What Meaningful Use What Meaningful Use Means to Your Means to Your PracticePractice

Speaker: Abdiel Marin Speaker: Abdiel Marin (Ab-Dee- L)(Ab-Dee- L)

President & Lead Developer forPresident & Lead Developer for

EyeMD EMR Healthcare Systems, Inc.EyeMD EMR Healthcare Systems, Inc.

Intro to Meaningful UseIntro to Meaningful Use

• Meaningful use is real, well funded, and is not Meaningful use is real, well funded, and is not going awaygoing away

• As of 5/31/2012 As of 5/31/2012 113,497 EPs & EHs have been reimbursed a total 113,497 EPs & EHs have been reimbursed a total

of 5.7 Billion of 5.7 Billion Dollars: 21.2 Billion is leftDollars: 21.2 Billion is left1181 Ophthalmologists have been reimbursed1181 Ophthalmologists have been reimbursed2394 Optometrists have been reimbursed2394 Optometrists have been reimbursed

• You will receive payment 6-8 weeks after attesting You will receive payment 6-8 weeks after attesting

• $44,000 in payments per Medicare provider are $44,000 in payments per Medicare provider are available if you start available if you start nownow

• It is easier for an Ophthalmologist to achieve It is easier for an Ophthalmologist to achieve Meaningful Use than a Primary Care Physician!Meaningful Use than a Primary Care Physician!

Waiting Will Cost YouWaiting Will Cost You• Waiting will reduce your Incentive ReimbursementWaiting will reduce your Incentive Reimbursement• Penalties will start in Penalties will start in 3 Years3 Years for MU. E-Rx already for MU. E-Rx already

started, PQRS penalties start next year.started, PQRS penalties start next year.• The Government expects you to procrastinate. The Government expects you to procrastinate.

• Unused MU funds will be deposited into the US Treasury Unused MU funds will be deposited into the US Treasury General Fund, penalties will decrease Medicare’s General Fund, penalties will decrease Medicare’s liabilities.liabilities.

Waiting Will Cost YouWaiting Will Cost YouE-Rx PenaltiesE-Rx Penalties

• 1.5% Penalty for 2013 if you did not send at 1.5% Penalty for 2013 if you did not send at least 10 E-Rx’s by June 30, 2012.least 10 E-Rx’s by June 30, 2012.

• 2% Penalty for 2014.2% Penalty for 2014.

PQRS PenaltiesPQRS Penalties• 1.5% Penalty for 2015 if you don’t report PQRS 1.5% Penalty for 2015 if you don’t report PQRS

for 2013!for 2013!• 2% Penalty every year after.2% Penalty every year after.

Total Penalty per Doctor billing 1mil MCR per Total Penalty per Doctor billing 1mil MCR per yearyear

• 2013 Total Penalty = 3% + $5,0002013 Total Penalty = 3% + $5,000 = $35,000= $35,000• 2014 Total Penalty = 4% + $15,0002014 Total Penalty = 4% + $15,000 = $55,000= $55,000• 2015 Total Penalty = 3% + $24,0002015 Total Penalty = 3% + $24,000 = $54,000= $54,000• 2016 Total Penalty = 4%2016 Total Penalty = 4% = $40,000= $40,000• 2017 Total Penalty = 5%2017 Total Penalty = 5% = $50,000= $50,000• 2018 Total Penalty = 7%2018 Total Penalty = 7% = $70,000= $70,000

Total Total = = $304,000 per Doctor$304,000 per Doctor

EMR Selection is Critical EMR Selection is Critical to Your Successto Your Success

• Achieving Meaningful Use should be easy and Achieving Meaningful Use should be easy and automaticautomatic

• MU is a great reimbursement program to help you MU is a great reimbursement program to help you modernize your practice, but selecting the wrong modernize your practice, but selecting the wrong EMR/EHR can easily spoil the incentive.EMR/EHR can easily spoil the incentive.

• An EMR should help streamline your practice, if it An EMR should help streamline your practice, if it hurts it something is wrong.hurts it something is wrong.

• The Meaningful Use Incentive will not offset the The Meaningful Use Incentive will not offset the costs associated with selecting the wrong EMR. costs associated with selecting the wrong EMR.

DO YOUR DUE DILIGENCE!DO YOUR DUE DILIGENCE!

How to Select an EMRHow to Select an EMRMake Sure the EMR is Make Sure the EMR is

ONC-ATCB ONC-ATCB Complete EHR CertifiedComplete EHR Certified

A Modular Certification will require you to purchase solutions from A Modular Certification will require you to purchase solutions from other vendors in order to achieve Meaningful Useother vendors in order to achieve Meaningful Use

Types of EMR SoftwareTypes of EMR Software

A Template EMR is an EMR that offers you a software structure that you A Template EMR is an EMR that offers you a software structure that you customize entirelycustomize entirely

PROSPROS

• You can customize the system in any way that you likeYou can customize the system in any way that you like• Multispecialty Clinics can use 1 EMR for all their specialtiesMultispecialty Clinics can use 1 EMR for all their specialties

CONSCONS

• Difficult & costly to customizeDifficult & costly to customize• Will require at least 1 year of customizations before you can go liveWill require at least 1 year of customizations before you can go live• Will require years of customization before it is perfectedWill require years of customization before it is perfected• You will likely not benefit from improvements suggested by other practicesYou will likely not benefit from improvements suggested by other practices• Future regulations may have a severe impact on your templates, forcing you Future regulations may have a severe impact on your templates, forcing you

to either redesign them, or modify them to adhere to regulations.to either redesign them, or modify them to adhere to regulations.• Extracting/Trending data from your EMR will be difficult and costlyExtracting/Trending data from your EMR will be difficult and costly• You may have to redo your templates after a major software version changeYou may have to redo your templates after a major software version change• The EMR will not have advanced automations that help to streamline data The EMR will not have advanced automations that help to streamline data

entryentry• You will likely not have advanced integrations with Diagnostic EquipmentYou will likely not have advanced integrations with Diagnostic Equipment• Vendor is not invested in your specialty, and will likely ignore the specialty if Vendor is not invested in your specialty, and will likely ignore the specialty if

they feel another specialty is more lucrative.they feel another specialty is more lucrative.• You will likely not have the resources to perfect & maintain the EMRYou will likely not have the resources to perfect & maintain the EMR

Template EMR vs. Specialty EMRTemplate EMR vs. Specialty EMR

Types of EMR SoftwareTypes of EMR Software

A Specialty EMR is an EMR that was designed specifically and only for your Specialty A Specialty EMR is an EMR that was designed specifically and only for your Specialty (Ophthalmology)(Ophthalmology)

PROSPROS

• You will not have to customize the structure of the softwareYou will not have to customize the structure of the software• The EMR customization process is reduced by 80% as you will only be customizing The EMR customization process is reduced by 80% as you will only be customizing

settings specific to your practicesettings specific to your practice• You can go live in 2-3 months, tech savvy practices much soonerYou can go live in 2-3 months, tech savvy practices much sooner• You will benefit from cumulative suggestions from other usersYou will benefit from cumulative suggestions from other users• Data can be easily mined for clinical studies & marketingData can be easily mined for clinical studies & marketing• Data entry can be automated & streamlined for efficiency & functionalityData entry can be automated & streamlined for efficiency & functionality• Ophthalmic relevant data is emphasizedOphthalmic relevant data is emphasized• Clinicians will feel that the software was designed just for themClinicians will feel that the software was designed just for them• Vendor is invested in the specialty, and will pay more attention to your needs.Vendor is invested in the specialty, and will pay more attention to your needs.• Vendor will make significant efforts to interface with all Ophthalmic Diagnostic Vendor will make significant efforts to interface with all Ophthalmic Diagnostic

equipment, some at no cost to youequipment, some at no cost to you

CONSCONS

• Major structural changes cannot be made by the userMajor structural changes cannot be made by the user• Clinics with Non-Ophthalmology related specialties will likely require a separate EMRClinics with Non-Ophthalmology related specialties will likely require a separate EMR

BEWARE OF TEMPLATE EMRs DISGUISED AS A SPECIALTY EMR!BEWARE OF TEMPLATE EMRs DISGUISED AS A SPECIALTY EMR!Only a handful of Ophthalmology Specialty EMRs existOnly a handful of Ophthalmology Specialty EMRs exist

Template EMR vs. Specialty EMRTemplate EMR vs. Specialty EMR

How to Select an EMRHow to Select an EMR

• Is the EMR specifically designed for Ophthalmology?Is the EMR specifically designed for Ophthalmology?• Does the EMR present relevant clinical visit data in a Does the EMR present relevant clinical visit data in a

way that allows the Ophthalmologist to “eyeball” it way that allows the Ophthalmologist to “eyeball” it quickly & easily?quickly & easily?

• Can you customize the system “on the fly”?Can you customize the system “on the fly”?• Does the EMR include an Imaging System?Does the EMR include an Imaging System?• If so, can you easily compare multiple images?If so, can you easily compare multiple images?• Is the quality of the Image Degraded when in the Is the quality of the Image Degraded when in the

EMR?EMR?• Can you create & apply predefined treatment plans?Can you create & apply predefined treatment plans?• Does the EMR require minimal clicks/typing?Does the EMR require minimal clicks/typing?• Does the EMR have a good track record for customer Does the EMR have a good track record for customer

service?service?

What What ReallyReally Makes an EMR/EHR Good or Bad Makes an EMR/EHR Good or Bad

How to Select an EMRHow to Select an EMR

• Find out how many users are live and still using the EMR system, not their practice management system.

• Ask for 2-3 EMR References and call them• Ask them “Does anyone in your practice have any vested interest

with the Company?”• Ask them “Are you 100% live on the system?”• Ask them “Are you happy with their Customer Service?”• Ask them “Do your support requests get resolved in a timely

manner?”• Ask them “If you had to purchase another EMR, would you purchase

this EMR again?”• Get the Doctors and Technicians involved in the Final Selection

Process• Be wary of Misleading Sales Demo Techniques

• Require the demonstrator enter all new data for an entire New Patient Visit

• Pay attention to how much customization will be required before the EMR can be useful to your practice

• When things appear to happen quickly, ask the demonstrator exactly what they are doing on the keyboard/mouse

• Some EMR demonstrators will prepare windows and minimize them, then pop them up quickly in an effort to mask the steps necessary to navigate to that area. Require them to close it and open the same screen again if you are suspicious of this.

Do Your Due DiligenceDo Your Due Diligence

How to Select an EMRHow to Select an EMR

• Does the Meaningful Use Measure Calculation Report help you Does the Meaningful Use Measure Calculation Report help you understand and correct measure specific issues?understand and correct measure specific issues?

Meaningful Use Features to Look ForMeaningful Use Features to Look For

How to Select an EMRHow to Select an EMR

• Does the EMR have the capability to submit Clinical Does the EMR have the capability to submit Clinical Summaries to a cost effective Patient Web Portal?Summaries to a cost effective Patient Web Portal?

• If so, how much does it cost and do you need a secure If so, how much does it cost and do you need a secure web server?web server?

• Does the Interface to the Practice Management System Does the Interface to the Practice Management System transfer Race, Ethnicity, and Preferred Language to the transfer Race, Ethnicity, and Preferred Language to the EMR?EMR?

• Can prescribed medications that originate in the Can prescribed medications that originate in the patients EMR record transfer seamlessly patients EMR record transfer seamlessly TOTO the E-Rx the E-Rx solution?solution?

• Does the EMR system gather information from the Does the EMR system gather information from the patient’s record and only asks relevant questions, or patient’s record and only asks relevant questions, or does it require you to fill out a Long Meaningful Use does it require you to fill out a Long Meaningful Use Questionnaire for each visit?Questionnaire for each visit?

Meaningful Use Features to Look ForMeaningful Use Features to Look For

Meaningful Use ResourcesMeaningful Use Resources

• Visit www.EyeMDEMR.com and click the link Visit www.EyeMDEMR.com and click the link for the Incentive Resource Centerfor the Incentive Resource Center

Here you will find simplified resources specific to Here you will find simplified resources specific to Ophthalmology to help you understand, register, Ophthalmology to help you understand, register, attest, and achieve Meaningful Useattest, and achieve Meaningful Use

Here you will also find a copy of this presentationHere you will also find a copy of this presentation

EyeMD EMR is a Certified Complete EyeMD EMR is a Certified Complete EMR designed specifically and only EMR designed specifically and only

for Ophthalmologyfor Ophthalmology

Thank you for Thank you for watching! Please watching! Please

visit us at our visit us at our booth in the booth in the Exhibit Hall!Exhibit Hall!