This final rule implements provisions of the American Recovery and Reinvestment Act of 2009 that provide incentive payments to eligible professionals, hospitals, and critical access hospitals that adopt and demonstrate meaningful use of certified electronic health records technology. It specifies criteria to qualify for incentive payments, how payments are calculated, and payment adjustments for those who fail to demonstrate meaningful use. The Office of the National Coordinator for Health Information Technology will also issue standards and certification criteria for electronic health records.

1. Healthcare IT Strategy [email_address]

2. Hi, I’m Paul Thank you for coming

3. This final rule implements the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111-5) that provide incentive payments to eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) participating in Medicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified electronic health record (EHR) technology. This final rule specifies—the initial criteria EPs, eligible hospitals, and CAHs must meet in order to qualify for an incentive payment; calculation of the incentive payment amounts; payment adjustments under Medicare for covered professional services and inpatient hospital services provided by EPs, eligible hospitals and CAHs failing to demonstrate meaningful use of certified EHR technology; and other program participation requirements. Also, the Office of the National Coordinator for Health Information Technology (ONC) will be issuing a closely related final rule that specifies the Secretary’s adoption of an initial set of standards, implementation, specifications, and certification criteria for electronic health records. ONC has also issued a separate final rule on the establishment of certification programs for health information technology. MU Final Rule: 1 of 800

4. Notes? Up to you

5. 3 points to answer: What’s up with EHR? Should you meet MU? What if there was no MU?

6. EHR , MU, ICD-10 reform, RHIOs, RECs, & N-HIN, are all complicated EHR , MU, ICD-10 reform, RHIOs, RECs, & N-HIN, are all complicated

7. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

8. Does meeting MU align with your business strategy? EHR & MU are not “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

9. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. Why do you buy a drill? Because you can’t buy holes Why buy an EHR? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

10. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. Why did you buy your EHR? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

11. Write down your answer… Remember it, you will need it later

12. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. What’s the elephant in the room? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

13. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. Meaningful Yoose “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

14. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. Meaningful Yoose What is the answer? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

15. Does meeting MU align with your business strategy? MU final rule Wordle “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

16. Does meeting MU align with your business strategy? 2 conflicting provider models yours National healthcare “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

17. Does meeting MU align with your business strategy? MU office (slaughter house) “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

18. Does meeting MU align with your business strategy? Is there merit in holding out? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

19. Does meeting MU align with your business strategy? Are all provider businesses all the same? NO! “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

20. Does meeting MU align with your business strategy? Pick a number between 1 and 6,000 “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

21. Does meeting MU align with your business strategy? Now I will pick a number… “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

22. Does meeting MU align with your business strategy? How far away is your number from mine “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

23. Does meeting MU align with your business strategy? … CMS writes MU final rule “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

24. Does meeting MU align with your business strategy? How far away is your organization from that target? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

25. Write down your answer… Remember it, you will need it later

26. Write down your answer… Remember it, you will need it later Expand your thinking

27. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. Keep the focus on you… “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

28. Does meeting MU align with your business strategy? Color outside the lines… “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

29. Does meeting MU align with your business strategy? Where are my stone Tablets? ONC “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

30. Does meeting MU align with your business strategy? ONC…we’re listening… “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

31. Does meeting MU align with your business strategy? Healthcare IT The heavy lifting is just beginning. “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

32. Does meeting MU align with your business strategy? ARRA money Good Luck “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

33. Does meeting MU align with your business strategy? What if there were no Meaningful Use? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

34. Does meeting MU align with your business strategy? We’re listening… Why buy a drill? Because you need a hole. “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

35. Should you try to meet Meaningful Use? Healthcare IT Strategy [email_address]

36. Does Meaningful Use work for You?

37. Does meeting MU align with your business strategy? “ Meeting Meaningful Use just for the ARRA money is like having a baby just for the tax refund.” PA CIO

38. Does Meaningful Use work for you? The CMS created a decision point. You must weigh meeting Meaningful Use. Meet Meaningful Use Do NOT meet Meaningful Use

39. Meeting Meaningful Use kicks off a chain reaction What if MU changes after you are committed to as strategy?

40. What might your options be? Fortunately, there are several options to evaluate. Full MU Delay meeting MU Phased MU ??? ?? NO MU

41. What should your MU Strategy be? You must decide how to define how to quantify your strategy for MU.

42. Why is this decision critical? External influencers will squeeze your Business and HIT strategy. MU PROVIDER Reform

43. Why is this decision critical? You need to ascertain where to place each option

44. Why is this decision critical? Once the nose of the camel gets under the tent… The camel wants to get all the way in. The government is moving towards a national healthcare business model. You have your own model. Do they complement one another or conflict?

45. More is unknown than known What is unknown cannot be controlled N-HIN Change requirements Standards No leader Plan B? Reform HIE Date Change

46. How do we plan your HIT strategy? What are the influencers and inputs? Your Strategic Plan HIT initiatives Align to Reform Strategic GAPS MU options Your HIS Strategy Meaningful Use Decision Text HIT platform Tie to HIT strategy

47. Should you attempt to meet Meaningful Use and why? Do you meet MU Yes No

48. Should you attempt to meet Meaningful Use and why? Do you meet MU Yes Full MU Partial By what date What Option By When No What’s the plan

49. If Full MU, what is the best date for you to meet it? Full MU By what date 2011 2012 21013 21014 21015

50. What are the ARRA implications to you of the dates for full MU? What are the implications? 2011 2012 2013 2014 2015 100% of incentive 100% of incentive 100% of incentive 60% of incentive 30% of incentive

51. What are the risks to you of seeking to meet full MU? What are the risks prior to 2016 Probability of passing MU? External risks? Align with your strategy? Meeting your key metrics? PENALTIES After 2016

52. What is the probability of passing the MU test for full MU? What is the probability of passing MU? Determine by year of test What are Stage 2 requirements What are Stage 3 requirements If the date change If the requirements change Vendor certification Impact of reform Affect on your strategy

53. What are the external risks to passing the MU test for full MU? What are the External Risks Determine by year of test Vendor Support Regulatory reform Acquisitions by your firm HIT staff shortages Change in Medicare payments Impact of reform Affect on strategy

54. Does passing the MU test for full MU align with your strategy? How does MU align with your strategy Quality and Safety Culture and Service Centralize Business Support Labor Productivity Supply Cost Revenue Cycle Patient Retention Primary care growth Physician Collaboration Growth

55. Does passing the MU test for full MU align with your metrics? How does MU align with your metrics Increase culture scores Increase operational excellence Improve customer service Increase clinical quality Increase staff satisfaction Decrease length of stay Decrease waiting times

56. What HIT projects do you have to do to meet full MU requirements? What’s needed for 2011 Clinical Transformation Standard orders EO Rx Meaningful Use CPOE Eligibility checking upgrades Quality performance Other years should be similar in terms of tasks

57. What influencers should be considered to meet full MU requirements? What are the Influencers Cost Staffing Other HIS projects Meaningful Use CPOE When can you complete What is the ROI Stage 2 & 3 requirements Other years should be similar in terms of tasks

58. What costs should be understood to meet full MU requirements? What is the Cost Systems Staffing training Change management Work flow improvement What is the ROI Other years should be similar in terms of tasks

59. What staffing should be answered to decide meeting full MU requirements? What are staffing needs How many By when? Skill sets Contractors Other years should be similar in terms of tasks

60. What does meeting full MU requirements do to other projects? What are Non-MU projects What are they Can they be delayed Allocating funds Allocating staff Other years should be similar in terms of tasks

61. What is the impact of doing CPOE? What is CPOE’s impact Would you do CPOE without MU CPOE is the bulk of work and risk What is chance of success Allocating staff Other years should be similar in terms of tasks

62. What is the best year to meet MU requirements? When can you complete MU 2011-2013 2014-2015 What is the ROI by year Impact of year on HIT projects Other years should be similar in terms of tasks

63. What will be the requirements of Stages 2 & 3 with MU? What are Stages 2 & 3 Unknown requirements Unknown cost Unknown risk What is chance of success Other years should be similar in terms of tasks

64. How do you measure the risk of trying to meet MU? Perform Risk Analysis Determine individual risks Determine their probability Determine their impact Map options by year to risks Develop risk matrix