1. making better healthcare possible ® Meaningful Use Stage 2 The Changing Seasons of Healthcare Conference WV-HFMA/WV-HIMSS September 27, 2012

2. making better healthcare possible ® Agenda  Brief Overview of HIT Timeline and Stage 2 Timing  Stage 2 Core Objectives  Stage 2 Menu Items  Changes to Stage 1 in Stage 2 Final Rule  Summary of Stage 2 CQM & Reporting  Q&A 9/27/20122Santa Rosa Consulting - Meaningful Use Stage 2

3. making better healthcare possible ® It’s Finally Here…. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 412, 413, and 495 Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage 2 Final Rule August 23, 2012  672 Pages  Some Compromises  Some Clarifications  Some Changes to Stage 1  Some Timeline Changes  Also released, The ONC’s 2014 Edition Standards & Certification Criteria (S&CC) Final Rule 9/27/20123Santa Rosa Consulting - Meaningful Use Stage 2

4. making better healthcare possible ® H.I.T. Timeline 49/27/2012Santa Rosa Consulting - Meaningful Use Stage 2

5. making better healthcare possible ® H.I.T. Timeline 5 Santa Rosa Consulting - Meaningful Use Stage 2 9/27/2012

6. making better healthcare possible ® H.I.T. Timeline 6 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012 1 Year Delay to October 1, 2014

7. making better healthcare possible ® Stages of Meaningful Use Stage 2 Timeline Delay  Stage 1 Completed Attestation in 2011 delayed Stage 2 until 2014  Special 3 month EHR Reporting Period for 1 st year Stage 2 9/27/2012Santa Rosa Consulting - Meaningful Use Stage 2 7

8. making better healthcare possible ® 14 Core Objectives 5 of 10 Menu Objectives Stage 1 16 Core Objectives 3 of 6 Menu Objectives Stage 2 9/27/2012Santa Rosa Consulting - Meaningful Use Stage 28 Total Hospital Objectives

9. making better healthcare possible ® Stage 2 Hospital Measures & Objectives 9 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

10. making better healthcare possible ® Stage 2: 16 Hospital Core Objectives Stage 2: 16 Hospital Core Objectives 9/27/2012Santa Rosa Consulting - Meaningful Use Stage 210

11. making better healthcare possible ® CPOE 11 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

12. making better healthcare possible ® Demographics 12 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

13. making better healthcare possible ® Vital Signs 13 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

14. making better healthcare possible ® Smoking Status 14 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

15. making better healthcare possible ® Clinical Decision Support 15 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

16. making better healthcare possible ® Lab Test Results 16 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

17. making better healthcare possible ® Patient List by Condition 17 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

18. making better healthcare possible ® eMAR 18 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

19. making better healthcare possible ® Patient Portal 19 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

20. making better healthcare possible ® Patient Education 20 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

21. making better healthcare possible ® Medication Reconciliation 21 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

22. making better healthcare possible ® Summary of Care Document 22 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

23. making better healthcare possible ® 23 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012 Summary of Care Document

24. making better healthcare possible ® 24 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012 Summary of Care Document

25. making better healthcare possible ® Immunization Data 25 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

26. making better healthcare possible ® Laboratory Reporting 26 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

27. making better healthcare possible ® Syndromic Surveillance Data 27 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

28. making better healthcare possible ® Security Risk Analysis 28 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

29. making better healthcare possible ® Stage 2: Hospital Menu Objectives (3 of 6 required) Stage 2: Hospital Menu Objectives (3 of 6 required) 9/27/2012Santa Rosa Consulting - Meaningful Use Stage 229

30. making better healthcare possible ® Advanced Directives 30 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

31. making better healthcare possible ® Imaging Results 31 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

32. making better healthcare possible ® Family Health History 32 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

33. making better healthcare possible ® Electronic Discharge Prescriptions 33 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

34. making better healthcare possible ® Progress Notes 34 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

35. making better healthcare possible ® Lab Results to Ambulatory 35 Santa Rosa Consulting - Meaningful Use Stage 29/27/2012

36. making better healthcare possible ® Changes to Stage 1 in MU 2 Final Rule 9/27/201236Santa Rosa Consulting - Meaningful Use Stage 2

37. making better healthcare possible ® Changes to Stage 1 in MU 2 Final Rule (cont.) 9/27/201237Santa Rosa Consulting - Meaningful Use Stage 2

38. making better healthcare possible ® Changes to Stage 1 in MU 2 Final Rule (cont.) 9/27/201238Santa Rosa Consulting - Meaningful Use Stage 2

39. making better healthcare possible ® Changes to Stage 1 in MU 2 Final Rule (cont.) 9/27/201239Santa Rosa Consulting - Meaningful Use Stage 2

40. making better healthcare possible ® Changes to Stage 1 in MU 2 Final Rule (cont.) 9/27/201240Santa Rosa Consulting - Meaningful Use Stage 2

41. making better healthcare possible ® Hospital Data Submission – CQM  The rule finalizes that, beginning in 2014, all Medicare providers that are beyond the first year of demonstrating meaningful use must electronically report their CQM data to CMS. (Medicaid EPs and hospitals that are eligible only for the Medicaid EHR Incentive Program will report their CQM data to their state.)  Eligible hospitals and CAHs will electronically report their CQMs through the EHR Reporting Pilot infrastructure for hospitals, which aligns with the Hospital Inpatient Quality Reporting program or through electronic submission of aggregate data through a CMS Portal.

42. making better healthcare possible ® Eligible hospitals and CAHs must report a total of 16 CQMs from a menu of 29 CQMs covering at least 3 of the 6 domains (effective FY 2014):  Patient and Family Engagement (5 CQM – 2 New)  Patient Safety (6 CQM – 4 New)  Care Coordination (2 CQM – 1 New)  Population and Public Health (None for Hospitals/CAHs)  Efficient Use of Healthcare Resources ( 2 CQM – 2 New)  Clinical Process/Effectiveness (14 CQM- 7 New) CQM Reporting

43. making better healthcare possible ® Open Discussion/Q&A 43 Contact Information: Doug Hires EVP, Strategic Advisory Services Santa Rosa Consulting, Inc. Email: doughires@santarosaconsulting.comdoughires@santarosaconsulting.com