The Medical Advantage highlights the urgent need for healthcare efficiency in the U.S. due to significant waste and errors in a largely paper-driven system. It emphasizes the importance of adopting electronic health records (EHR) to qualify for federal incentives under the HITECH Act and to improve patient management and revenue cycles. The document underscores the growing pressure on physicians to become cost-efficient amidst healthcare reforms and the need for technological advancements in practice management.

1. “The Medical Advantage ” TM
A HEALTH CARE TECHNOLOGY AND TRAINING COMPANY
The Medical Advantage, Inc. formerly a certified Allscripts Reseller

2. EMR: Why Wait - The Time is Now!
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3. There is an Urgent Need
US Healthcare Market Large And Troubled
$2.2 Trillion Spent in Healthcare
$700 Billion in Waste
1000’s of Medical Errors
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4. The Opportunity
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
01/15/13 Confidential Property of The Medical Advantage and Gregory French 4

5. Growing pressure on reimbursements,
you need to be more cost efficient
Physicians Working Harder
Source: Modern Medicine
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6. 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
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2011

7. What You Need To Do:
General Program Details
HITECH - The Approach
Stage 3
Stage 2
Stage 1
2013 2015
2011
Exchange of Improved
Capture &
clinical data Outcomes
Share Data
(Advancement
of processes)

8. Medicaid Incentive Program
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9. Who is eligible?
› Medicare › Medicaid
1. Doctor of medicine or 1. Physicians (MDs and DOs)
osteopathy 2. Dentists
2. Doctor of dental surgery or 3. Certified nurse-midwives
medicine 4. Nurse practitioners
3. Doctor of podiatric 5. Physician assistants
medicine practicing in an FQHC or RHC
4. Doctor of optometry that is so led by a physician
5. Chiropractor assistant
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10. “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
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11. Meaningful Use
Stage 1 Meaningful Use Objectives
Core Objective Menu Set (Pick 5, 1 must be Pop Health)
Computerized Provider Order Entry (CPOE) for medication orders directly Implement drug-formulary checks
entered by any licensed healthcare professional who can enter orders into
the medical record per state, local and professional guidelines
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 The EP who receives a patient from another setting of care or provider of care
ethnicity, and date of birth 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 Capability to submit electronic syndromic surveillance data to public health
Medicaid incentive payment, the states) 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

12. 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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13. 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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14. 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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15. Measures of EHR Use
* See Allscripts web site for entire list
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16. Measures of EHR Use
* See Allscripts web site for entire list
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17. Measures of EHR Use
* See Allscripts web site for entire list
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18. Measures of EHR Use
* See Allscripts web site for entire list
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19. Measures of EHR Use
* See Allscripts web site for entire list
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20. 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
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21. The Path is Clear…
“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