Your EHR Resource
Contact:
Dr. Martha Riddell and Dr. Carol Ireson
Meaningful Use Advisors, Kentucky REC
Martha.Riddell@uky.edu
Clires0@email.uky.edu
859-323-3090

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

ARRA…A Massive Stimulus for Health IT Adoption &HIE Expansion
Appropriations for Health IT
$2 billion for loans, grants & technical assistance for:
• National Resource Center and
Regional Extension Centers
• EHR State Loan Fund
• Workforce Training
• Research and Demonstrations
Appropriations for HIE
At least $300 million of the total at
HHS Secretary’s discretion for HIE development
• Funneled largely through States or qualified State-designated entities
• For planning and/or implementation
New Incentives for Adoption
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
$1.5 billion in grants through HRSA for construction, renovation and equipment, including acquisition of HIT systems
Broadband and Telehealth
$4.3 billion for broadband & $2.5 billion for distance learning/ telehealth grants

Bending the Curve Toward Transformed Health-Incentives for HIT Adoption
Achieving Meaningful Use of Health Data
Improved outcomes
Advanced clinical processes
Data capture and sharing
2009 2011 2013 2015
4

• 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.

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.

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

Who is a Medicare Eligible Provider?
Eligible Providers in Medicare FFS
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)

Who is a Medicaid Eligible Provider?
Eligible Providers in Medicaid
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)
• Children’s Hospitals

Providers Eligible for Incentives
Eligible Providers- Medicare
Eligible Professionals (EPs)*
Doctor of Medicine or Osteopathy
Doctor of Dental Surgery or Dental
Medicine
Doctor of Optometry
Doctor of Podiatric Medicine
Chiropractor
Eligible Hospitals*
Acute Care Hospitals
Critical Access Hospitals (CAHs)
Eligible Providers- Medicaid
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
Children’s Hospitals

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.

Medicare Incentives

Medicaid Incentives

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

Primary Care Physicians
• FPs, OB/Gyn, Peds, Int. Med
• Small practices (<10 prescribers; physicians, PAs,
ARNPs)
• Community health centers
• Rural clinicians and those with critical access hospitals
• Practices and clinics that serve the underserved

• Assistance with the Physician
Quality Reporting Initiative
• Continuing Medical Education
• Assistance with Medicare’s eprescribing initiative (eRx)

• 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

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

•
•
•

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

• Complete
Practice
Readiness
Assessment
• Identify Target
Improvement
Opportunities
• Address Practice
Readiness
Barriers
Initiation Phase
Planning
• Conduct a
Practice
Workflow
Assessment
• Perform MU Gap
Analysis
• Create a MU
Work Plan
• Facilitate Change
Management on EHR
Resources
• Assist with Selection and Purchase of HER
• EHR Implementation or
Modification for MU
• Facilitate HIE
Connectivity
Monitoring Phase
•
•
Provide Supplemental
UK REC Services
Continuing Education
• Onsite Coaching and
Mentoring
Implementation
Phase
Achieving
Meaningful Use
• Demonstrate
MU to CMS

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

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

• 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

2010
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)
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

“

Dr. Martha Riddell
Meaningful Use Advisor
Kentucky REC
Martha.Riddell@uky.edu
859-323-3090
Dr. Carol Ireson
Meaningful Use Advisor
Kentucky REC
Clires0@email.uky.edu
859-323-3090
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@uky.edu