EHR Update CPSP Annual Meeting November 7, 2012

1. EHR UpdateCPSP Annual MeetingNovember 7, 2012 Mary Wieg, NC III Program Standards Branch Maternal, Child and Adolescent Health Division

2. EHR Basics for PSCs • Read the MCAH/CPSP Policies and Procedures • CPSP documentation requirements are the same for electronic and paper records • Provider is responsible for demonstrating that their systems meet CPSP requirements • PSC provides TA re: CPSP requirements • PSC not expected to be an EHR expert. • EHRs are not required.

3. EHR Incentive Programs • There are Medicare and Medicaid programs • CMS administers Medicare program. • State administers Medicaid program • Providers must register at CMS • for M-Cal program at http://www.Medi-Cal.ehr.ca.gov • Program began in 2011 but providers may still register • First year incentives are for adoption, implementation, or upgrade (AIU)-attestation • Subsequent years providers must demonstrate “Meaningful Use” by submitting data.

4. What is Meaningful Use (MU)? • Providers must submit data to demonstrate their system’s functionality • Includes measures of quality, patient and family engagement, care coordination, and population and public health. • MU Stage 1 (2011-2013): • 15 required core objectives, and • 5 chosen from a menu of 10 measures • Demonstrate for 30-80% of patients, depending on measure • Many of the measures are applicable to pregnant and postpartum patients.

5. What is Meaningful Use (MU)? • Stage 2 (2014 and on): • Must meet Stage 1 first. • Must demonstrate for a larger percentage of their patient population • 17 core objectives and 3 menu objectives • Summary of Care Document at Transitions of Care and Referrals. • More Clinical Decision Support • More emphasis on health information exchange—ability to download and transmit • E-mails between patient and provider • New optional measures

6. EHR vs. Health Information Exchange (HIE) • An EHR functions in the care setting • HIE is electronic health information transfer so that patient information is available when and where it is needed for care, using privacy and confidentiality standards and procedures • California Office of Health Information Integrity (Cal OHII)—www.ohii.gov—is leading this effort. • Providers need to be aware of the interoperability of their EHR systems • The OHII has published a HIE Ready Buyer’s Guide, which is on their Web site.

7. Health IT is a Dynamic Field • Most first generation EHRs aren’t capable of Stage 2 MU, especially interoperability and HIE • In a survey in the Bay area, 71% of physicians had EMR, but only 30% could meet the MU objectives measured. • Many providers are replacing or upgrading their systems • Standards have stabilized • Industry leaders are predicting continuing competition and consolidation • We need to be flexible and continue to be a resource to providers so that they know the requirements. • Know your local Regional Extension Center

8. Help for Providers The HITECH Act established Regional Extension Centers to provide education, outreach and TA to primary care providers • California Health Information Partnership and Services Organization (CalHIPSO) • California Rural Indian Health Board • CalOptima’s Regional Extension Center • HITEC-LA