1. HIT Standards Committee Implementation Workgroup Liz Johnson, Tenet Healthcare, Co-Chair Judy Murphy, Aurora Health Care, Co-Chair January 12, 2011

2. Implementation Workgroup Members Co-Chairs Judy Murphy Aurora Health Care Liz Johnson Tenet Healthcare Corporation Members Rob Anthony Centers for Medicare & Medicaid/CMS Lisa Carnahan National Institute of Standards and Technology/NIST Anne Castro BlueCross BlueShield of South Carolina Simon P. Cohn Kaiser Permanente John Derr Golden Living, LLC Carol Diamond Markle Foundation Timothy Gutshall Iowa HIT Regional Extension Center Joseph Heyman Whittier IPA Kevin Hutchinson Prematics, Inc. Lisa McDermott Cerner Corporation Nancy Orvis Dept. of Defense Wes Rishel Gartner, Inc. Cris Ross Surescripts Kenneth Tarkoff RelayHealth Micky Tripathi MA eHealth Collaborative Tim Morris Emory University Mera Choi Office of the National Coordinator/ONC Ex Officio Aneesh Chopra Chief Technology Officer, OSPT

3. Real World Experiences - MU Hearing Panels 1.Implementation Support – Regional Extension Centers (Monday, Jan 10th) 2.Implementation Support – EHR Certification (Monday, Jan 10th) 3.Implementation Support – Health Information Exchange (Tuesday, Jan 11th) 4.Early Adopters Seeking Attestation - Eligible Providers Experience (Tuesday, Jan 11th) 5.Early Adopters Seeking Attestation – Eligible Hospitals (Tuesday, Jan 11th)

4. Panelist Questions Identify your challenges, barriers, and successes. Outline the implementation approaches and methodologies you used that worked and didn’t work. Include any real-world user stories, illustrations, or examples. Discuss your outcomes/results. Include any surprises or unexpected outcomes and how you addressed them? Describe your experience using the ONC and CMS communications regarding the meaningful use criteria, standards specifications and measurement.

5. Panel 1: Regional Extension Centers Paul Kleeberg, MD, Clinical Director, MN/ND Regional Extension Assistance Center Dan Nelson, Desert Ridge Family Practice, Phoenix, AZ Lisa Levine, MPH, Vice President-Operations, Family Health Center of Worcester, MA Clayton Gillett, Executive Director, O-HITEC, Oregon’s Regional Extension Center Mat Kendall, Office of the National Coordinator

6. Alisa Ray, Executive Director, CCHIT Patricia Daiker, RN, Vice President, Medhost John Travis, Senior Director – Regulatory Compliance, Cerner Brad Melis, Founder and Executive Vice President, ChartLogic Carol Bean, Office of the National Coordinator Panel 2: Certification

7. Linda Reed, CIO, Atlantic Health & Board Member, NJ Health Connect James A. Fuzy, President & CEO, Mississippi Health Partners Reid W. Coleman, MD, Lifespan, RI Claudia Williams, State HIE, Office of the National Coordinator Panel 3: Health Information Exchange

8. Careen Whitley, MD, Hill Physicians Group, San Francisco, CA Lyle Berkowitz, MD, Northwestern, IL Robert Murry, PhD, MD, Hunterdon Healthcare, NJ Scott Hammer, MD, Southern Delaware Medical Group Scott Monteith, MD, Michigan State University & Private Practice Willa Drummond, MD, Professor, University of Florida Richard Sadja, CFO, Family Practice, Glendale, CA Harm Scherpbier, MD, CMIO, Main Line Health, PA Robert Anthony, Centers for Medicare and Medicaid – Reactor Josh Seidman, ONC – Reactor Panel 4: Early Adopters – Eligible Providers

9. Panel 5: Early Adopters – Eligible Hospitals Joanne Sunquist, RN, CIO, Hennepin CO Medical Center, MN Nancy Vogt, Deputy Chief Compliance Officer, Aurora Health Care, WI Chuck Christian, CIO, Good Samaritan Hosp, IN Denni McColm, CIO, Citizen’s Memorial Hospital, MO Brian Jacobs, MD, VP & CMIO, Children’s National Medical Center, Washington DC Russ Branzell, CIO, Poudre Valley Regional Med Center, CO Joel C. Berman, MD, CMIO, & Josie Bendiks, CIS Director, Concord Hospital, NH Len Bowes, MD, Intermountain Health, UT Robert Anthony, Centers for Medicare and Medicaid - Reactor

10. Regional Extension Centers –Mixed reviews of value –Variation from region to region – cost, customers, definitions –“Best practice” unclear Certification –Certification process working well –Certification Rule – purchasing/implementation challenges Modules vs. Complete Definition of a vendor’s “complete” EHR Mix and Match 2 vendors’ products to use as “complete” Health Information Exchanges –Want interoperability standards specified ASAP –Sustainability and value proposition still unclear –Varying initiatives – unsure when/how to align What We Heard

11. What We Heard – Eligible Providers and Hospitals Timing Issues - MU Criteria finalized in July 2010 –Late vendor software changes –Late certification of vendor products –Late delivery of upgrades to providers/hospitals Communication –Want prompt responses – FAQ’s and Help Desk –Want consolidated documentation to understand regulations – CMS and ONC - reliable, clear and complete explanations in one place (single source of truth) Quality Measures difficult Variety of implementation stories Want “Meaningful Use” Roadmap

12. A Look Back … Top Ten Recommendations from the Implementation/Adoption Experience Hearing on 10/29/09 1.Keep it simple. 2.Don’t let “perfect be the enemy of “good enough.” 3.Keep the implementation cost as low as possible. 4.Design for the little guy. 5.Do not try to create a one-size-fits-all standard. 6.Separate content and transmission standards. 7.Create publicly available vocabularies & code sets. 8.Leverage the web for transport (“health internet”). 9.Position quality measures so they motivate standards adoption. 10.Support implementers.

13. Summarize all hearing findings Compare with the initial “Top Ten” Recommendations Formulate recommendations Discuss with Standards Committee Chairs Discuss with HITPC Adoption and Certification Workgroup Chairs Create Action Plan Report back to HITSC Next Steps