the medical advantage, inc. - emr & meaningful use

“The Medical Advantage TM” A HEALTH CARE TECHNOLOGY AND TRAINING COMPANY

The Medical Advantage, Inc. formerly a certified Allscripts Reseller1

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EMR: Why Wait - The Time is Now!

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There is an Urgent Need

$2.2 Trillion Spent in Healthcare

$700 Billion in Waste

1000’s of Medical Errors

US Healthcare Market Large And Troubled

Inefficiencies: Information and Practice Management

• Our healthcare system is largely a paper driven industry (similar to the way financial services used to be)

• Inefficient use of staff and physician time means less profitability. practice management automation can help with improvements that can result in an increased number of patient visits and office profitability

• Claims processing is an inefficient and manual process for many physicians leading to delayed payments and high cost (a measurable revenue enhancement opportunity resulting from more complete and automated information)

• Lack of integration across physicians, hospitals, clinics, labs, pharmacies, and patients leads to errors and waste

• Estimates of 20-35 million additional people will likely be in the healthcare system as a result of healthcare reform which makes achieving greater efficiency more critical

04/10/23 4Confidential Property of The Medical Advantage and Gregory French

The Opportunity

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Growing pressure on reimbursements, you need to be more cost efficient

Physicians Working Harder

Source: Modern Medicine

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Funding- HITECH Act

$19 billion in incentives require proof of "meaningful" use – Allow patients to access their health records in a timely manner;

– Develop capabilities to exchange health information where possible;

– Implement at least one clinical decision support rule for a specialty or clinical priority;

– Provide patients with electronic copies of discharge instructions and procedures;

– Submit insurance claims electronically; and

– Verify insurance eligibility electronically when possible

Those that adopt first will benefit the most (declining incentives) Physicians can earn between $44,000 to $64,000 over five

years from Medicare / Medicaid if they are utilizing an EHR in 2011

What You Need To Do: General Program Details

HITECH - The Approach

Stage 3 Stage 2

Stage 1

2011Capture & Share Data

2013Exchange of clinical data (Advancement of processes)

2015ImprovedOutcomes

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Medicaid Incentive Program

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Who is eligible?

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“MEANINGFUL USE”

In order to qualify for the incentive payments physicians

have to demonstrate “meaningful use” of an EHR by

Proving three things:

– Use of an EHR with ePrescribing capability that meets current HHS standards

– Connectivity to other providers to improve access to the authorized patient health history

– Ability to report on their use of the technology to HHS

Meaningful UseStage 1 Meaningful Use Objectives

Core Objective   Menu Set (Pick 5, 1 must be Pop Health)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  

Implement drug-formulary checks

Implement drug-drug and drug-allergy checks   Lab results

Maintain an up-to-date problem list of current and active diagnoses 

Generate lists of patient based on specific conditions to use for quality improvement, reduction of disparities, research or outreach.

Generate and transmit permissible prescriptions electronically (eRx) 

Send reminders to patients based on patient preferences and selected by specific criteria

Maintain active medication list

Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, medication allergies) within 4 business days of the information being available to the EP

Maintain active medication allergy list   Provide access to patient-specific education resources upon request

Record the following demographics: preferred language, gender, race and ethnicity, and date of birth  

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

Record and chart vital signs   Provide summary care record for each transition of care

Record smoking status for patients 13 and over   Capability to submit electronic data to immunization registries

Report ambulatory clinical quality measures to CMS (or, for EPs seeking the Medicaid incentive payment, the states)  

Capability to submit electronic syndromic surveillance data to public health agencies

Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule    

Provide patients with an electronic copy of their health information    

Clinical summaries provided to patients for all office visits    

Capability to exchange key clinical information among providers of care and patient authorized entities electronically    

Protect Health Information    

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How will I submit proof & required reports?

› First opportunity to actually file for the incentives will be April 2011

› New web-based portal is being developed through which all required reports will be submitted

› Note: Must keep records of all qualification & reports for six years following each Reporting Year (similar to HIPAA)

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How will Meaningful Use be measured?

› Two required components under HITECH statute › EHR Functional (operational) metrics › Clinical Quality Metrics

› Can opt out of some metrics if they are irrelevant for your practice / patients

› No longer any manual chart review required

to determine if you’ve met the thresholds – everything can now be reported out of the EHR

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What are the EHR Functional Metrics?

› 15 Core measures

› Required of everyone

› 10 Menu Set measures

› You choose five that best fit within your practice

› Can attest that almost any of the metrics are irrelevant to your practice to remove it from the list and reduce the number of metrics you must report on

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Measures of EHR Use

* See Allscripts web site for entire list

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Measures of EHR Use

* See Allscripts web site for entire list

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Measures of EHR Use

* See Allscripts web site for entire list

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Measures of EHR Use

* See Allscripts web site for entire list

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Measures of EHR Use

* See Allscripts web site for entire list

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Why You Should Not Wait! 

• Too much change for your practice at once….more change coming 2011-2015!

– EMR Certification and implementation

– Continued “Meaningful Use” requirements

– ANSI 5010 – This covers certain electronic health care administrative transactions (claims, remittances, eligibility, claim status request and response).

– ICD 10 coding enhancements are coming

– Regulatory health care changes

“We're investing in electronic medical records and other technologies that can drive down healthcare costs.”- President Barack Obama

“Cost savings from a mandatory requirement that Medicare providers adopt and use HIT as a condition of participating in the Medicare program…savings total $34 billion over 10 years from physicians and hospitals.”

- CBO

The Path is Clear…