Second Symposium: The ARRA Funds and the Final Definitions of Meaningful Use

1. Second Symposium:The ARRA Funds and the Final Definitions of Meaningful Use Dr. Joaquín Fernández Quintero, MDPresident TeleMedik Innova Health Solutions March 11, 2010

2. Our objectives today • Facts about who we are • To continue educating healthcare professionals on key aspects of ARRA funds related to Healthcare Information Technology (HIT) • To promote the dissemination of HIT in Puerto Rico

3. Facts about TeleMedik… Expanded Capacity for over 100 seats and offices • TeleMedik pioneered TRIAGE in 1997. • Leader company today in the Triage and Health Education Services • Serves over 1.6 million members • Pioneer in TeleHealth , Pharmacy Auditing Program, telephonic smoking cessation (Quit Line) and weight control programs. • Health Risk Assessments • Predictive Modeling Assessment Accreditedsince 2001 HealthCall Center Disease Management

4. Facts about us… TeleMedik Innova Health Solutions Strong Leadership and Multidisciplinary team of Health Professionals Leaded by clinicians in the local market Strong Infrastructure to ensure business continuity and flexibility Maintains and manages one of the largest databases in Health Care across the Island • Founded in 2007 • 2008 PRIDCO approval for Tax exemption decree for Software Manufacturing and Exporting Services • Developed and deployed over 15 Softwares for Health Care services

5. TeleMedik’s Key Drivers for the past 15 years • Higher ER (Emergency Room) utilization expenses • Increasing admissions to hospitals • Pharmacy benefit wrongful utilization and up the hill expenses • High risk lifestyles with higher medical expenditures • Poor communication, segregated information and isolated efforts • A need to comply with Federal and State regulations • Lack of trusted, flexible and up to date data base systems for 1.6 millions of lives in PR

6. Clients and Business Partners • AEE American Health • Asociación de Maestros • AstraZeneca-IPR • CLARO • COSVI • Cruz Azul de Puerto Rico • Departamento de Salud • Horizon Blue Cross Blue Shield • HUMANA • Lucy LópezRoig & Asociados • MAPFRE • Medical Card System • UPR • Medlar, Brazil • MMM • PICA • PMC Medicare Choice • Salud Dorada con Medicare • SSS

7. Business alliances and partnerships • Babilon Technologies • Cardiocom • Centennial • CLARO (formerly Verizon) • Cy Solutions • DxCG • Engineering Solutions Group • Envision Technologies • Greenway Medical • HealthCom • MD Anderson • NuStream , Data Access • Patient Keeper • Recinto de Ciencias Médicas • SAIL (Laboratories)

8. Our Speakers Presentations • Health Information Exchange and Meaningful Use at the Hospital Level • EHR, Meaningful Use, and ARRA Funds: The Federal Perspective in 2010 • Broadband Infrastructure and Health Information Exchange Systems in Puerto Rico • Technology solutions for Community Health Centers (FQHCs)

9. Electronic Health Record

10. Who is a Medicare Eligible Provider?

11. Who is a Medicare Eligible Provider?

12. Eligibility: Patient Volume

13. What is Meaningful Use? • The Recovery Act specifies the following 3 components of Meaningful Use: • Use of certified EHR in a meaningful manner (ex: e-prescribing) • Use of certified EHR technology for electronic exchange of health information to improve quality of health care • Use of certified EHR technology to submit clinical quality and other measures

14. Conceptual Approach toMeaningful Use

15. Meaningful Use Stages • Meaningful Use will be defined in 3 stages through rulemaking • Stage 1 – 2011 • Stage 2 – 2013* • Stage 3 – 2015* *Stages 2 and 3 will be defined in future CMS rulemaking.

16. Stage 1 – Health Outcome Priorities* • Improving quality, safety, efficiency, and reducing 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.

17. Meaningful Use Summary • EPs • 25 Objectives and Measures • 8 Measures require ‘Yes’ or ‘No’ as structured data • 17 Measures require numerator and denominator • Eligible Hospitals and CAHs • 23 Objectives and Measures • 10 Measures require ‘Yes’ or ‘No’ as structured data • 13 Measures require numerator and denominator • Reporting Period – 90 days for first year; one year subsequently

18. Clinical Quality Measures Overview • 2011 – Providers required submit summary quality measure data to CMS by attestation • 2012 – Providers required to electronically submit summary quality measure data to CMS • EPs are required to submit clinical data on the 2 measure groups: core measures and a subset of clinical measures most appropriate to the EP’s specialty • Eligible hospitals are required to report summary quality measures for applicable cases

19. Incentive Payments For Medicare EP’s

20. Incentive Payments For Medicare EP’s Practicing in HPSA’s

21. Incentive Payments For Medicaid EP’s

22. NEWS

23. Partnership with CPR Solutions • CPR Solutions Group, formed in 2000 and headquartered in Charleston (WV), brings together a team of IT specialists and medical personnel to serve clients in network infrastructure and electronic health record (EHR) systems.

24. Health Information Exchange Our Driver: Turning Data into Smart Decisions

25. The transition to a NHIN Source: HIMMS Conference 2010

26. Health Information Exchange- Service Concept Source: HIMMS Conference 2010

27. Key Alliances to support this effort Hardware

28. Contact Us • Call us at :Dr. Joaquín Fernández Quintero • (787) 999-6200 • Fax us at : (787) 999-6210 • E-mail: telemedik@telemedik.com • Visit our sites @ www.telemedik.com www.telemedikinnova.com