1. Jessica Jacobs September 15, 2010

2. Ambulatory providers are physicians who perform the majority of their services outside the hospital – No more than 90% of their services are performed at a hospital Currently there are 200,0000 physician offices, 515,000 total practicing ambulatory physicians* What does Ambulatory Mean? https://questions.cms.hhs.gov/app/answers/detail/a_id/9844/~/[ehr-incentive-program]-are-physicians-who-practice-in-hospital-based Note: Excludes radiologists, pathologists, anesthesiologists, ER and all other hospital-based physicians

3. In other words… ThemNot Them

4. An Electronic Health Records (EHR) is “a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports.” – HIMSS, 2010 Colloquial Definition – Computer records in a doc’s offices that can talk to pharmacies, has decision support, talks to hospitals, improves quality, decreases costs, and saves the world What is an EHR?

5. Adoption Definitions Any Any EHR Adoption Basic Patient Demographics Problem Lists Clinical Notes Rx Orders Lab Results Imaging Results Full All Basic Requirements Medical History/Follow Up Test Orders Rx/Test Orders sent Electronically Drug/Drug Interactions 44%21%6%

7. Adoption Definitions Any Any EHR Adoption Basic Patient Demographics Problem Lists Clinical Notes Rx Orders Lab Results Imaging Results Full All Basic Requirements Medical History/Follow Up Test Orders Rx/Test Orders sent Electronically Drug/Drug Interactions 44%21%6%

8. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was a part of ARRA Allocated funds to spur the adoption of electronic health records - mostly administered through ONC and CMS Incentive Payments for Meaningful Use are administered through CMS – Medicare: Maximum Incentive = $44k/physician – Medicaid: Maximum Incentive = $63k/physician – Incentives will be paid 2011- 2016, then penalties will begin Meaningful Use Rules were released July 13, 2010 HITECH… and Meaningful Use

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11. The rates of ambulatory adoption have risen significantly over the past five years Unfortunately that increase in adoption has not translated into “meaningful” adoption The current rate of meaningful adoption is 6.3%, hopefully new rules and certifications will help increase this percentage Key Take-Aways