28

2. Provider refers patient for a specialist consult

3. Provider may send referral and patient care summary to specialist (via fax, via patient)

4. Specialist receives referral and patient care summary information

Missouri HIO

•Provider Directory

•Secure Messaging

1. Patient visits primary care provider; provider needs to refer patient to a specialist

4. Specialist sees patient

1. Patient visits primary care provider; provider needs to refer patient to a specialist

2. Providers uses EHR to access provider directory and identify specialist of choice

3. Provider sends referral and patient care summary to specialist; specialist receives email alert

4. Specialist sees patient

29

Use Case – Retrieval of Patient Information (2012)

Missouri Statewide Health Information Exchange Network

RHIO

Hospital System

Hospital Clinic Labs

FQHC Lab RHC

1. New patient visits primary care provider; provider wants to learn about patient’s medical history

2. Provider uses EHR to initiate search for patient health information

Master Patient Index & Record Locator Service

3. Provider’s EHR system looks up patient using the Statewide HIO’s master patient index (MPI), validates patient consent

5. Statewide HIE Network documents access to Network in audit log

4. Statewide HIO uses its record locator service (RLS) to locate and retrieve information on identified patient from connected Qualified Organizations RHIO

FQHC Lab RHC

- Patient information

6. Aggregated patient health information is returned to provider and information is incorporated into the provider’s EHR

Hospital

Request for Proposals – Technical Services Partner for Statewide Health Information Exchange

Solicits proposals from interested and qualified parties to partner with the Missouri HIO in designing, implementing, and operating Missouri’s statewide HIE platform

Key Milestones* Date – subject to change

Notice to community 11/5/2010

RFP released to vendors 11/12/2010

Letter of intent submitted (required for consideration)

11/19/2010

Vendor Q&A call 11/23/2010

Written proposals submitted 12/10/2010 (11:59 pm CDT)

Finalists announced Early January 2011

Finalist selection Early February 2011

MHIO: 2010 Action Plan

Complete executive search for MHIO President

Obtain ONC approval for strategic and operational plans releasing implementation funding

Develop and release request for proposal (RFP) for technical services

Finalize statewide privacy and security guidance

Coordinate and align with Medicaid Health IT Plan and the Missouri HIT Assistance Center

Develop finance and sustainability model

Initiate communications plan and outreach to consumers and providers

You can influence this process

Resources

35

Putting the “Meaning” in Meaningful UseDr. Karen Edison, M.D.

Meaningful Use

Objectives

Identify “eligible providers” for receiving meaningful use incentive payments and understand the differences between the Medicare and Medicaid incentive programs

Identify the core and menu sets of the meaningful use criteria for eligible providers and identify the timeline for the incentive programs

Recognize the role of the Missouri Health Information Technology Assistance Center (MO HIT AC) in providing assistance to primary care providers in achieving meaningful use

Eligibility

Eligible Providers

39

Eligibility Overview

Medicare Fee-For-Service (FFS) Eligible Professionals (EPs) Eligible Hospitals and Critical Access Hospitals (CAHs)

Medicare Advantage (MA) MA EPs MA-affiliated eligible hospitals

Medicaid EPs Eligible Hospitals (EH)

EPs must choose either the Medicare or Medicaid Incentive (can change once)

40

Medicare Eligible Providers (FFS)

MEDICARE Eligible Professionals (EPs) Doctor of Medicine or Osteopathy Doctor of Dental Surgery or Dental Medicine Doctor of Podiatric Medicine Doctor of Optometry Chiropractor

MEDICARE Eligible Hospitals (EHs) Acute Care Hospitals Critical Access Hospitals (CAHs)

Medicare Advantage Eligible Provider

MA Eligible Professional – Must Furnish, on average, at least 20 hours/week of patient

care services and be employed by the qualifying MA organization; OR

Be employed by, or be a partner of an entity that through contract with the qualifying MA organization furnishes at least 80% of the entity’s Medicare patient care services to enrollees

Hospitals – paid under the Medicare FFS incentive program

Medicaid Eligible Providers

MEDICAID Eligible Professionals: Physicians Nurse Practitioners (NPs) Certified Nurse-Midwives (CNMs) Dentists Physician Assistants (PAs) working in an FQHC or

RHC led by a PA

MEDICAID Eligible Hospitals Acute Care Hospitals (including CAHs) Children’s Hospitals

43

Medicaid Patient Volume Thresholds

Physicians, Dentists, Certified Nurse Midwives, Physician Assistants, Nurse Practitioners 30% Medicaid Patients

Acute Care Hospitals 10% Medicaid Patients

Medicaid EP practicing in an FQHC or RHC 30% “needy individual” patient volume threshold

Medicaid Patient Volume - Pediatricians

Pediatricians 20% Medicaid Patients

▪ Pediatricians with 20% Medicaid patient volume eligible for reduced incentive, totaling $42,502

▪ Pediatricians with 30% Medicaid patient volume are eligible for the full incentive amount - $63,750

Journey towards ‘Meaningful Use’

What is “Meaningful Use?”

Use of a certified EHR in a meaningful manner;

Use of certified EHR technology for electronic exchange of health information to improve quality of health care; and

Use of certified EHR technology to submit clinical quality measures (CQM) and other such measures selected by the Secretary

46

Staged Approach

STAGE 1: Data Capture Focus is on electronic capture of health information in a

structured format

STAGE 2: Data Aggregation Quality improvement at the point of care and electronic

exchange of information Target: 2013

STAGE 3: Data Use to Impact Outcomes Improvements in quality, safety and efficiency; clinical

decision support; & patient self-management tools Target: 2015

48

Meaningful Use Stages

Data Capture and SharingImproved Outcomes

Stage 1 Stage 2 Stage 3

Overview

* For Stage 2, CMS may also consider applying the criteria more broadly to both the inpatient and outpatient hospital settings. CMS expects to propose Stage 2

criteria by the end of 2011.* CMS expects to propose Stage 3 criteria by the end of 2013.

50

POLICY PRIORITIES FOR MEANINGFUL USE

51

Improve quality, safety, efficiency, and reduce health disparities

Access to comprehensive patient health data for patient’s health care team

Use of evidence-based order sets and CPOE

Clinical decision support at the point of care

Generate lists of patients who need care and use the list to reach out to patients

52

Engage patients and families

Provide patients and their families with timely access to data, knowledge, and tools to make informed decisions and to manage their health

53

Improve Care Coordination

Exchange meaningful clinical information among the members of a patient’s professional health care team

Improve population and public health

Submit immunization, syndromic surveillance and reportable disease data to public health agencies

Ensure privacy and security protection for personal health information

Protect confidential information through operating policies, procedures, and technology

Provide transparency of data sharing to patient

56

Stage 1 Meaningful Use Objectives

Stage 1 objectives (2011 and 2012) Include a core set of objectives that all EPs must

meet, as well as a menu set of objectives and measures (EP must select 5 from Menu Set).

EPs must report on 20 of 25 Meaningful Use Objectives

Reporting period is 90 days for first year; full year in subsequent years

For some objectives and measures, 80% of a provider’s patients must have a record in the certified EHR

Core ObjectivesStage 1 Meaningful Use CORE Objective Stage 1 Measure

Use CPOE At least one medication order entered for 30% of patients

Implement drug to drug and drug allergy interaction checks

Functionality enabled

E-Prescribing 40% of permissible prescriptions

Record demographics 50%

Maintain an up-to-date problem list 80%

Maintain active medication allergy list 80%

Record and chart changes in vital signs 50%

Record smoking status 50%

Implement one clinical decision support rule 1 rule (tracking compliance with rule not required)

Core ObjectivesStage 1 Meaningful Use CORE Objective Stage 1 Measure

Capability to exchange key clinical information (i.e., problem list, medication list, medication allergies, diagnostic test results) among providers of care and patient authorized entities electronically

1 test of the functionality

Provide patients with an electronic copy of their health information upon request

50% of those who request electronic copy, within 3 business days

Provide clinical summaries for patients for each office visit

50% of all office visits, within 3 business days

Protect electronic health information created or maintained by a certified EHR

Conduct or review a security risk analysis and implement updates as necessary

Report clinical quality measures as specified by the Secretary of HHS

2011 – report via attestation; 2012: report electronically

Menu Set of Objectives and Measures

Stage 1 Meaningful Use Menu Objective

Stage 1 Measure

Implement drug-formulary checks Functionality enabled

Incorporate clinical lab test results into Certified EHR Technology as structured data

40% of those with results in either a positive/negative or numerical format

Generate lists of patients by specific conditions to use for quality improvement and other activities

1 list

Send reminders to patients per patient preference for preventive or follow-up care

20% of patients 65+ or 5 years and younger

Provide patients with timely electronic access to their health information

10% of patients, within 4 business days

Use Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient if appropriate

10%

Menu Set of Objectives and Measures

Stage 1 Meaningful Use Menu Objective

Stage 1 Measure

Perform medication reconciliation 50%

Provide summary of care record for each transition of care or referral

50%

Capability to submit electronic data to immunization registries or Immunization Information Systems and actual submission in accordance with applicable law and practice

1 test

Capability to submit electronic syndromic surveillance data to public health agencies and actual submission in accordance with applicable law and practice

1 test

Reporting Requirements for Quality Measures – 6 total measures

Report Three Core Measures Hypertension: Blood Pressure Measurement Tobacco Use Assessment and Tobacco Cessation Adult Weight Screening

Alternate Core Measures Weight Assessment for children and adolescents Influenza Immunization Childhood Immunization

62

Menu set – Quality Measures

EPs choose three measures from a menu of 38 additional Clinical Quality Measures, which include: Hemoglobin A1C > 9 LDL <100 BP <140/90 Asthma Assessment Colorectal CA screening Others…

Incentives

64

INCENTIVE PAYMENTS

Medicare EP Payment Schedule

    Adoption Year 2011 2012 2013 2014 2015 2016 TOTAL PENALTY

2011 $18,000 $12,000 $8,000 $4,000 $2,000 $0 $44,0002012 $18,000 $12,000 $8,000 $4,000 $2,000 $44,0002013 $15,000 $12,000 $8,000 $4,000 $39,0002014 $12,000 $8,000 $4,000 $24,0002015 $0 1%2016 $0 2%

3% 3% 3% 3% 3% 3% 3% 3% 3%

Maximum Payment 

66

Medicare Incentive payments

Medicare EPs practicing in Health Professional Shortage Areas (HPSAs) receive a 10% additional incentive payment

Medicaid EP Payment Schedule

Payment Amount for Year: 2011 2012 2013 2014 2015 2016

2011 $21,2502012 $8,500 $21,2502013 $8,500 $8,500 $21,2502014 $8,500 $8,500 $8,500 $21,2502015 $8,500 $8,500 $8,500 $8,500 $21,2502016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,2502017 $8,500 $8,500 $8,500 $8,500 $8,5002018 $8,500 $8,500 $8,500 $8,5002019 $8,500 $8,500 $8,5002020 $8,500 $8,5002021 $8,500

TOTAL Possible Incentive  $63,750 $63,750 $63,750 $63,750 $63,750 $63,750

First Year Medicaid EP Qualifies to Receive Payment

Medicaid EP Incentives

EPs can receive a total of 6 years of payment (total: $63,750)

the first incentive payment year at $21,250, plus five years at $8,500

EPs can start qualifying for incentives in January 2011. Medicaid incentives run through 2021

EPs may demonstrate MU as late as FY 2016 and still qualify for the maximum total incentive

Medicaid – Adopt/Implement/Upgrade

Medicaid EPs can receive the incentive in their first participation year for adopting, implementing or upgrading an EHR

Adopt: Acquire and Install Implement: Start Using Upgrade: Expand

Must be certified EHR technology

70

Incentive Payments – Key Concepts

Eligibility begins for EPs in any calendar year beginning on or after January 1, 2011

Payment year: The first year an EP receives an incentive payment

For the first payment year, the reporting period is any 90-day period within a payment year in which the physician successfully demonstrates meaningful use of certified EHR technology

In subsequent payment years, the EHR reporting period is the entire payment year – after the first payment year, the physician must successfully demonstrate meaningful use of certified EHR technology for the entire year

Payment - Timing

CMS expects to begin making Medicare incentive payments in May, 2011 EPs will receive a single incentive payment for a

payment year, not periodic installments Estimate is that it will be 15-46 days from successful

MU attestation to making incentive payments

States determine deadlines for Medicaid incentives, but most are expected to be in place by Summer 2011

A bit more detail on Medicare payments… The Medicare incentive payment amounts are a

maximum. An individual provider’s incentive payment is equal to 75% of the total “allowed charges” during the payment year, up to the amounts outlined in the chart

2 milestones required to trigger payment Successfully demonstrating Meaningful Use EP’s allowed charges have reached the qualifying

threshold for maximum incentive payment for the Payment Year ($24,000 for 2011)

EPs who do not meet the maximum threshold during the year will receive their payment the following year

How does a physician get started?

In order to qualify for a meaningful use incentive payment, an EP must have certified EHR technology

Medicare EPs must: Have a National Provider Identifier (NPI) Be enrolled in the CMS Provider Enrollment,

Chain and Ownership System (PECOS)

Registration

All physicians must register via the EHR Incentive Program website: http://cms.gov/EHrIncentivePrograms

EPs must attest that they are meaningful users through a secure mechanism (e.g., claims-based reporting, online portal) for Payment Year 2011

Registration: Medicaid

States will connect to the EHR Incentive Program website to verify provider eligibility and prevent duplicate payments

States will ask for additional information to make timely and accurate payments: Patient Volume Licensure Meaningful Use Certified EHR Technology

Resources

Are you a primary care physician in a small practice? You may be eligible for assistance from the

Missouri HIT Assistance Center The Assistance Center serves primary care

physicians in small (10 or fewer providers) practices with adoption, implementation, and achievement of meaningful use of certified EHR technologies

For more information: www.ehrhelp.missouri.edu

Missouri Health

Information Technology Assistance

Center

Your Answer to All Things EHR

Missouri HIT Assistance Center

Partnership: University of Missouri

▪ Dept of Health Management and Informatics▪ Center for Health Policy ▪ Dept of Family and Community Medicine

Missouri Telehealth Network

Primaris

Missouri Primary Care Association

Kansas City Quality Improvement Consortium

Hospital Industry Data Institute (Critical Access Hospitals)

Missouri HIT Assistance Center - Vision

Assist Missouri's health care providers in using electronic health records to improve the access and quality of health services; to reduce inefficiencies and avoidable costs; and to optimize the health outcomes of Missourians

81

EHR Adoption Challenges

FinancialFinancial

Organization Change

Organization Change

• Expense of system• Uncertainty around ROI• Provider and staff productivity• Uncertainty about financial incentives

• Disruption of workflow and productivity• Privacy and security concerns• Maintaining patient centeredness and satisfaction

• Concerns about technically supporting a system• Lack of necessary computer skills • Finding the right EHR to suit practice needs (“usability”)• Having the right IT staff in place• Possibility of information overload

TechnicalTechnical

82

EHR Implementation Challenges

Require significant support to carry out proper workflow re-design

Result can be piecemeal and less effective use of EHR capabilities and fewer financial and quality benefits Substantial time spent customizing forms and redesigning

workflow More time spent with patients leading to longer workdays

or fewer patients during the initial period Overburdened planning and implementing without

additional technical support

Conflicting messages

Gap in the costs and incentives at an individual physician level

$K

2009 2010 2011 2012 2013 2014 2015

-30

-5

-5 +18

-5 +12

+8+4 +2

-5-10 -5

Physician costMedicare

incentive

Net gap:-$21K

Source: Massachusetts eHealth Collaborative

Positive Financial Returns with Increasing BenefitsNet benefit from using an EMR for a 5 year period was $86,400 per provider

85

Wange, S., et al. (2003) “A Cost-Benefit Analysis of Electronic Medical Records in Primary Care”. The American Journal of Medicine. V.114 , April

“I think of the regional extension centers as a comprehensive support team for small practices. These centers will provide not only technical assistance, but general information when these small practices need help.”

AAFP President-elect Roland Goertz, M.D., M.B.A., testifying before the House Energy and Commerce Committee's Health Subcommittee that solo and small rural practices, in particular, need assistance if they are to adopt health information technology. 86

Missouri HIT Assistance Center

Who will we serve?

PRIORITY: Primary Care Providers, including physicians (Family Practice, Internal Medicine, OB/GYN, Pediatrics) and other health care professionals (NP, PA) with prescribing privileges in the following settings:

Small group practices (10 or fewer providers with prescriptive privileges)

Ambulatory clinics connected with a public or critical access hospital

Community health centers and rural health clinics Other ambulatory settings that predominately serve

uninsured, underinsured, and medically underserved populations

55 Critical Access and Rural Hospitals

Service Area and Demographics

Population - 5,874,327

Primary Care Providers - 5300

Priority PCPs - 2400

Priority PCPs Served - 1167

Total Providers - 17,946

CAH and Rural Hospitals - 55

Who are we and what is our role?

Team of experienced local Health IT professionals with intimate knowledge of the Missouri medical community

Part of a national network of select organizations designated by HHS to assist providers with modernizing their practices with certified EHRs

Direct, rapid and reliable access to a pipeline of key information on health IT and meaningful EHR use

89

Who are we and what is our role?

For providers who do not currently have a certified EHR system We help you choose and implement one in your office

For providers who already have a system We help eligible providers meet the criteria for

incentive payments from Medicare or Medicaid for the meaningful use of certified EHRs

Assistance Center Services

Continuing Education and Training for ALL Providers Vendor Selection and Group Purchasing

Group Purchasing Vendor Selection

EHR Implementation and Project Management Practice Workflow Analysis and Redesign

Practice Readiness Assessment Change Management Workflow Re-Design

Functional Interoperability and HIE Resources for Health Information Exchange Security Risk Analysis

Help Providers Achieve “Meaningful Use”

EHR Vendor Selection

Vetted Vendors : Allscripts

Professional Amazing Charts Cerner e-MDs eClinicalWorks EHS

GE Centricity Greenway McKesson

Practice Partner NextGen Pulse Sage Intergy

The Missouri HIT Assistance Center will work with any vendor (within reason)

We help you with each step toward meaningful use

Practice readiness assessment Workflow analysis for redesign Vendor Selection Implement HR Meaningful Use attestation Meaningful Use incentives

For physicians with EHRs we provide a direct path to meaningful use

Identify barriers Identify solutions Standardize processes Analyze reports Meaningful Use incentives

Our ultimate goal?

To help prevent the demise of the small independent practice, particularly in Missouri’s most underserved communities

Many Thanks for slides I borrowed!

Ron Levy, Director of Missouri Dept. Social Services

Karl Korkendorfer MD, Family & Community Medicine, Univ. of Missouri

Amy Hoyt, Counsel Dept. of Insurance

Benoy Thomas, MHI & MHA Candidate

Mike Fondell, EHR Pathways Kier Walls, Manatt Probably others………..

Additional Resources

Information, tip sheets, & more from CMS: http://www.cms.gov/EHRIncentivePrograms

Info about Missouri’s statewide HIO and MO HealthNet (Medicaid) Incentive Program: http://www.dss.mo.gov/hie

Learn about certification & other ONC programs: http://healthit.hhs.gov

For More Information:

Website: http://ehrhelp.missouri.edu

E-Mail: EHRhelp@missouri.edu

Phone: 1-877-882-9933