1. How to receive your incentive dollars quickly
Zoom to Meaningful Use
How to receive your incentive dollars quickly

2. What is Meaningful Use?
Government program to promote adoption of electronic health record systems (EHR)
Part of the ARRA (stimulus) legislation
$32 billion was set aside for this purpose
Physicians receive incentive payments for “meaningful use” of an EHR
Administered through the Medicare and Medi-Cal programs

3. What do I need to start? A certified EHR
ZoomMD is ONC-ATCB certified by CCHIT
You must be a Medicare or Medi-Cal provider.
Must have an NPI number through NPPES
Annual Part B charges that will qualify for maximum Medicare incentives:
$24000 Part B charges for $18000
$16000 Part B charges for $12000
$10,667 Part B charges for $8000
$5,334 Part B charges for $4000
$2,667 Part B charges for $2000
$20000 Part B charges for $15000

4. Specific Medicare / Medi-Cal requirements
Can participate in either the Medicare or Medi-Cal program (one-time switch allowed)
For the Medicare program, you must have $24000 in annual charges to Medicare
For the Medi-Cal program, 30% of your patient volume must be Medi-cal patients (20% if you are a pediatrician)
Your inpatient volume cannot exceed 90% of your total volume
Annual Part B charges that will qualify for maximum Medicare incentives:
$24000 Part B charges for $18000
$16000 Part B charges for $12000
$10,667 Part B charges for $8000
$5,334 Part B charges for $4000
$2,667 Part B charges for $2000
$20000 Part B charges for $15000

5. The ZoomMD method Themes to live by
It is a practice effort, not a doctor effort
Everyone must fulfill their role
With everyone doing their part, MU is achievable
MU Champion is designated by the practice
Physician has ultimate responsibility
Choose options wisely and let the system do the heavy lifting whenever possible.
Track, track, track
Keep your eyes on the goal

6. What do I have to do to earn the incentive payments?
Meet meaningful use requirements
15 core measures
5 menu measures
3 core or alternate core clinical quality measures
3 additional clinical quality measures
These requirements will increase in stages over time.
Annual Part B charges that will qualify for maximum Medicare incentives:
$24000 Part B charges for $18000
$16000 Part B charges for $12000
$10,667 Part B charges for $8000
$5,334 Part B charges for $4000
$2,667 Part B charges for $2000
$20000 Part B charges for $15000

7. Moving forward: Staging of “Meaningful use”
“These goals can be achieved only through the effective use of information to support better decision-making and more effective care processes that improve health outcomes and reduce cost growth.”
Focus of:
2015 Stage 3 Improved outcomes
2013 Stage 2
Advanced clinical processes
2011 Stage 1
Data capture and sharing
“Phased-in series of improved clinical data capture supporting more rigorous and robust quality measurement and improvement.”
Connecting for Health, Markle Foundation “Achieving the Health IT Objectives of the American Recovery and Reinvestment Act” April 2009

8. Roles – Color legend Color Role Physician/NP/PA MA or Nurse
Front office staff/ administration
ZoomMD setup
Each position will have a specific role.
The above indicates primary responsibility for data entry. Others will still have a responsibility to review data and take any appropriate action.
Each member of the staff has a specific role to play towards achieving meaningful use

9. MU Stage 1 Measures – Core
MU Stage 1 Measures – Core. Must meet ALL 15 Green = provider; Yellow = MA; Brown = office; Blue = ZoomMD
Measure
Metric
Problem List
80%
Electronic Prescriptions
40%
Active Medication Allergy List
CPOE (for medication only)
30%
Active Medication List
Drug-drug and drug-allergy alerts
Turn on
Smoking Status (>13 y.o.a.)
50%
Electronically exchange info
Test
Vital Signs and Growth Charts
Clinical decision support rules 1
Clinical Summaries
Report quality measures 6
Electronic copy of health info
Privacy and security of patient data in EHR
YES
Patient Demographics
Metric = % of patient charts that should have this information or % of items that need to be completed in order to satisfy that particular measure.

10. MU Stage 1 Measures – Menu set
MU Stage 1 Measures – Menu set. Must meet 5 of 10 Blue = potential choices setup by ZoomMD. Rest not required in Stage 1
Measure
Metric
Drug formulary checks
Yes
Electronic Immunization data
Test
Labs as structured data*
40%
Syndromic Surveillance
Patients and Conditions list
YES
Reminders (<5 or >65)
20%
Patient-Specific education
10%
Electronic patient access to information
Medication reconciliation
50%
Summary of Care provided for transitions of care
Labs as structured data can be chosen if Quest labs are an option. If not, Electronic patient access to information can be chosen.

11. MU Stage 1 Clinical Quality Measures – Reportable through EHR Report 3 core or alternate core
CORE MEASURES
1. Hypertension: Blood Pressure Measurement
2. a. Tobacco Use Assessment b. Tobacco Cessation Intervention
3. Adult Weight Screening and Follow-up
ALTERNATE CORE MEASURES
1. Weight Assessment and Counseling for Children and Adolescents
2. Influenza Immunization for Patients ≥ 50Years Old
3. Childhood Immunization Status

12. MU Stage 1: Clinical Quality Measures Additional set
Choose and submit 3 additional quality measures from a list of 38
Chooses measures appropriate to your specialty
Do not have to achieve any particular number in the measure reported
Primary care physicians can achieve this requirement by reporting on a single disease – Diabetes Mellitus

13. What do I do? Physicians/Nurse practitioners/PAs
A. Electronic prescriptions
Computerized physician order entry (medication only)
B. Report on core or alternate core measures
Tobacco Use Assessment and Tobacco Cessation Intervention
Weight
a. Adult Weight Screening and Follow-up
b. Weight Assessment and Counseling for Children and Adolescents (pediatrics)
Order influenza vaccine for patients >50 (substitute for 1 or 2 above)
C. Choose and report 3 quality measures for your specialty
Diabetes recommended for primary care
D. Order labs through Quest

14. What do I do? Physicians/NPs/PAs Data Review recommended for patient safety Review is not mandated for Meaningful Use
Problem List
Medication related information
Active Medication Allergy List
Active Medication List
Drug-drug and drug-allergy alerts (automatically fire)
Drug formulary information
Smoking Status (>13 y.o.a.)
Vital Signs and Growth Charts (Growth charts – peds)
Labs received into EHR
Childhood immunization status (pediatricians)

15. What do I do? Medical Assistant
Enter Problem List
Based on provider’s prior note
Active Medication Allergy List
Enter based on old records and patient report
Active Medication List
Enter patient’s current medication
Smoking Status (>13 y.o.a.)
Record patient’s smoking status
Vital Signs and Growth Charts
Enter vital signs and growth charts at each visit
Measure blood pressure

16. What do I do? Business/Administration/Front office
Demographics entry
Ensure all patients have all demographics and insurance information and map to Newcrop
Clinical Summaries
Give each patient a copy of their clinical summary
Electronic copy of health info
Give or send patients electronic copy of health info upon request
Privacy and security of patient data in EHR
Plan, monitor, report

17. What do I do? Practice designee – ZoomMD to assist
Build
clinical decision support rule – one rule
Setup
practice to receive electronic lab results from Quest
Test
Electronically exchange information
Electronic Immunization data
Syndromic Surveillance
Done automatically
Drug formulary checks
Turn on drug-drug and drug-allergy alerts
Patients and conditions list

18. Zap your prescriptions electronically
Physicians: Four steps to Meaningful Use Physician role + other roles = achievement of meaningful use
Zap your prescriptions electronically
Prescribe electronically
Offer assistance with weight reduction.
Review patient weight and follow-up as required
Offer tobacco cessation help.
Review tobacco use and intervene as required
Measure clinical quality.
Record data as required for selected clinical quality measures

19. Why is it important for me the physician to achieve Meaningful Use?
Enhance quality of care
Meaningful use criteria will become standard of care
Improved communication with other physicians
Collection of data in structured format will enable data analysis and can drive outcomes
Incentive payments

20. Medicare program: Incentive Payments for Eligible Professionals (physicians) for Meaningful Use of EHR In dollars. Green = Assumes providers meet all criteria in 2011 or 2012
Funding year
Adoption year
2011
2012
2013
2014
2015
18000
12000
8000
15000
4000
2000
2016
TOTAL
44000
39000
24000
PENALTY

21. Medicare Penalties for not meeting MU Penalties are applied to each physician’s Medicare payments
2015
2016
2017 and beyond 1% 2% 3%

22. Eligible professional (physician) – Medi-Cal incentive payments (Dollars) Medi-Cal program has no penalties. Typical schedule.
Calendar year
Adoption year
2011
2012
2013
2014
2015
2016
21250
8500
2017
2018
2019
2020
2021
TOTAL
63750