Achieving Meaningful Use: Ready? Set? GO! Anna Twomey, SME Healthcare Solutions Architect

Achieving Meaningful Use:Ready? Set? GO!

Anna Twomey, SME

Healthcare Solutions Architect

Meaningful Use Agenda

MU BackgroundMU Phase One Criteria BreakdownMU Technology SupportMU Case Study Clinical (EPs) SettingMU Case Study Hospital (Admissions) SettingQuestions and Wrap Up

Meaningful Use Overview

The stimulus plan incorporates programs with a total spending amount of $787 billion.

Of this amount, approximately $30 billion is allocated to several healthcare programs, including: IT adoption. Health information exchange. Research and development. Standards development. Education and outreach.

Though the federal government has published funding programs and incentive amounts, it has not yet published the process for accessing those funds.

The American Recovery and Reinvestment Act of2009 (ARRA) offers funding for several healthcareprograms with a total of approximately $30 billion.

Meaningful Use - Definition and Timing

The Medicare incentives are offered to nonhospital-based physicians who are using EHRs in a meaningful way. To show that physicians are “meaningful users,” they need to:

Use an eligible EHR system. Use electronic prescription. Participate in the electronic exchange of health information to improve the

quality of care. Measure and report clinical quality measures.

The secretary’s calculation of a provider’s incentive payment amount and determination of whether a provider is a meaningful EHR user is non-reviewable.

ONC, in conjunction with the secretary of HHS, will govern the standards and policies of ARRA.

The Health Information Technology for Economic and Clinical Health(HITECH) Act contains funding through a Medicare payment incentives

and penalties program ($17.2 billion) and the Office of the NationalCoordinator for Health Information Technology (ONC) ($2 billion).

Meaningful Use Key Terms and Conditions

Copyright 2007, Information Builders. Slide 5

By 2011, the definition implies an EHR actively used at the point of care withCPOE (which may drop to fax), alerts/reminders, medicines, vitals,

demographics, ADR, coded problem list, e-prescribing, and quality measures.

Meaningful Use – Medicare Stimulus Payments

Qualified physicians who adopt EHR technology by 2011 will receive amaximum payment of $44,000. Physicians who adopt to EHR technology in orafter 2015 will receive penalties up to 3% of their Medicare reimbursements.

Amount Physicians Receive Each Year(assuming meaningful use is demonstrated by the beginning of that year)

Year Physicians First File 2011 2012 2013 2014 2015 2016 2017 Total

2011 $18,000 $12,000 $8,000 $4,000 $2,000 $0 $0 $44,000

2012 $0 $18,000 $12,000 $8,000 $4,000 $2,000 $0 $44,000

2013 $0 $0 $15,000 $12,000 $8,000 $4,000 $0 $39,000

2014 $0 $0 $0 $12,000 $12,000 $4,000 $0 $24,000

2015 and After(penalty up to amaximum of 3%) $0 $0 $0 $0 -1% -1% -1% -3%

Additionally, the payments will be increased by 10% if the physicians are working inareas certified by the secretary of HHS as “health professional shortage areas.”

Meaningful Use – Medicaid Stimulus PaymentsMedicaid payments to physicians are limited to $65,000 over 5 years. The first-year payment is capped at $25,000, and these costs should occur no

later than 2016. States may make payments to Medicaid providers to encourage adoption

and use of certified EHR technology. Providers must demonstrate a meaningful use of EHR. A minimum of 30% (20% for pediatricians) of patients should be covered by

Medicaid.

Payments are made to physicians based on average costs determined by ONC.

The payment schedule is as follows:

First-year costs should occur no later than 2016, and no payments will be made after 2021.

No duplicative Medicare and Medicaid payments will be made.

Year Physicians First File First Year

Second Year

Third Year

Fourth Year

Fifth Year Total

2011 til 2016 $25,000 $10,000 $10,000 $10,000 $10,000 $65,000

So.. Phase One Breakdown…

Phase One Includes: CPOE used for orders for 80% of EPs and 10% for Hospitals 75% of prescriptions are transmitted electronically. 80% of patients seen or admitted have at least one structured

medication entry (or “None”). 80% of hospitals and EPs maintain an up-to-date problem list of

current and active diagnoses based on ICD9 or SNOMED CT ® Maintain active medication list for all patients (80% for EPs and 80%

for Hospital admissions) 80% of hospitals and EPs maintain active medication allergy lists for

patient clientele and admissions. Etc.

Phase OneProviders have through 2012 to meet Stage 1 criteria, after which the criteria

become more stringent.

Technology Breakdown


Reporting

Query & Analysis

Dashboards

Information Delivery

Performance Management

Enterprise Search

Visualization & Mapping

Mobile Applications App/Dev, Portals

& Mash-ups Predictive Analytics

MS Office & e-Publishing

Front office

Extended BI

Core BI

Extensions to the WebFOCUS platform allow you to build more application types at a lower cost

Business to Business

Data Warehouse & ETL

Master Data Management

Data Quality Business Activity MonitoringBack office

Achieving Meaningful Use of Health Data means…

Data Capture

Data Sharing Across Platforms

Advanced Clinical Process

Achieving Cost Effective Treatments

Improving Outcomes

2009

2011

2013

2015

P4P

Chronic Disease Mgt.

Physician Alignment

Patient Flow

Reduce Readmits

Whole Patient

EMR/EHR/PHR/HIE

Cost Cutting & Consolidation

Comparative Effectiveness

Clinical Decision Support

Meaningful Use Data Exchange…

1) Patient Centric – One patient, One record2) Usable – Usability must be second nature

technology (3 click max)

3) Interoperable – Agnostic to any data format or message exchange methodology

4) No Borders – GRID technology that spans national and international boundaries (use what we have… internet technologies)

5) Affordable - Affordability is the key to adoption (hosted SaaS/ASP model)

Typical Healthcare Environment

AdministrativeApplications

Revenue Cycle

ApplicationsClinical

ApplicationsOR/MRI/ERApplications

HR Schedule

Applications

PhysicianPractice

Applications

Other Applications“External”

• Accounting• AP• Fixed assets• Purchasing• Inventory• HR• Benefits• Payroll• EDI

• Pre-Auth• MPI• Registration• Patient Charge• Charge Master• Billing• Collections• Claims

Scrubber• Grouper• Contract

Negotiations

• EMR• Order Entry• ED• Pharmacy• Laboratory• Radiology• Pathology• PACS• Cath Lab

• PhysicianPreferenceCards

• Requisition• Inventory• Implant Log• Scheduling

• Time and Attendance

• Absence Management

• Licensing• Credentials• Productivity• Accountable

• Scheduling• Charge

Capture• Billing• Collection• Practice Plan• Accounting• Comp Plans• Contract

Negotiations

• JACHO• CMS (MMIS) • Infectious

Disease Trak• Chronic

Disease Trak• Fraud

Detection• DHS –

Security HIPAABioHazard

Integration to Different Applications and Systems

Data capture across all systems as associated by patient encounter, (CCR/CCD)

• Lawson• Oracle

(PSFT)• Eclipsys TSI• GEAC• SAP• McKesson• D&B

• McKesson• Siemens• Kauffman Hall• Meditech• Avega

• McKesson• Cerner• Epic• GE (IDX)• Siemens• Meditech• Eclipsys

• McKesson• Cerner• Orbit• OR SOS• OR MIS

• McKesson (PerSe)

• Kronos• API• MEDITECH• Oracle HR


• Cerner• Epic• Proprietary

• Gov Owned• City• State• County

Custom applications/solutions for every reporting need within your enterprise

Typical Healthcare Environment - Foundation

AdministrativeApplications

Revenue Cycle

ApplicationsClinical

ApplicationsOR/MRI/ERApplications

HR Schedule

Applications

PhysicianPractice

Applications

Other Applications“External”

• Accounting• AP• Fixed assets• Purchasing• Inventory• HR• Benefits• Payroll• EDI

• Pre-Auth• MPI• Registration• Patient Charge• Charge Master• Billing• Collections• Claims Scrubber• Grouper• Contract

Negotiations

• EMR• Order Entry• ED• Pharmacy• Laboratory• Radiology• Pathology• PACS• Cath Lab

• PhysicianPreferenceCards

• Requisition• Inventory• Implant Log• Scheduling

• Time and Attendance

• Absence Management

• Licensing• Credentials• Productivity• Accountable

• Scheduling• Charge

Capture• Billing• Collection• Practice Plan• Accounting• Comp Plans• Contract

Negotiations

• JACHO• CMS (MMIS) • Infectious

Disease Trak• Chronic

Disease Trak• Fraud

Detection• DHS –

Security HIPAABioHazard

Integration to Different Applications and Systems• Lawson• Oracle (PSFT)• Eclipsys TSI• GEAC• SAP• McKesson• D&B

• McKesson• Siemens• Kauffman Hall• Meditech• Avega

• McKesson• Cerner• Epic• GE (IDX)• Siemens• Meditech• Eclipsys

• McKesson• Cerner• Orbit• OR SOS• OR MIS


• Kronos• API• MEDITECH• Oracle HR

• Cerner• Epic• McKesson

(PerSe)

• Gov Owned• City• State• County

350+

Information Management

Integration Assembly

Adapters

NHINHL7

SNOMEDLOINC

HIPAA


iHIE Integration Power



Adapters

Applications

Transactions

Databases

Messages

DocumentsServices

The ability to integrate, transform and migrate those assets for all business requirements.

More than 350 packaged adapters, providing connectivity to all enterprise information assets.

Providing support for all 7 styles of data integration required for business intelligence.


iHIE Adapters

Industry leading provider All enterprise assets

85 databases 150 real-time sources

Applications Messages Transactions Documents Services

Replaces manual programming Completely reusable



Adapters

Applications

Transactions

Databases

Messages

DocumentsServices


iHIE SOA Middleware

iWay Software offers the widest reaching integration solutions at the lowest cost !

AdaptersService Composition Registry

Designer

Service Consumption

ProcessManager

Trading Partner

EnterpriseIndex

DataMigrator

SecurityOption

MFT

Governance

Explorer Transformer

Service Enablement

Universal Adapter Suite

Streamlines business processes Infrastructure augmentation Infrastructure standardization Multi-purpose integration

SOA, EAI, B2B, etc. Specific industry solutions

Financial services, government, supply chain, healthcare, etc.

Minimizes technology shifts, new business initiatives and mergers

SOA Governance

Adapters


Orchestration of Services

__________

Listeners / Responses

Hospitals

Clinics

Labs

Ambulatory

Physician

Orders

ReferralNurse

Home Health

PH Investigator

Nurse Managers

ME \ Death \ Immunization

Therapy

Orc

hes

trat

ion

of

Ser

vice

s

ETL

&

DQS

DataCapture

ReportCard

Analytics

QualityTracking

DecisionSupport


Impacting the Practitioners

Questions?