presentation given regarding meaningful use at missouri ACP, september 2011.

1. Meaningful use at
Missouri Bedsides
MO ACP Scientific Session
September, 2011
Carl Dirks MD, CMIO
Saint Luke’s Health System, KC
Associate Professor of Medicine
UMKC

2. Where it started?

3. A National Goal for Universal
Electronic Medical Records by
2015
• 2004-2005
• established health IT
“czar” (David Brailer)
• focused on standards
development, interop

4. Back to the Future!

5. did we land it yet?

6. M-HITECH ACT
• Medicare and Medicaid Health Information
Technology for Economic and Clinical
Health Act - Page 665 of 2009 ARRA
• 19 Billion dollars for medicare/medicaid
EHR HIT incentive funding
• 2 Billion dollars in grants through the
Office of the National Coordinator (ONC)
• comparative effectiveness research 1.1
billion

7. complimentary HITECH
Programs
• Beacon Community Program
• State HIE Coop Agreement program
• Healthcare IT extension program
• Strategic Health IT Advanced Research Projects (SHARP)
program
• Community College Consortia to educate HIT pros.
• Curriculum Deveopment Centers Program
• Program of Assistnace for University-Based Training
• Competency Examination for individuals Completing Non-
Degree Training Program

8. conceptual approach
Conceptual Approach to
Meaningful Use
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9. Stage 1 priorities
• Improve quality, safety, efficiency, and reduce
health disparities
• Engage patients and families in their health
care
• Improve care coordination
• Improve population and public health
• Ensure adequate privacy and security
protections for personal health information
Adapted from National Priorities Partnership. National Priorities and Goals: Aligning Our Efforts to Transform America’s Healthcare. Washington, DC: National Quality Forum; 2008.

10. I. Meaningful use of
certified EHR
technology
II. Information Exchange
III. Reporting on measures
using EHR
Meaningful EHR User

11. http://ehrhelp.missouri.edu/docs/IncentiveTimeline.pdf

12. other points
• based on 75% of Medicare part B claims up
to maximums, 3K bonus to qualify by 2012
• must qualify by 2012 to receive max
incentives
• Penalties begin in 2015 1% medicare

13. Eligibility Requirements
for Professionals
• Hospital-based eligible professionals are not
eligible for incentive payments. An eligible
professional is considered hospital-based if 90% or
more of his or her services are performed in a
hospital inpatient (Place Of Service code 21) or
emergency room (Place Of Service code 23)
setting.
https://www.cms.gov/EHRIncentivePrograms/15_Eligibility.asp#BOOKMARK1

14. Fall 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Stage 1 Max
Paymnts
Stage 2 Stage 3
Medicare $18,000 $12,000 $8,000 $4,000 $2,000 $44,000
Incentive
Payments $18,000 $12,000 $8,000 $4,000 $2,000 $44,000
$15,000 $12,000 $8,000 $4,000 $39,000
$12,000 $8,000 $4,000 $24,000
Medicaid $21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
Incentive
Payments $21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
Medicare/Medicaid?
• Adopt, Implement, Upgrade- WAY EASY
• providers can change programs (medicare/
medicaid) once prior to 2015
• skip a year, skip a check
http://www.healthit.gov/providers-professionals/ehr-incentive-payment-timeline

15. Medicaid eligibility
• Physicians - Nurse practitioners - Certified nurse-midwife -
Dentist
• Physician assistant who furnishes services in a Federally Qualified
Health Center or Rural Health Clinic that is led by a physician
assistant.
• To qualify for an incentive payment under the Medicaid EHR
Incentive Program, an eligible professional must meet one of the
following criteria:
• Have a minimum 30% Medicaid patient volume*
• Have a minimum 20% Medicaid patient volume, and is a
pediatrician*
• Practice predominantly in a FQHC or Rural Health Center
and have a minimum 30% patient volume attributable to
needy individuals
• * Children's Health Insurance Program (CHIP) patients do not
count toward the Medicaid patient volume criteria.

16. I. Meaningful use of
certified EHR
technology
II. Information
Exchange
III.Reporting on
measures using
EHR
Meaningful EHR User
Stage I

17. certified platform
• temporary certification program - stage
specific
• CCHIT
• Drummond group
• InfoGaard
• permanent cert program to follow, ? 2012
• self certification - homegrown systems

18. ONC-Authorized Testing and
Certification Body (ONC-ATCB)
• inpatient/ambulatory
• complete certifications- provides all the
technologies to completely comply with
MU rules
• Modular certs- break down to subsets, have
to have complete solution of certified
“modules”
http://onc-chpl.force.com/ehrcert/CHPLHome

19. certification
complete - modular

20. online shopping?

22. years, but the majority (53 percent, or 1,436) said they ROBERT L. EDSALL AND KENNETH G. ADLER, MD, MMM with this E
had up to three years of experience with the system they 11. I am
The 2011 EHR User
reported on. Another 43 percent (1,169) reported more and qualif
Satisfaction Survey
RESPONSES FROM 2,719 FAMILY PHYSICIANS
About the Authors
Robert Edsall is editor-in-chief of Family Practice Management. Dr. Adler is a prac
If you’re shopping for an EHR system,
you might appreciate this advice from
tion technology for Arizona Community Physicians in Tucson, Ariz., a Certified Pro several hundred colleagues.
ment Systems, a juror for the Certification Commission for accepted responses Information Tec
ability of the survey instrument, we Health
only from AAFP members as a way of avoiding frivolous
care IT. He holds a Master of Medical Management degree and a Certificate in H responses, multiple responses per individual and other
such potential sources of bias.
The results are not intended to be a statistically accu-
the Family Practice Management Board of Editors. Author disclosure: no relevant rate picture of EHR use among AAFP members; rather,
our intent was simply to collect opinions from as many
users of as many EHR systems as possible and to convey
the range of responses as clearly as we could in an easily
digestible form.
Article Web Address: http://www.aafp.org/fpm/2011/0700/p23.html
Survey results
We were able to collect a total of 3,427 responses, far
W
more than in previous surveys. Of those, 603 were
excluded because the respondents said they did not use
EHR systems; 99 were excluded because they either did
ith government incentive checks for not name the system they use, named a practice man-
meaningful use of electronic health agement system rather than an EHR system, named a
record (EHR) technology already in “home-grown” proprietary system or named something
24 | FAMILY PRACTICE MANAGEMENT | www.aafp.org/fpm | July/August 2011
the hands of some physicians and
with the concomitant acceleration of computerization, it
that we could not verify to be an EHR system; finally,
six were excluded because the respondents indicated that
seems high time for another survey of user satisfaction they had a significant financial interest in or affiliation
with EHR systems. As with our three earlier surveys,1-3 with a manufacturer or vendor of an EHR program (e.g.,
Our intent was simply to collect opinions from instrument in an issue of Family
we published the survey an ownership interest, a sizable stock purchase or involve-
as many users as possible and to convey the and made an online version avail-
Practice Management ment in development of the software). That left 2,719
range of responses as clearly asthrough the FPM web site.4 Again this year, in an
able we could. responses for analysis.
effort to maximize responses, we kept the survey short Respondents in the analysis group reported a total of

23. MU stage 1(2011-2012)
• 90 day qualification period in first year
• multiple practices? paper/EMR?
• 1. core set (15/15 items required)-
exceptions can be established ie
chiropracter doesn’t prescribe, etc (limited
per items with allowed exceptions)
• 1-A. within core set- 3 core/alt CQM, 3
additional CQM
• II. menu set - 5/10 menu items, 1 of which
must be a public health item (2 choices)

24. Core set 1-15
• 1. Use computerized provider order entry (CPOE)
for medication orders directly entered by any
licensed healthcare professional who can enter
orders into the medical record per state, local and
professional guidelines.
• >30% of all patients seen during the reporting
period who have a medication on their
medication list
• exclusions: provider who writes less than 100
scripts in reporting period
• has to be person capable of responding to
decision support, doesn’t have to transmit ERX

25. • 2. Drug-Drug, Drug-allergy checks (yes/no)
• 3. Active problem list in structured data
• Free text doesn’t count, “no active problems”
per EHR structure entry does
• 4. 40% of prescriptions II-V sent electronically
(faxes via EMR count) - controlled substances?
• exception <100 scripts sent in 90 days

26. • 5. Active medication list -80%, “no active
meds” counts
• 6. Allergies - 80%, “no known allergies”
structured counts
• 7. Record demographics - 50% of unique
patients, structured data
• Preferred Language, Gender, Race,
Ethnicity, DOB (standard nomenclature)

27. • 8. Record and chart changes in vital signs
>50%
• Height, Weight, Blood Pressure, BMI,
growth charts from age 2-20
• allows attestation to exclusion if you
feel out of your scope of practice
• 9. Smoking status of ages 13 and older
>50%
• 10. submit clinical quality measures to
CMS/State (medicaid)

28. • 11. implement one clinical decision support
tool, and track compliance
• yes/no
• left open ended (purposefully)
• in addition to drug-drug, drug-allergy
checks

29. • 12. share health information with
patient electronically (>50%)
• Problem List
• Diagnostic Test Results
• Medication List
• Medication Allergy List
• 3 business days from request - calculated based on
receipt of patient request
• Form and format should be human readable and
comply with the HIPAA Privacy Rule, as specified
at 45 CFR 164.524(c). The media could be any
electronic form such as patient portal, PHR, CD,
USB fob, etc. EPs are expected to make reasonable
accommodations for patient preference as outlined
in 45 CFR 164.522(b). (ENCRYPTION!)
https://questions.cms.hhs.gov/app/answers/detail/a_id/10663

30. • 13. provide clinical summaries for patients after each visit *
• >50% of patients, within 3 business days
• Clinical Summary – An after-visit summary that provides a patient with relevant and
actionable information and instructions containing the patient name, provider’s office
contact information, date and location of visit, an updated medication list, updated vitals,
reason(s) for visit, procedures and other instructions based on clinical discussions that
took place during the office visit, any updates to a problem list, immunizations or
medications administered during visit, summary of topics covered/considered during visit,
time and location of next appointment/testing if scheduled, or a recommended
appointment time if not scheduled, list of other appointments and tests that the patient
needs to schedule with contact information, recommended patient decision aids,
laboratory and other diagnostic test orders, test/laboratory results (if received before 24
hours after visit), and symptoms.

31. • The provider is permitted, but not required, to limit the measure of this objective to those
patients whose records are maintained using certified EHR technology.
• The provision of the clinical summary is limited to the information contained within certified
EHR technology.
• The clinical summary can be provided through a PHR, patient portal on the web site, secure e-
mail, electronic media such as CD or USB fob, or printed copy. If the EP chooses an electronic
media, they would be required to provide the patient a paper copy upon request.
• If an EP believes that substantial harm may arise from the disclosure of particular information,
an EP may choose to withhold that particular information from the clinical summary.
• Providers should not charge patients a fee to provide this information.
• When a patient visit lasts several days and the patient is seen by multiple EPs, a single clinical
summary at the end of the visit can be used to meet the meaningful use objective for “provide
clinical summaries for patients after each office visit.
• The EP must include all of the items listed under “Clinical Summary” in the above “Definition
of Terms” section that can be populated into the clinical summary by certified EHR
technology. If the EP's certified EHR technology cannot populate all of these fields, then at a
minimum the EP must provide in a clinical summary the data elements for which all EHR
technology is certified for the purposes of this program (according to §170.304(h)):
o ProblemList
o DiagnosticTestResults o MedicationList
o MedicationAllergyList

32. • 14. Capability to exchange key clinical
information
• Capability to exchange key clinical information (for
example, problem list, medication list, medication allergies,
and diagnostic test results), among providers of care and
patient authorized entities electronically.
• Must be separate legal entity
• Patient Authorized Entities – Any individual or organization
to which the patient has granted access to their clinical
information. Examples would include an insurance company
that covers the patient, an entity facilitating health
information exchange among providers, or a personal
health record vendor identified by the patient. A patient
would have to affirmatively grant access to these entities.
• TEST ONLY. FAILING COUNTS

33. • 15. Protect Health Information
• HIPAA security audit
• can be done prior to reporting period
• will require being re-evaluated per
reporting period
• yes/no

34. Menu sets
• 1. implement drug-formulary checks
• 2. Incorporate clinical lab-test results into EHR as structured
data. (>40% of tests with numeric value or pos/neg state)
• exclusion: no tests ordered during period with pos/neg or
numeric value
• 3. Generate patient lists by specific conditions to use for
quality improvement, reduction of disparities, research, or
outreach.
• 4. Send patient reminders per patient preference for
preventive/follow-up care.
• More than 20% of all patients 65 years or older or 5 years
old or younger were sent an appropriate reminder during
the EHR reporting period.

35. • 5. Provide patients with timely electronic access to
their health information (including
lab results, problem list, medication lists, and
allergies) within 4 business days of the information
being available to the EP.
• At least 10 percent of all unique patients seen by the EP
are provided timely (available to the patient within four
business days of being updated in the certified EHR
technology) electronic access to their health
information- subject to the EP’s discretion to withhold
certain information according to HIPAA.

36. • 6. Use certifiededucation resources and provide
patient-specific
EHR technology to identify
those resources to the patient if appropriate.
• >10% unique patients received patient
information based on “EHR logic” to identify and
suggest information based on info in EHR

37. • 7. The EP who receives a patient from
another setting of care or provider of care
or believes an encounter is relevant should
perform medication reconciliation.
• >50% of transitions of care
• comparing the medical record to an external list
of medications obtained from a patient, hospital,
or other provider.
• “relevant” (provider discretion) - vs referral,
patient referral, discharge, etc.

38. • 8. The EP who transitions their patient to
another setting of care or provider of care
or refers their patient to another provider
of care should provide summary care
record for each transition of care or
referral.
• >50% of referrals have summary record

39. Menu set
(must include one of these public
health items)
• 9. capability to submit data to
immunization registries TEST ONLY (one
of 2 public health items)
• 10. Capability to submit electronic
syndromic surveillance data to public health
agencies and actual submission according to
applicable law and practice.
• *Biosense program

40. immunizations details
• Contact Lori Sprock, MSN, APRN, Missouri Public Health Information Exchange
(MoPHIE) Project, Missouri Department of Health and Senior Services at
lori.sprock@oa.mo.gov (573) 526-3021. This request must come from the provider,
not the vendor.
• The provider should state they are preparing to apply for Meaningful Use and want
to test an exchange with the Immunization Information System.
• Lori will provide information on conducting the test.
• The provider will need to contact their vendor to enable their system to transmit
HL7 messages. The vendor should be able to provide instructions on how to do this.
• The test should then be conducted with the vendor and DHSS assistance.
• It is highly unlikely that the test will be successful. However, DHSS will send a letter
to the provider stating they completed the test. This should satisfy the Meaningful
Use requirements for 2011.
• DHSS will continue working with providers and their vendors to eventually get
everyone participating in successful IIS exchange.
http://ehrhelp.missouri.edu/?q=node/73

41. Clinical Quality
measures
• Must include 3 core items, if those 3 don’t
qualify then must use core alternates.
• also select 3 additional clinical quality
measures.

42. Core quality measures
• NQF 0421 | PQRI 128 Adult Weight
Screening and Follow-Up
• NQF 0013 Hypertension: Blood Pressure
Measurement
• NQF 0028 Preventive Care and Screening
Measure Pair: a. Tobacco Use Assessment,
b. Tobacco Cessation Intervention

43. Alternate Core -
if core not germaine
• NQF 0041| PQRI 110 Preventive Care and
Screening: Influenza Immunization for Patients ≥ 50
Years Old
• NQF 0024 Title: Weight Assessment and Counseling
for Children and Adolescents
• NQF 0038 Title: Childhood Immunization Status

44. still need 3 quality
measures!
• some onerous(ish) - NQF0001/PQRI 64
• Percentage of patients aged 5-40 with a diagnosis
of asthma who were seen for at least 2 office
visits, who were evaluated during at least one
office visit for the frequency (number) of daytime
and nocturnal asthma symptoms
• some straightforward
• (% of patients with A1C >9)

46. Attestation
• 2011 is completion by individual
attestation
• no “automated upload” of performance/
compliance data

47. data thus far
• >77K registrations for
medicare/Medicaid
• CMS presentation to
• 3500 EP’s + EH’s paid via
HIP policy committee
medicaid incentives
• data as of July 2011
• approx 1000 EP’s have
been paid via medicare
incentives
http://ahier.blogspot.com/2011/08/ehr.html

48. Robert Tagalicod
Director, Office E-Health Standards & Services (OESS)
HIT Policy Committee
August 3, 2011
!""#$%%&&&'()*'+,-%./012(32"4-356,+67)*%

49. • On average, all thresholds were greatly exceeded,
but every threshold had some providers on the
borderline
 Most popular menu objectives: Drug formulary,
incorporating lab test results & patient list
 Least popular menu objectives: Medication reconciliation
& summary of care record
• Little difference between Eligible Professionals (EP)
& Hospitals
• Little difference among specialties in performance,
but differences in exclusions
!
"##$%&&'''()*+(,-.&/0123)43#5.467-,78*+&

50. • 2383 EPs had attested
 2246 Successfully
 137 Unsuccessfully
• 100 Hospital had attested
 All successfully
NOTE: This data-only analysis shows our earliest adopters
who have attested, but does not inform us on
barriers to attestation.
!
"##$%&&'''()*+(,-.&/0123)43#5.467-,78*+&

51. Eligible providers
!"#$%&'($ )$*+,*-./%$ 01%234',/ 5$+$**.2
"#$%&'()*+%,-#$.(/#01 2345 6651 789
:;<= >?5 6!5 789
=@#$.&%)($ A&#0$&(,()* ??5 635 789
B)$%&A%&C.# @C,+&#0D@.0 3E5 789 E?5
F&D*GH%&ID@C&J+$K#$L0 789 789 EM5
;C.(#).+@(0.0 789 789 E65
N#)'+&#I()'#&0+.%+AC.(#).0 M?5 E5 M?5
* Refers to problem, med, allergy lists, vital signs, demographics & smoking
status. Exclusion is for vital signs.

52. Eligible providers
!"#$%&'($ )$*+,*-./%$ 01%234',/ 5$+$**.2
"!#$%&'$(')*+,-.'/0($12+-3$0 456 786 9:;
<((3=* >3?3-'?@22+13*? AB6 C6 576
D+-3*0-'"E@=+-3$0'F*?$@1=*? CA6 9:; !C6
G32*,&'*,*=-1$03= +==*?? 456 86 !46
!"#$%&'($ )$*+,*-./%$ 01%234',/ 5$+$**.2
"#$%&'(%)*+,#&)*&%-%'(%)* ./0 10 230
4566',7+)8+&',#+'(+(,'*9%(%)*9 ..0 10 .30

53. Eligible providers
!"#$%&'($ )$*+,*-./%$0 12%345',/ 6$+$**.3
"##$%&'()&*%+ ,-. /0. 10.
23%45*#&672$589&::(%69 ;. 1;. <=.
* Performance is percentage of attesting providers who conducted test

54. Eligible Hospitals
!"#$%&'($ )$*+,*-./%$ 01%234',/ 5$+$**.2
"#$%&'()*+%,-#$.(/#01 2345 678 678
9:;< !!5 678 678
8'/=)$#+'(&#$.(/#0 3>5 45 ?>5
@)$%&A%&=.# B=,+&#0CB.0 3D5 678 ?E5
F&C*GH%&ICB=&J+$K#$L0 678 678 >>5
:=.(#).+B(0.0 678 678 M35
* Refers to problem, med, allergy lists, vital signs, demographics & smoking
status. Exclusion is for vital signs.

55. Eligible hospitals
!"#$%&'($ )$*+,*-./%$ 01%234',/ 5$+$**.2
"#! $%&'#%(#)*+,-)#./(%01+-.%/ !23 443 567
" ! $%&'#%(#8.9$)+0:*#
443 =23 567
;/9-0<$-.%/9
>+-.*/-#*8<$+-.%/#0*9%<0$*9 =?3 567 @@3
!"#$%&'($ )$*+,*-./%$ 0$+$**.1
#$%&'()&*+ ,$'*+'&-&()&*+ ."/ 01/
2344(,56*76'(,$6()6),(+8&)&*+8 .!/ .9/

56. Eligible hospitals
!"#$%&'($ )$*+,*-./%$0 12%345',/ 6$+$**.3
!""#$%&'(%)$* +,- ,- ./-
012)3('451 6'4701*#5(* 89- 8+- ::-
;<$=3)"%>7;#3?1%55'$>1 @A- .- BB-
* Performance is percentage of attesting providers who conducted test

57. Missouri HealthNet
Health Information Technology Survey
Survey Findings
November 3, 2010
Adams-Gabbert Proprietary

58. EHR Adoption
Survey Question # 12. Does your organization currently use an EHR system?
Yes 604
No
68%
No 1285 Yes
32%
Total 1889
Note on Physician Counts
Yes 5197
No 2932
Note: Question # 12 responses are based on total completed surveys
Adams-Gabbert Proprietary 11

59. Findings and Observations
What did we learn?
! Technology Readiness
" Technology infrastructure for internet access is available
" EDI and web based systems are in use statewide
" Email has become the preferred method of contact
" Technology support and direction is needed
" Very limited use of technology for patient access
! EHR Adoption
" EHR solutions today involve a wide variety of software products and tools
" More detailed information and education is needed
! What does EHR deliver for my patients and my practice?
" Technology support with EHR selection and implementation is needed
" Costs, resource requirements to transition from paper are key concerns
Adams-Gabbert Proprietary 23

60. Findings and Observations
What did we learn? (continued)
! Challenges Reaching Providers (especially physicians)
" No e-mail addresses
" 409 letters in returned mail for wrong address
" Only 50% of records had phone numbers (of those 5% wrong numbers)
" No hierarchical structure to the data. So, there was no reliable way to
associate groups, clinics, or physicians to hospitals.
" Inconsistent use of provider types
! Other
" More effective communication with providers is needed
" Current provider data needs to be updated
" Survey findings reinforce the need for a statewide provider repository
" Future provider surveys need to be more focused

61. EHR Planning
Survey Question # 28. What is the degree of Electronic Health Record
implementation readiness in your organization?
0% 10% 20% 30% 40% 50%
Implementation is not planned in the next 2 years 552
Implementation is planned in the next 3 months 34
Implementation is planned in the next 3 - 6
56
months
Text
Implementation is planned in the next 6 - 9
months 35
Implementation is planned in the next 9-12
months 58
Implementation is planned in the next 1 - 2 years 323
Other 227
0 100 200 300 400 500 600
Number of Responses
Note: Question # 28 responses are based on total respondents who do not have EHR systems
Adams-Gabbert Proprietary 17

62. Fall 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021
Stage 1 Max
Paymnts
Stage 2 Stage 3
Medicare $18,000 $12,000 $8,000 $4,000 $2,000 $44,000
Incentive
Payments $18,000 $12,000 $8,000 $4,000 $2,000 $44,000
$15,000 $12,000 $8,000 $4,000 $39,000
$12,000 $8,000 $4,000 $24,000
Medicaid $21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
Incentive
Payments $21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
$21,250 $8,500 $8,500 $8,500 $8,500 $8,500 $63,750
Ready for year 2, right?
Full year compliance required
http://www.healthit.gov/providers-professionals/ehr-incentive-payment-timeline

63. proposed stage 2 reqs.
• most menu items transition to core
• some threshold changes, other remain the
same
• 30% of visits have at least one electronic EP
note
• 30% of EH patient days have at least one
electronic note by a phys., NP, or PA
• 30% of EH med orders - EMAR (barcode
meds)
http://www.emrandehr.com/2011/01/21/great-chart-comparing-meaningful-use-
stage-1-with-stage-2-and-3/

64. Proposed stage 2
• 80% of patients offered the ability to view
and download via a web based portal,
within 36 hours of discharge, relevant info
about EH encounters.
• EP - online secure messaging in use
• Patient preferences for communication
medium recorded for 20% of patients
• list of care team members (including PCP)
available for 10% of patients in EHR
• record a longitudinal care plan for 20% of
“high priority” conditions

65. • funded by HITECH, must be sustainable
after underwriting/rollout period
• contracting negotiations ongoing with
Cerner (primary HIE vendor)
• interoperation will be an important
component for later stages of MU
http://www.missourihealthconnect.org/

66. Questions?
cdirks@saint-lukes.org
twitter @cddirks

67. HIT resources
• Office of the National coordinator
• http://healthit.hhs.gov
• Missouri HIT assistance center (REC)
• http://assistancecenter.missouri.edu/
• Missouri Health Connection
• http://www.missourihealthconnect.org/
• Attestation calendar
• http://www.cms.gov/apps/ehr/

68. What Happens after You Sign with
Missouri Health Information
Technology Assistance Center?
Introduction:
Lorelei Schieferdecker
Centers for Medicare & Medicaid Services
Presentation:
Nancie McAnaugh, MSW
Center for Health Policy
MO HIT Assistance Center
Rachel Mutrux
Missouri Telehealth Network

69. For More Information:
 Website: http://ehrhelp.missouri.edu
 E-Mail:
 EHRhelp@missouri.edu
 Phone:
 1-877-882-9933