1. Zoom to Meaningful Use
How to receive your incentive dollars
quickly
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2. What is Meaningful Use?
• Government program to promote adoption of
electronic health record systems (EHR)
• Part of the ARRA (stimulus) legislation
• $32 billion was set aside for this purpose
• Physicians receive incentive payments for
“meaningful use” of an EHR
• Administered through the Medicare and
Medi-Cal programs
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3. What do I need to start?
• A certified EHR
– ZoomMD is ONC-ATCB certified by CCHIT
• You must be a Medicare or Medi-Cal provider.
• Must have an NPI number through NPPES
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4. Specific Medicare / Medi-Cal requirements
• Can participate in either the Medicare or
Medi-Cal program (one-time switch allowed)
• For the Medicare program, you must have
$24000 in annual charges to Medicare
• For the Medi-Cal program, 30% of your
patient volume must be Medi-cal patients
(20% if you are a pediatrician)
• Your inpatient volume cannot exceed 90% of
your total volume
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5. The ZoomMD method
Themes to live by
• It is a practice effort, not a doctor effort
– Everyone must fulfill their role
– With everyone doing their part, MU is achievable
• MU Champion is designated by the practice
• Physician has ultimate responsibility
• Choose options wisely and let the system do the
heavy lifting whenever possible.
• Track, track, track
• Keep your eyes on the goal
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6. What do I have to do to earn the incentive
payments?
• Meet meaningful use requirements
– 15 core measures
– 5 menu measures
– 3 core or alternate core clinical quality measures
– 3 additional clinical quality measures
• These requirements will increase in stages
over time.
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7. Moving forward: Staging of “Meaningful use”
“These goals can be achieved only through the
effective use of information to support better
decision-making and more effective care
processes that improve health outcomes and
reduce cost growth.”
2011 Stage 1
Data capture
and sharing
2013 Stage 2
Advanced
clinical processes
2015 Stage 3
Improved
outcomes
“Phased-in series of improved clinical data capture
supporting more rigorous and robust quality
measurement and improvement.”
Connecting for Health, Markle Foundation “Achieving the Health IT Objectives of the American Recovery and Reinvestment Act” April 2009
Focus of:
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8. Roles – Color legend
Color Role
Physician/NP/PA
MA or Nurse
Front office staff/
administration
ZoomMD setup
Each position will have a specific role.
The above indicates primary responsibility for data entry. Others will
still have a responsibility to review data and take any appropriate
action.
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9. MU Stage 1 Measures – Core. Must meet ALL 15
Green = provider; Yellow = MA; Brown = office; Blue = ZoomMD
Measure Metric Measure Metric
Problem List 80% Electronic Prescriptions 40%
Active Medication Allergy List 80% CPOE (for medication only) 30%
Active Medication List 80% Drug-drug and drug-allergy alerts Turn
on
Smoking Status (>13 y.o.a.) 50% Electronically exchange info Test
Vital Signs and Growth Charts 50% Clinical decision support rules 1
Clinical Summaries 50% Report quality measures 6
Electronic copy of health info 50% Privacy and security of patient data
in EHR
YES
Patient Demographics 50%
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10. MU Stage 1 Measures – Menu set. Must meet 5 of 10
Blue = potential choices setup by ZoomMD. Rest not required in Stage 1
Measure Metric Measure Metric
Drug formulary checks Yes Electronic Immunization data Test
Labs as structured data* 40% Syndromic Surveillance Test
Patients and Conditions
list
YES Reminders (<5 or >65) 20%
Patient-Specific
education
10% Electronic patient access to
information
10%
Medication reconciliation 50%
Summary of Care
provided for transitions
of care
50%
*Interface with Quest is included
at no additional charge

11. MU Stage 1 Clinical Quality Measures – Reportable
through EHR
Report 3 core or alternate core
CORE MEASURES
1. Hypertension: Blood Pressure Measurement
2. a. Tobacco Use Assessment b. Tobacco Cessation Intervention
3. Adult Weight Screening and Follow-up
------------------ALTERNATE CORE MEASURES------------------------
1. Weight Assessment and Counseling for Children and Adolescents
2. Influenza Immunization for Patients ≥ 50Years Old
3. Childhood Immunization Status
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12. MU Stage 1: Clinical Quality Measures
Additional set
• Choose and submit 3 additional quality measures
from a list of 38
• Chooses measures appropriate to your specialty
• Do not have to achieve any particular number in
the measure reported
• Primary care physicians can achieve this
requirement by reporting on a single disease –
Diabetes Mellitus
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13. What do I do?
Physicians/Nurse practitioners/PAs
A. Electronic prescriptions
1. Computerized physician order entry (medication only)
B. Report on core or alternate core measures
1. Tobacco Use Assessment and Tobacco Cessation Intervention
2. Weight
a. Adult Weight Screening and Follow-up
b. Weight Assessment and Counseling for Children and Adolescents
(pediatrics)
3. Order influenza vaccine for patients >50 (substitute for 1 or 2
above)
C. Choose and report 3 quality measures for your specialty
1. Diabetes recommended for primary care
D. Order labs through Quest
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14. What do I do? Physicians/NPs/PAs
Data Review recommended for patient safety
Review is not mandated for Meaningful Use
• Problem List
• Medication related information
– Active Medication Allergy List
– Active Medication List
– Drug-drug and drug-allergy alerts (automatically fire)
– Drug formulary information
• Smoking Status (>13 y.o.a.)
• Vital Signs and Growth Charts (Growth charts – peds)
• Labs received into EHR
• Childhood immunization status (pediatricians)
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15. What do I do?
Medical Assistant
• Enter Problem List
– Based on provider’s prior note
• Active Medication Allergy List
– Enter based on old records and patient report
• Active Medication List
– Enter patient’s current medication
• Smoking Status (>13 y.o.a.)
– Record patient’s smoking status
• Vital Signs and Growth Charts
– Enter vital signs and growth charts at each visit
• Measure blood pressure
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16. What do I do?
Business/Administration/Front office
• Demographics entry
– Ensure all patients have all demographics and
insurance information and map to Newcrop
• Clinical Summaries
– Give each patient a copy of their clinical summary
• Electronic copy of health info
– Give or send patients electronic copy of health info
upon request
• Privacy and security of patient data in EHR
– Plan, monitor, report
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17. What do I do?
Practice designee – ZoomMD to assist
• Build
– clinical decision support rule – one rule
• Setup
– practice to receive electronic lab results from Quest
• Test
– Electronically exchange information
– Electronic Immunization data
– Syndromic Surveillance
• Done automatically
– Drug formulary checks
– Turn on drug-drug and drug-allergy alerts
– Patients and conditions list
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18. Physicians: Four steps to Meaningful Use
Physician role + other roles = achievement of meaningful use
Zap your prescriptions electronically
Prescribe electronically
Offer assistance with weight reduction.
Review patient weight and follow-up as required
Offer tobacco cessation help.
Review tobacco use and intervene as required
Measure clinical quality.
Record data as required for selected clinical quality measures
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19. Why is it important for me the physician to
achieve Meaningful Use?
• Enhance quality of care
• Meaningful use criteria will become standard of care
• Improved communication with other physicians
• Collection of data in structured format will enable
data analysis and can drive outcomes
• Incentive payments
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20. Medicare program: Incentive Payments for Eligible
Professionals (physicians) for Meaningful Use of EHR
In dollars. Green = Assumes providers meet all criteria
in 2011 or 2012
Funding
year
Adoption year
2011 2012 2013 2014 2015
2011 18000
2012 12000 18000
2013 8000 12000 15000
2014 4000 8000 12000 12000
2015 2000 4000 8000 8000
2016 2000 4000 4000
TOTAL 44000 44000 39000 24000 PENALTY
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21. Medicare Penalties for not meeting MU
Penalties are applied to each physician’s
Medicare payments
2015 2016 2017 and
beyond
1% 2% 3%
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22. Eligible professional (physician) – Medi-Cal incentive payments (Dollars)
Medi-Cal program has no penalties. Typical schedule.
Calendar
year
Adoption year
2011 2012 2013 2014 2015 2016
2011 21250
2012 8500 21250
2013 8500 8500 21250
2014 8500 8500 8500 21250
2015 8500 8500 8500 8500 21250
2016 8500 8500 8500 8500 8500 21250
2017 8500 8500 8500 8500 8500
2018 8500 8500 8500 8500
2019 8500 8500 8500
2020 8500 8500
2021 8500
TOTAL 63750 63750 63750 63750 63750 63750
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