1. NeHII Annual Meeting August 1 st, 2013 Marty Fattig, CEO Nemaha County Hospital

2. Last Year Waiting for Stage 2 Final Rule Issued on September 4, 2012 One year delay 90-day Attestation Period 2014 edition of Stage 1 Very steep climb Little flexibility Clinical Quality Measures Patient portal Public health reporting

3. Stage 3 Four Subcommittees Quality Patient Engagement Care Coordination Population Health Granularity of Data

4. Stage 3 Quality Demographics eCQMs Outcomes measures Patient Engagement Expanded use of patient portal Patient Generated Data

5. Stage 3 Care Coordination Summary of care record Preparing for clinical integration (ACO’s, Value Based Purchasing, etc.) Transitions of care Population Health More public health exchange of data Interface with registries Public health data mining

6. Other Issues Stage 3 Request for Comments Over 600 Received Alternate approaches being considered Consolidation Team Deeming Team

7. ONC/CMS Messages Marilyn Tavenner statement Farzad Mastashari Keynote Triple Aim Better Health, Better Healthcare, Lower Cost

8. My Efforts January Letter May 1 st Meeting 12 Federal Attendees 15 Rural hospital representatives Issues Addressed Financial Timeline Vendor Availability and Capacity Payment for CAH Rural Health Clinics HIE’s

9. Senate Finance Committee Hearing Those Asked to Testify Janet Marchibroda, Director, Health Innovation Initiative, Bipartisan Policy Center, Washington, DC John Glaser, Ph.D., Chief Executive Officer, Health Services, Siemens Healthcare, Malvern, PA Dr. Colin Banas, MD, Chief Medical Information Officer and Associate Professor, Virginia Commonwealth University, Richmond, VA Mr. Marty Fattig, Administrator and Chief Executive Officer, Nemaha County Hospital, Auburn, NE

10. Senate Finance Committee Hearing Main Messages Stretch Out the Timeline Make the Objectives more flexible Close the digital divide between urban and rural Three years at each stage for all providers 2014 Time crunch This is hard regardless of size Revisit original congressional intent: EHRs HIEs “Reboot” http://www.finance.senate.gov/hearings/hearing/?id=510032e9- 5056-a032-52e0-a289c076ea2e http://www.finance.senate.gov/hearings/hearing/?id=510032e9- 5056-a032-52e0-a289c076ea2e

11. Role of Health Information Exchanges More important than ever Re-double efforts to standardize and connect Role of “Direct” protocol Support financially sustainable models

12. Contact Information Marty Fattig 2022 13 th Street Auburn, NE 68305 (402) 274-4366 mfattig@nchnet.org