PA REACH East: Your Trusted Partner in Achieving Meaningful Use of Electronic Health Records

By Donald F. Wilson, M.D.

For the first time we, as a society, possess both the knowledge and the technology to transform the medical practice, empower patients, and significantly improve healthcare through the “meaningful use” of Electronic Health Records (EHRs).  Thanks to the national Health Information Technology for Economic and Clinical Health Act (HITECH), enacted as part of the 2009 American Recovery and Reinvestment Act (ARRA), a substantial amount of federal funds have been made available to help providers transition to a certified EHR system, and achieve meaningful use (MU) of the technology.  A portion of this funding was allocated to create a network of state-based Regional Extension Centers (RECs), whose primary initiative is to serve as a trusted consultant and support system to providers who are adopting or upgrading to a certified EHR system.

PA REACH East is the REC for eastern Pennsylvania, and has hit the ground running in their efforts to assist primary care providers.  PA REACH East is working hard to meet their goal of supporting approximately 5,700 priority primary care providers (small practices and those serving safety-net populations) to achieve meaningful use of EHRs and enable statewide health information exchange.

The federal government developed the meaningful use (MU) rule to ensure that health care providers effectively use the tremendous capabilities that a certified EHR system can deliver.  PA REACH has assembled a team of experienced and knowledgeable professionals that serve as trusted advisors to help providers navigate through the sometimes-confusing maze that is meaningful use.

By achieving the milestone of MU, Pennsylvania’s health care providers will not only be qualified for the incentive funds available from the Centers for Medicare & Medicaid Services (CMS), but will also provide patients with a superior level of care. It is important to note that the measures required to meet MU are closely aligned with the key initiatives of Patient Centered Medical Home. PA REACH is currently assisting several practices with their applications for Medical Home Certification.

The services provided by PA REACH East are available at a minimal cost, but have proven to be invaluable to providers across the state. PA REACH East understands that transitioning to a certified EHR system is a significant undertaking for any practice, and will provide project management from contract signing through data submissions for MU. Here are just some of the invaluable services the PA REACH East team will provide to their contracted practices:

• Vendor Selection: PA REACH East will work with practices to select and implement ANY certified EHR vendor.  PA REACH East will help practices “ask the right questions” during the vendor preview process, serving as a trusted advisor as to the system functionality  needed to meet daily operational needs, as well as the reporting capabilities needed to attest to MU. PA REACH East practices have the opportunity to take advantage of pre-negotiated volume discounts from certified EHR vendors that have been selected to participate in PA REACH East’s “Group Purchasing Options”.  For a list of these vendors, please visit the Vendor page on their Web site at: http://www.pareacheast.org/Pages/For-Vendors.aspx
• Workflow Re-Design: PA REACH East project coordinators will conduct on-site analysis of each practice’s current workflow, identifying any areas for improvement, and helping to implement changes most conducive to EHR implementation. They will also assess a practice’s specific needs and develop customized criteria useful in selecting a certified EHR system.
• EHR Implementation: PA REACH East will assist practices with achieving effective implementation of a certified EHR product, including extensive staff training, and pre-implementation planning.
• Meaningful Use Expertise: PA REACH East will serve as an experienced guide to lead practices towards achieving “Meaningful Use” of their EHR systems.  They will assist with the performance of the quality checks needed to ensure optimal of system capability, while also ensuring that EHR systems have the data submission capabilities needed to attest to MU.  PA REACH East will also teach staff how to submit the data necessary to become eligible for financial incentives from CMS. PA REACH East will be beta testing CMS’s Meaningful Use Attestation tool, further enhancing their ability to effectively assist practices in this important process
• Compliance with Privacy & Security Requirements: Maintaining the privacy & security of health information is of the utmost of importance in transforming medical record keeping into an electronic world.  The PA REACH East coordinators, in conjunction with their highly trained Privacy and Security Officer, will ensure that EHR systems are in compliance with the legal, regulatory, professional and ethical requirements needed to protect the integrity, privacy and security of patients’ health information.
• Best Practices: The PA REACH East team will be able to share with practices an “inside look” at best practices and lessons learned from the extensive experience they have gained from working with providers across the Commonwealth.

Why do providers need to act now? The clock is ticking! The federal funds that are fueling the movement toward health information technology (HIT) across the country will only be available for a limited time! The American Recovery and Reinvestment Act (ARRA – the economic stimulus bill) allocated millions of dollars to be used to encourage health care providers to implement EHRs into their practice or facility, with strict deadlines. The funding has been made available in a two-fold approach:

1. CMS Incentive Programs: Incentive payment plans that provide direct payments to all eligible providers who successfully attest to MU criteria by set deadlines (up to $44,000 from Medicare, or up to $63,750 from Medicaid)

1. RECs: EHR consultant organizations (PA REACH East & West) that are 90% subsidized by the federal government to provide low cost EHR consultant services for providers

This federal funding will only be available for a limited time, so providers need to get on board NOW to ensure that they are able to take advantage of the maximum benefits of this program.  Please see the charts below for a snapshot of the incentive programs.

Incentive Payments for Medicare Eligible Providers (EPs)

First Calendar Year (CY) for which the EP receives an incentive payment

CY 2011

CY 2012

CY 2013

CY 2014

CY 2015

and later

CY 2011

$18,000

CY 2012

$12,000

$18,000

CY 2013

$8,000

$12,000

$15,000

CY 2014

$4,000

$8,000

$12,000

$12,000

CY 2015

$2,000

$4,000

$8,000

$8,000

$0

CY 2016

$2,000

$4,000

$4,000

$0

TOTAL

$44,000

$44,000

$39,000

$24,000

$0

Incentive Payments for Medicaid Eligible Providers (EPs)

First Calendar Year (CY) for which the EP receives an incentive payment

CY 2011

CY 2012

CY 2013

CY 2014

CY 2015

CY 2016

CY 2011

$21,250

CY 2012

$8,500

$21,250

CY 2013

$8,500

$8,500

$21,250

CY 2014

$8,500

$8,500

$8,500

$21,250

CY 2015

$8,500

$8,500

$8,500

$8,500

$21,250

CY 2016

$8,500

$8,500

$8,500

$8,500

$8,500

$21,250

CY 2017

$8,500

$8,500

$8,500

$8,500

$8,500

CY 2018

$8,500

$8,500

$8,500

$8,500

CY 2019

$8,500

$8,500

$8,500

CY 2020

$8,500

$8,500

CY 2021

$8,500

TOTAL

$63,750

$63,750

$63,750

$63,750

$63,750

$63,750

The ultimate goal of health information technology (HIT) is to build a health information exchange that will significantly elevate the level of patient care in the United States. By developing a safe, secure, and highly functional network that will allow medical information to be transferred and shared, health care practices will also benefit from higher productivity, process efficiencies, and cost savings. The key to success is to make sure that all providers implement certified EHR systems that can effectively interface and “talk to each other.” In order to make this a reality, the Office of the National Coordinator (ONC) has developed a list of certified EHR systems that feature the functionality needed to ensure this interface. Visit www.cchit.org/products/onc-atcb to see the most up-to-date list of ONC-ATCB certified EHR systems. In the Keystone state, the Pennsylvania Health Information Exchange (PHIX) is being developed to facilitate a statewide network.

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Donald F. Wilson, M.D., is Medical Director, Quality Insights of Pennsylvania and PA REACH.  He can be reached at dowilson@wvmi.org. For more details about PA REACH East, please visit: www.pareacheast.org , or call 1.877-346-6180 ext. 7815.  PA REACH East works jointly with their counterpart in the western portion of the state, PA REACH West. For more details about PA REACH West, please visit their Web site at: www.pareachwest.org.