Kentucky Regional Extension Center

1. Overview: Healthcare Information Technology Initiatives Kentucky Regional Extension Center Your EHR Resource Contact: Dr. Martha Riddell and Dr. Carol Ireson Meaningful Use Advisors, Kentucky REC Martha.Riddell@uky.edu Clires0@email.uky.edu 859-323-3090

2. REC 201 • Overview of ARRA HIT Initiatives • History of Kentucky HIT efforts • Purpose of Regional Extension Centers • Service Area of Kentucky REC’s • Description of REC Services

3. ARRA…A Massive Stimulus for Health IT Adoption &HIE Expansion Appropriations for Health IT New Incentives for Adoption • $2 billion for loans, grants & technical assistance for: • National Resource Center and Regional Extension Centers • EHR State Loan Fund • Workforce Training • Research and Demonstrations • New Medicare and Medicaid payment incentives for HIT adoption • $20 billion in expected payments through Medicare to hospitals & physicians • $14 billion in expected payments through Medicaid • ~$34 billion expected outlays, 2011-2016 Appropriations for HIE Appropriations for HIE $1.5 billion in grants through HRSA for construction, renovation and equipment, including acquisition of HIT systems • At least $300 million of the total at HHS Secretary’s discretion for HIE development • Funneled largely through States or qualified State-designated entities • For planning and/or implementation Broadband and Telehealth $4.3 billion for broadband & $2.5 billion for distance learning/ telehealth grants

4. 2009 2011 2013 2015 Bending the Curve Toward Transformed Health-Incentives for HIT Adoption Achieving Meaningful Use of Health Data

5. Kentucky’s Efforts • In 2005, Senate Bill 2 created the Kentucky eHealth Network (KeHN) Board to oversee the development, implementation and operation of a statewide e-health network. • Kentucky also received a Medicaid Transformation Grant to develop the foundational components for a statewide health information exchange, the Kentucky Health Information Exchange (KHIE), to be completed by the second quarter of 2010.

6. Phase I KHIE

7. Kentucky Regional Extension Center Mission The Kentucky Regional Extension Center based at the University of Kentucky will assist primary care providers and critical access/rural hospitals with EHR adoption, HIE participation, and achievement of meaningful use. Vision The long-term vision of the Kentucky Regional Extension Center is to improve the quality and value of health care for the people of Kentucky and to serve as a model for other areas that face similar challenges.

8. Incentives for Meaningful Use (MU) The ARRA/HITECH Act authorizes incentive funding for health care providers who demonstrate “meaningful use of health information technology.” • Incentive programs for Medicare and Medicaid • Programs for hospitals and eligible professionals • Must use certified EHR technology AND demonstrate adoption, implementation, upgrading or meaningful use • Programs differ between Medicare and Medicaid • Medicare incentive program is federally run by CMS • Medicaid incentive program is run by States and is voluntary

9. Who is a Medicare Eligible Provider? • Eligible Professionals (EPs) • Doctor of Medicine or Osteopathy • Doctor of Dental Surgery or Dental Medicine • Doctor of Podiatric Medicine • Doctor of Optometry • Chiropractor • Eligible Hospitals • Acute Care Hospitals* • Critical Access Hospitals (CAHs) Eligible Providers in Medicare FFS

10. Who is a Medicaid Eligible Provider? • Eligible Professionals (EPs) • Physicians • Nurse Practitioners (NPs) • Certified Nurse-Midwives (CNMs) • Dentists • Physician Assistants (PAs) working in a Federally Qualified Health Center (FQHC) or rural health clinic (RHC) that is so led by a PA • Eligible Hospitals • Acute Care Hospitals (now including CAHs) • Children’s Hospitals Eligible Providers in Medicaid

11. Providers Eligible for Incentives

12. Hospital-based EPs • Hospital-based EPs do not qualify for Medicare or Medicaid EHR incentive payments. • The Continuing Extension Act of 2010 modified the definition of a hospital-based EP as performing substantially all of their services in an inpatient hospital setting or emergency room. The rule has been updated to reflect this change. • A hospital-based EP furnishes 90% or more of their services in either the inpatient or emergency department of a hospital.

13. Medicare Incentives

14. Medicaid Incentives

15. Medicaid Only: Adopt/Implement/ Upgrade (A/I/U) • First participation year only for Medicaid providers • Adopted –Acquired and Installed Ex: Evidence of installation prior to incentive • Implemented –Commenced Utilization of Ex: Staff training, data entry of patient demographic information into EHR • Upgraded –Expanded Upgraded to certified EHR technology or added new functionality to meet the definition of certified EHR technology • Must use certified EHR technology • No EHR reporting period

16. Kentucky Regional Extension Center

17. Kentucky REC Strategic Partners

18. Targeted Providers Primary Care Physicians • FPs, OB/Gyn, Peds, Int. Med • Small practices (<10 prescribers; physicians, PAs, ARNPs) • Community health centers • Rural clinicians and those with critical access hospitals • Practices and clinics that serve the underserved

19. Other Services the REC Provides • Assistance with the Physician Quality Reporting Initiative • Continuing Medical Education • Assistance with Medicare’s e-prescribing initiative (eRx)

20. Education & Outreach • Awareness Campaign with Professional Associations • On-line CME for baseline EHR knowledge available 24/7 • Creation of Learning Communities for interactive learning • Live & video CME/CE regional workshops • Annual conferences in conjunction with statewide primary care associations • Meaningful use work groups for targeted providers

21. Vendor Selection/ Purchasing KY REC Provides unbiased support regarding purchase of EHR systems • KY REC is partnering with the Tri-State REC to provide vendor selection assistance. This will include: • Master Requirements Template • Group Purchasing activities

22. Practice &Workflow Redesign • Workflow analysis and process redesign tools provided • Process Improvement training available • Sharing of best practices

23. Implementation/ Project Management • Comprehensive on-site readiness assessment • Administrative/Clinical lead designated in each practice • Implementation planning guidance • System selection information and support • Post-implementation evaluation

24. KY REC Services

25. Interoperability &HIE • Work with KHIE to achieve HIE • Work with strategic partners to achieve health information exchange

26. Privacy & Security • Provide Privacy & Security CME • Share best practices • Provide individualized consultation

27. Progress Towards Meaningful Use • Establish Primary Care Physician and Practice Manager meaningful use workgroups • Co-sponsor & participate in KAN annual meetings • Fund PBRN study of ten practices for identification of lessons learned, best practices

28. Medicare Incentive Payment Schedule Fall 2010 Certification of EHR vendors will start April 2011 Attestation of meaningful use begins 2011-2012 Clinicians can begin using a certified EHR in a meaningful Manner (must use for 90 days) 2010 2011 Jan. 2011 Registration with CMS can begin. This will be done through PECOS May 2011 CMS payments Will begin *Medicaid EHR incentives will be managed by states

29. “We are not building new relationships with priority primary care providers — we are building on respected existing relationships with the practice community. “

30. Questions?

31. Contact Information Dr. Martha Riddell Meaningful Use Advisor Kentucky REC Martha.Riddell@uky.edu 859-323-3090 Dr. Carol Ireson Meaningful Use Advisor Kentucky REC Clires0@email.uky.edu 859-323-3090 General REC Information Contact: Kentucky Regional Extension Center 2333 Alumni Park Plaza, Suite 200 Lexington, KY 40517 Toll Free: 866-KY-RECEHR 859-323-3090 KYREC@uky.edu