3. Meaningful Use The Catalyst for Connected Health Sameer Bade Strategic Product Planner

4. One Year Ago….  American Recovery and Reinvestment Act (ARRA) –Total: $787 Billion –Healthcare (total): $59 Billion  Health Information Technology for Economic and Clinical Health (HITECH) Act –$20 Billion net investment to drive adoption of electronic health record (EHR) technology –Payments beginning October 1, 2011 (hospitals) and January 1, 2012 (eligible providers or EPs) –Stimulus turns to penalties after 2015

5. Meaningful Use Calendar of Events Dec Jan Feb Mar Apr May June 2011 2012 2013 2014 Regulations Released Regulations published in Federal Register. 60-day comment period begins. Comment period closed. CMS finalizes and publishes Final Rule in Spring of 2010. Incentive payments released. Stage 2 criteria proposed. Stage 3 criteria proposed. CMS Timeline Today Review public comments and develop further recommendations Interim final rule from ONCHIT with initial set of standards, certification criteria, and implementation specifications for Stage 1 of the EHR incentive program Refine Stage 2 meaningful use criteria. ONC publishes the Certification Process rules

6. Certification  Aimed at vendors –Criteria and specifications defined in Interim Final Rule –Process document not yet published  Can be done in two ways: –“Complete EHR Certification” certifies that the vendor’s entire system meets the full set of requirements. Integration burden falls to vendor. –“Modular EHR Certification” certifies that the vendor’s system meets one or more of the capabilities required. Integration burden fall to buyer  Certification is required to permit the buyer to get stimulus funds.  Microsoft will pursue Modular Certification for HealthVault Community Connect Meaningful Use Reporting  Aimed at hospitals and EPs.  Have to demonstrate meaningful use of certified electronic medical record (EMR) systems by reporting specific measures tied to a set of objectives.  The criteria for meaningful use are defined in three stages –Stage 1 requirements for reporting in 2011 are the only ones presently defined. –Stage 2 requirements will soon be defined and will be required beginning in 2013 and finally –Stage 3 requirements will be required beginning in 2015.  Meaningful use is organized around broad themes referred to as Health Outcome Policy Priorities. One-Two Punch 6© 2009 Microsoft Corporation. All rights reserved. Microsoft Confidential

7. Health Outcome Priorities and Care Goals – Stage 1

8. Engage patients and families in their health care Improve care coordination At least 80% of all patients who request an electronic copy of their health information are provided it within 48 hours At least 80% of all patients who are discharged from an eligible hospital and who request an electronic copy of their discharge instructions and procedures are provided it At least 10% of all unique patients seen by the EP are provided timely electronic access to their health information Clinical summaries are provided for at least 80% of all office visits Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information Provide summary of care record for at least 80% of transitions of care and referrals Perform medication reconciliation for at least 80% of relevant encounters and transitions of care A Closer look at Objectives and Measures

9. Data capture and sharing Advanced clinical processes Improved outcomes Long-term Approach to Meaningful Use 9 o Stage 1 – 2011 Stage 2 – 2013 Stage 3 – 2015

10.  The longer term purpose of this entire Act is to drive improvements in care quality and cost performance.  Healthcare organizations should be looking at technologies and vendors that are addressing the longer term goals: –Providing a comprehensive patient view, –Allowing for real-time patient cohorting, –Seeing real-time performance against quality measures. –Connecting beyond the health system walls –Engaging patients in their health and wellness, –Assisting in coordinated care, and –Allowing early detection and reporting of key public health indicators.  Finally, all these capabilities have to be grounded in a commitment to secure data exchange and patient privacy. Stage 1 is the beginning…. Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning. Sir Winston Churchill, 1942

11. Microsoft Amalga UIS and HealthVault Your Bridge to Meaningful Use Existing Electronic Health Record(s)

12. Enables clinicians to exchange key clinical information and provides data supporting medication reconciliation Working toward integration of Amalga UIS with HealthVault to provide a Summary of Care Record for every patient Meaningful Use “Every time we look at data from another source, we save $400 because we are not duplicating what has been done” Dr. John Whitcomb Medical Director Aurora Healthcare Meaningful Use Engage Patients & Families Improve Care Coordination Improve Population & Public Health

13. Improve Quality and Availability of information at the point of admission Consistent Delivery of Summarized Patient Information to Interested Physicians with every Discharge Direct Access & Ownership of Health Data for all NYP Patients Connected Community “The vision for what myNYP.org could be is a place where you, in a very trusting way, can store information, enter it in, own it, control it,understand it, and share it.” Dr. Mehmet Oz Vice Chairman & Professor of Surgery, NYP Columbia University Meaningful Use

14. General Health Information Health History Discharge Instructions Lab & Test Results Medications EKGs & Images myNYP.org Engage Patients & Families Improve Care Coordination Improve Population & Public Health

15. Delivering Beyond Meaningful Use Engage Patients & Families Improve Care Coordination Improve Population & Public Health Improve Quality, Safety & Efficiency Ensure Privacy & Security Protections ARRA HITECH 5 Policy Priorities Measure Reporting Provide patients with access to their health information Provide patients with an electronic copy of their health information Exchange key clinical info. among providers w/patient authorized entities Record smoking status for patients Generate lists of patients by specific conditions to use for quality improvemen t Send reminders to patients

16. Key Points 16© 2009 Microsoft Corporation. All rights reserved. Microsoft Confidential  We believe we have strong offering aimed squarely at two of the broader areas of Meaningful Use.  Microsoft will pursue Modular Certification for HealthVault Community Connect.  Our roadmap will continue to build out capabilities needed to maintain certification over Stage 2 and 3.  Meaningful use is really about the “use” – so focus on customer readiness and getting to production fast.  Payments cannot be collected until the customer gets system into use for at least 3 months (initially) and then is able to report against the required measures

17. This material is provided for informational purposes only. Microsoft makes no warranties, express or implied. ©2010 Microsoft Corporation