Kentucky Regional Extension Center

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Kentucky Regional Extension Center
Overview Healthcare Information Technology
Initiatives

• Your EHR Resource

Contact Dr. Martha Riddell and Dr. Carol Ireson
Meaningful Use Advisors, Kentucky
REC Martha.Riddell_at_uky.edu Clires0_at_email.uky.edu 8
59-323-3090
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REC 201

• Overview of ARRA HIT Initiatives
• History of Kentucky HIT efforts
• Purpose of Regional Extension Centers
• Service Area of Kentucky RECs
• Description of REC Services

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ARRAA 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

Appropriations for HIE
Appropriations for HIE
1.5 billion in grants through HRSA for
construction, renovation and equipment, including
acquisition of HIT systems

• At least 300 million of the total at HHS
  Secretarys discretion for HIE development
• Funneled largely through States or qualified
  State-designated entities
• For planning and/or implementation

Broadband and Telehealth
4.3 billion for broadband 2.5 billion for
distance learning/ telehealth grants
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Bending the Curve Toward Transformed
Health-Incentives for HIT Adoption Achieving
Meaningful Use of Health Data
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Kentuckys Efforts

• In 2005, Senate Bill 2 created the Kentucky
  eHealth Network (KeHN) Board to oversee the
  development, implementation and operation of a
  statewide e-health network.
• Kentucky also received a Medicaid Transformation
  Grant to develop the foundational components for
  a statewide health information exchange, the
  Kentucky Health Information Exchange (KHIE), to
  be completed by the second quarter of 2010.

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Phase I KHIE
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Kentucky Regional Extension Center

• Mission
• The Kentucky Regional Extension Center based at
  the University of Kentucky will assist primary
  care providers and critical access/rural
  hospitals with EHR adoption, HIE participation,
  and achievement of meaningful use.
• Vision
• The long-term vision of the Kentucky Regional
  Extension Center is to improve the quality and
  value of health care for the people of Kentucky
  and to serve as a model for other areas that face
  similar challenges.

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Incentives for Meaningful Use (MU)
The ARRA/HITECH Act authorizes incentive funding
for health care providers who demonstrate
meaningful use of health information technology.

• Incentive programs for Medicare and Medicaid
• Programs for hospitals and eligible professionals
• Must use certified EHR technology AND demonstrate
  adoption, implementation, upgrading or meaningful
  use
• Programs differ between Medicare and Medicaid
• Medicare incentive program is federally run by
  CMS
• Medicaid incentive program is run by States and
  is voluntary

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Who is a Medicare Eligible Provider?

• Eligible Professionals (EPs)
• Doctor of Medicine or Osteopathy
• Doctor of Dental Surgery or Dental Medicine
• Doctor of Podiatric Medicine
• Doctor of Optometry
• Chiropractor
• Eligible Hospitals
• Acute Care Hospitals
• Critical Access Hospitals (CAHs)

Eligible Providers in Medicare FFS




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Who is a Medicaid Eligible Provider?

• Eligible Professionals (EPs)
• Physicians
• Nurse Practitioners (NPs)
• Certified Nurse-Midwives (CNMs)
• Dentists
• Physician Assistants (PAs) working in a Federally
  Qualified Health Center (FQHC) or rural health
  clinic (RHC) that is so led by a PA
• Eligible Hospitals
• Acute Care Hospitals (now including CAHs)
• Childrens Hospitals

Eligible Providers in Medicaid
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Providers Eligible for Incentives
Eligible Providers- Medicare Eligible Providers- Medicaid
Eligible Professionals (EPs) Doctor of Medicine or Osteopathy Doctor of Dental Surgery or Dental Medicine Doctor of Optometry Doctor of Podiatric Medicine Chiropractor Eligible Professionals (EPs) Physicians (Pediatricians have special eligibility and payment rules) Nurse Practitioners (NPs) Certified Nurse-Midwives CNMs) Dentists Physician Assistant (PAs) who lead a FQHC)or rural health clinic
Eligible Hospitals Acute Care Hospitals Critical Access Hospitals (CAHs) Eligible Hospitals Acute Care Hospitals, Critical Access Hospitals Childrens Hospitals
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Hospital-based EPs

• Hospital-based EPs do not qualify for Medicare or
  Medicaid EHR incentive payments.
• The Continuing Extension Act of 2010 modified the
  definition of a hospital-based EP as performing
  substantially all of their services in an
  inpatient hospital setting or emergency room. The
  rule has been updated to reflect this change.
• A hospital-based EP furnishes 90 or more of
  their services in either the inpatient or
  emergency department of a hospital.

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Medicare Incentives
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Medicaid Incentives
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Medicaid Only Adopt/Implement/ Upgrade (A/I/U)

• First participation year only for Medicaid
  providers
• Adopted Acquired and Installed Ex Evidence of
  installation prior to incentive
• Implemented Commenced Utilization of Ex Staff
  training, data entry of patient demographic
  information into EHR
• Upgraded Expanded Upgraded to certified EHR
  technology or added new functionality to meet the
  definition of certified EHR technology
• Must use certified EHR technology
• No EHR reporting period

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Kentucky Regional Extension Center
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Kentucky REC Strategic Partners
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Targeted Providers

• Primary Care Physicians
• FPs, OB/Gyn, Peds, Int. Med
• Small practices (lt10 prescribers physicians,
  PAs, ARNPs)
• Community health centers
• Rural clinicians and those with critical access
  hospitals
• Practices and clinics that serve the underserved

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Other Services the REC Provides

• Assistance with the Physician Quality Reporting
  Initiative
• Continuing Medical Education
• Assistance with Medicares e-prescribing
  initiative (eRx)

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Education Outreach

• Awareness Campaign with Professional Associations
  
• On-line CME for baseline EHR knowledge available
  24/7
• Creation of Learning Communities for interactive
  learning
• Live video CME/CE regional workshops
• Annual conferences in conjunction with statewide
  primary care
• associations
• Meaningful use work groups for targeted providers
  

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Vendor Selection/ Purchasing
KY REC Provides unbiased support regarding
purchase of EHR systems

• KY REC is partnering with the Tri-State REC to
  provide vendor selection assistance. This will
  include
• Master Requirements Template
• Group Purchasing activities

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Practice Workflow Redesign

• Workflow analysis and process redesign tools
  provided
• Process Improvement training available
• Sharing of best practices

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Implementation/ Project Management

• Comprehensive on-site readiness assessment
• Administrative/Clinical lead designated in each
  practice
• Implementation planning guidance
• System selection information and support
• Post-implementation evaluation

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KY REC Services
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Interoperability HIE

• Work with KHIE to achieve HIE
• Work with strategic partners to achieve health
  information exchange

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Privacy Security

• Provide Privacy Security CME
• Share best practices
• Provide individualized consultation

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Progress Towards Meaningful Use

• Establish Primary Care Physician and Practice
  Manager meaningful use workgroups
• Co-sponsor participate in KAN annual meetings
• Fund PBRN study of ten practices for
  identification of lessons learned, best practices
  

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Medicare Incentive Payment Schedule
Fall 2010 Certification of EHR vendors
will start
April 2011 Attestation of meaningful use begins
2011-2012 Clinicians can begin using a certified
EHR in a meaningful Manner (must use for 90 days)
2010
2011
Jan. 2011 Registration with CMS can begin. This
will be done through PECOS
May 2011 CMS payments Will begin
Medicaid EHR incentives will be managed by
states
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We are not building new relationships with
priority primary care providers we are building
on respected existing relationships with the
practice community.
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• Questions?

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Contact Information
Dr. Martha Riddell Meaningful Use
Advisor Kentucky REC Martha.Riddell_at_uky.edu 859-32
3-3090 Dr. Carol Ireson Meaningful
Use Advisor Kentucky REC Clires0_at_email.uky.edu 85
9-323-3090
General REC Information Contact Kentucky
Regional Extension Center 2333 Alumni Park Plaza,
Suite 200 Lexington, KY 40517 Toll Free
866-KY-RECEHR 859-323-3090 KYREC_at_uky.edu