1. esMD Pilot Project University of Pittsburgh Medical Center Human Engineering Research Laboratories www.herl.pitt.edu Brad E. Dicianno, MD, MS Associate Professor Physical Medicine and Rehabilitation Medical Director, UPMC Center for Assistive Technology

2. UPMC role Human Engineering Research Laboratories www.herl.pitt.edu -Center for Assistive Technology -Human Engineering Research Laboratories -Previous work in leading best practice in PMD documentation, CME courses -Active in PMD research

3. Overview of Pilot Human Engineering Research Laboratories www.herl.pitt.edu -Problems with incomplete documentation/denials -Need for electronic workflow -esMD clinical template -Alternative PDF workflow for clinics already following best practice

4. Standards demonstrated Human Engineering Research Laboratories www.herl.pitt.edu -Ability to produce and transmit a PDF from EMR -Ability to share document with vendor and collaboratively complete documentation -Ability to transmit the PDF to CMS via HIH with proper metadata

5. Resources Needed Human Engineering Research Laboratories www.herl.pitt.edu -Clinician experts are key -Clinical office staff who submit documentation -Supplier/Vendor -HIH -CMS -EMR team e.g. EpicCare

6. Pilot Ecosystem Human Engineering Research Laboratories www.herl.pitt.edu Payer Patient LCMP DME Supplier Physicians Content Transport Services ECM CMS Private Network Medicare Administrative Contractors 6 HIH eClinical Template University of Pittsburgh Clinical PDF Bundled PDF Detailed Product Description Clinical PDF + LCMP Evaluation

7. Other Partnerships Human Engineering Research Laboratories www.herl.pitt.edu -NuMotion -EpicCare -Other HIH?

8. Measures of Success Human Engineering Research Laboratories www.herl.pitt.edu - Successful transmission of complete PDF - Ability to transmit PDF via different workflows

9. Timeline Human Engineering Research Laboratories www.herl.pitt.edu -Obtain example of best practice documentation -Assemble collaborative team -Identify metadata to be transmitted -PDF Generation -Approval of HIH for collaboration -Begin process of testing workflow

10. Lessons Learned Human Engineering Research Laboratories www.herl.pitt.edu -Input from clinicians is key -Need significant support from EMR vendor -Many steps to get workflow through HIH in place -Collaboration by CMS and Vendor crucial

11. Questions? Human Engineering Research Laboratories www.herl.pitt.edu dicianno@pitt.edu