1.  By phone: 1) Dial +1.860.970.0010 2) Enter conference ID: 614-290-513# Join the audio conference:  Via internet: 1) Click the phone icon 2) Click “Connect”

2. Stage 1 Beyond the First Year of MU in 2014 Presenters: Randy Marsden – Chief Client Officer Leo Vilenskiy – Senior Customer Support Representative Rebecca Imhoff – Special Projects Coordinator

3.  Please feel free to ask a question at any time via chat  Please include your name and what practice you are from  We will also have a Q and A session at the end of the webinar  The video of the webinar as well as the slides will be available on the Government Regulations in 2014 page on the IO Practiceware Support Website. Ask Questions

4.  Based on the Stage 1 Changes Tipsheet  See the CMS website:  http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Downloads /Stage1ChangesTipsheet.pdf http://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/Downloads /Stage1ChangesTipsheet.pdf  Note, the specifications for EPs published on the CMS website are out of date, we are waiting on them to update these and they couldn’t tell us a date. Yes, there is a difference between 2013 and 2014 Stage 1

5.  No longer allowed to count an exclusion toward the 5 menu measures if there is another menu measure available.  Current menu:  Drug formulary checks  Incorporate lab- test Exclusions on Menu Measures

6. Menu MeasurePossible exclusionWhat we expect… Drug formulary checksDo you write less than 100 prescriptions in the reporting period? You will pick this as 1 menu measure Lab-test resultsDid you not order a lab test?You won’t report this Patient listNONEYou will pick this as 1 menu measure Patient remindersDid you not see patients 5 or younger or 65 and older? You will pick this as 1 menu measure View, download, transmitDo you not have broadband in your area? Do you not have clinical data to send? You won’t report this Education resourcesDid you not have any office visits?You will pick this as 1 menu measure Med reconciliationDid you not have any referrals in?You won’t report this Summary of careDid you not refer out more than 100 times? You won’t report this ImmunizationDid you not administer immunizations, or did you not have a registry in your area? You will pick this as 1 menu measure and apply for an exclusion Syndromic surveillanceDid you not collect syndrome data, or did you not have a registry in the area? You won’t report this Example

7. Use CPOE for medication orders Old requirement  More than 30% of distinct patients with at least one medication seen by the provider have at least one medication order entered using CPOE. New requirement for 2014  More than 30% of medication orders were entered using CPOE.

8. Generate and transmit drug prescriptions electronically (e-Rx) New Exclusion  Any EP who: does not have a pharmacy within their organization and there are no pharmacies that accept electronic prescriptions within 10 miles of the EP's practice location at the start of his/her EHR reporting period.

9. Record demographics New Method of Entry Declined to Specify New Lists, multiselect

10. Why it was changed  Allowing Declined to Specify is allowed for Race, Ethnicity, Gender, and Language.  2 or More races is no longer allowed, must multiselect.  Lists are from the government, no customizations allowed.  We allow you to type to filter, or sort.

11. Record and chart changes in vital signs Old objective  More than 50% of distinct patients aged 2 and over seen by the provider have their height, weight and blood pressure recorded as structured data.  Weight  Blood pressure  Calculate and display BMI  Plot and display growth charts for children 2-20 years, including BMI New objective  More than 50 percent of all unique patients seen have blood pressure (for patients age 3 and over only) and height and weight (for all ages) recorded as structured data.  Possible exclusions:  You saw no patients 3 y/o or older  All the vital signs have no relevance to you  BP has no relevance to you  Height and weight has no relevance to you

12. Record smoking status for patients 13 years or older More options now available

13. Why it was changed  Added smoking frequency  Added Start/End date  Neither are required at this time, but they allow for better documentation of smoking status.

14. Report ambulatory clinical quality measures to CMS or the States  Reporting for the entire year also satisfies PQRS.  You will use an EHR registry to report this, such as IRIS. You must send data electronically for 1 quarter or the entire year.

15. View, download, transmit (Timely access) Old requirement  More than 50% of all patients who request an electronic copy of their health information are provided it within 3 business days. New requirement  Provide timely access to more than 50% of patients to view, download, and transmit their health information within 4 business days. CMS wanted to align Stage 1 and 2 requirements here. We have asked CMS, but they have yet to publish the new specifications. Therefore, we don’t know which measure number this is.

16. View, download, transmit (Patient use) Old requirement  More than 10% of distinct patients seen by the provider are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the provider’s discretion to withhold certain information. New requirement  At least 5% of your patients viewed, downloaded, or transmitted their health information CMS wanted to align Stage 1 and 2 requirements here. We have asked CMS, but they have yet to publish the new specifications. Therefore, we don’t know which measure number this is.

17. Provide clinical summaries for patients for each office visit New method  Send automated via patient portal.

18. Capability to exchange key clinical information among providers of care and patient-authorized entities electronically No longer an objective

19. Use certified EHR technology to identify patient- specific education resources and provide those resources to the patient if appropriate New Methods  Patient Portal – price TBD  AAO Patient Education Materials

20. Perform medication reconciliation for patient received from another care setting or provider or believes an encounter is relevant New Method  Newcrop medication reconciliation  Waiting on final usage documentation from NewCrop  Can continue to use paper, but use the Med Reconciliation exam element

21. Provide summary of care record for each transition of care or referral New Method  Newcrop secure messaging  Waiting on final usage documentation from NewCrop  Can continue to use paper/fax

22.  First Year of MU in 2014  Wednesday, March 5 th at 2 PM  Stage 2: Beyond the First Year on MU in 2014  Wednesday, March 12 th at 2 PM Follow Up Webinars