The document discusses how the American Recovery and Reinvestment Act (ARRA) provided major funding to promote health information technology adoption and health information exchange through programs like regional health IT extension centers. It specifically discusses West Virginia's application for over $9 million over 4 years to create a regional extension center consortium to help over 1,800 healthcare providers adopt and meaningfully use health IT. The extension centers will provide various services to help providers implement systems, achieve meaningful use criteria to qualify for incentive payments, and improve healthcare through use of health IT.

1. ARRA & Regional HIT Extension Centers Jack L. Shaffer, Jr. CIO – Community Health Network of West Virginia

2. A quick word about the Community Health Network of West Virginia The Network is a tax-exempt, non-profit health center-controlled West Virginia corporation – formed in 2000. The Network is primarily an application service provider (ASP) delivering centralized practice management, electronic medical records (EMR), and technology services for its members. Currently with 50 clinical locations in production using the Indian Health Services RPMS-EHR system (CCHIT-Certified, public domain / open source EHR derivation of the VA’s VistA system) 70 FTE providers – 300+ concurrent users. 10 More clinics to implement over the next year. Our focus is health improvement through the strategic use of health information technology along with workflow modifications to improve health outcomes.

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 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 Appropriations for HIE $4.3 billion for broadband & $2.5 billion for distance learning/ telehealth grants Broadband and Telehealth $1.5 billion in grants through HRSA for construction, renovation and equipment, including acquisition of HIT systems Community Health Centers

4. ARRA – HITECH Funding Streams $17.2 billion in incentives for EMR adoption Paid via Medicare OR Medicaid Estimated $234 million+ could go to WV ambulatory providers over 4 years Estimated $500+ million could go to WV acute hospitals over 4 years Avg. hospital with 7,550 discharges and 50% Medicare share will receive $4 million over 4 years. Must meet “meaningful use” criteria to achieve 100% of ARRA funds $2 billion for the Office of the National Coordinator Health Information Exchange Creation of Regional HIT Extension Centers

5. Extension Center? Regional health IT extension centers will aim to help health care providers become "meaningful users" of health IT by 2011 so they can qualify for federal health IT stimulus funding. Blumenthal noted that the federal economic stimulus package allocated nearly $700 million to form a nationwide network of "local health care geek squads.“ The health IT extension center program is patterned after the federal agriculture extension service created nearly a century ago. Similar to how the agricultural extension centers help farmers address pesticide, crop and land use issues, the new health IT extension centers would help health care providers "not just get computers, not just store the information, but use the information," Blumenthal said.

6. Each State will be served by a RHITEC (some states may have more than one and some states will be served by a multi-state RHITEC) Federal support for the first two years Services to include Assistance selecting a system Assistance negotiating fair pricing Project implementation assistance Workflow Redesign Functional interoperability Privacy and Security Support Training and support on using technology and demonstrating medical use Progression to “meaningful use” Regional HIT Extension Center - FAQ

7. Not a grant. It is a cooperative agreement between the RHITEC and the ONC for specific services. 90/10 match first 2 years then 10/90 for next 2 years. Focus is primary care providers. Funding capped at 10 providers per organization. Capped at ~$5K per provider. Regional HIT Extension Center - FAQ

8. In West Virginia…….. Applied for ~9M in Federal funding over a 4 year period. The WV-RHITEC is a consortium comprised of the Health Improvement Institute; the Community Health Network of West Virginia and West Virginia Medical Institute. The Consortium will have strategic partners throughout the State assisting with executing its mission.

9. Targeted Groups for WV-RHITEC We have the opportunity to help more than 1,800 providers adopt and use health-IT over the next 4 years. Assuming a 90% success rate in progressing to meaningful use, these providers could receive over $80 million to support HIT adoption and use efforts.

10. Targeted Groups for WV-RHITEC The following table reflects the commitments received by the Extension Center by category: PC designates Primary Care Providers; M-use means meaningful use. 411 411 0 Non PC Providers 914 772 142 Total Providers 503 361 142 Total PC Providers 460 342 118 Priority PC Providers Total EHR to M-use Paper to M-use Category

11. What Does this Mean to All of You? Need to move forward with implementation and meaningful use of technology The environment is heating up and the tipping point is near Meaningful Use - Evidence based decision support tools Computerized order entry and results reporting E-prescribing Care opportunity reports based on age appropriate and disease based guidelines Engagement of patients and families-Patient Health Records Care coordination across the boundaries of the clinic Reporting and sharing data for quality improvement purposes

12. Meaningful Use? Blumenthal emphasized that the meaningful use of electronic health records is not just about introducing technology to collect and share information. It's also about physicians and hospitals changing how they operate and the sequence of their work. "We are involved in a vast social project of change management," he noted. Providing better information is the foundation for change, he said. Beyond that, physicians and hospitals will need help and training to understand what improvements to make.

13. Bending the Curve Towards Transformed Health Achieving Meaningful Use of Health Data 2009 2011 2013 2015

14. HIT-Enabled Health Reform Achieving Meaningful Use 2009 2011 2013 2015 HIT-Enabled Health Reform HITECH Policies 2011 Meaningful Use Criteria ( Capture/share data ) 2013 Meaningful Use Criteria ( Advanced care processes with decision support ) 2015 Meaningful Use Criteria ( Improved Outcomes )

15. Meaningful Use - Examples

17. Extension Centers are key for M-use "I know this from my own experience as a physician," he said. "You can show me that my results are not up to those of my colleagues. That didn't mean I knew how to improve them." He cited activities, such as workflow redesign, workforce education and rearranging offices and nurses' stations so that the right information is more accessible. ONC will help providers adopt these techniques in their own practices through its regional extension center program, which will assist providers in deploying and operating electronic health records.

18. Questions?