John: Welcome to stimulus planning with MEDITECH and Perot Systems. My name is John Valutkevich, I'm an EHR Coordinator here at MEDITECH, and I'm happy to have Hoda Sayed-Friel, our Vice President of Marketing at MEDITECH and Paul Peck who is also the Vice President of Consulting Services with Perot Systems. And today we're going to address some of the issues and interests of our customers in light of the American Recovery and Reinvestment Act.

Video Clip #1: MEDITECH Customers are Well-Positioned

John: What I would like to start with is basically our customers and their positioning within the marketplace. Hoda, how well would you say our customers are positioned in terms of taking advantage of the American Recovery and Reinvestment Act?

Hoda: I think our customers are very well positioned. I think one of the things that we've been doing over the last three or four years is pushing our Advanced Clinical Systems and those are really the prerequisites for moving ahead with the Recovery Act and getting the stimulus dollars that the Obama administration has put forth. So things like our Physician Care Manager product, our PCS Nursing application, Computerized Physician Order Entry, all of those types of applications are certainly part of what's going to be needed for that. Any of our customers who have already started their I.T. planning to implement those things for quality and effectiveness are actually going to reap the major benefits from the stimulus package.

John: Excellent, Excellent. And Paul, based on your group's experiences and the information that's available today, can you expand on that in terms of Perot Systems?

Paul: Sure, John. I think as far as MAGIC customers, Client/Server customers, and those that are entering forth with the 6.0 product line, we've always seen the formulation of an electronic health record as an end state, a goal, so the announcement of the stimulus package fits very nicely with what we see MEDITECH customers building into their strategic plans and their go-forward strategies.

Hoda: And I also see our efforts moving into the interoperability front, are helpful too, so part of a lot of the stimulus package and the funds out there to fund the ability to share electronic health information across multiple entities. So the work that we've done with our partners at LSS and Patient Care Technologies, as well as the interfaces that we've put together for interoperability, I think will go a long way in helping our customers move forward with any of the recommendations and requirements from HHS.

John: Excellent, all good points.

Clip #2 Certification

John: OK, moving along. Some of the specifics in the legislation actually have to do with certification. So, Hoda I was curious about your take on the certification effort that might be surrounding the American Recovery and Reinvestment Act.

Hoda: There is certainly a lot of discussion with regards to what the certification requirements are going to be. But as we've always done at MEDITECH, we've made sure that we've abided by the federal requirements for certification. So, as everyone knows, our 5.6 MAGIC and 5.6 Client/Server applications were certified in 2007 and there are discussions right now regarding whether 2007 is going to be enough or whether they're going to mandate a 2008 or a 2009 certification. Our plans right now, since 5.6 in MAGIC and Client/Server are already 2007 certified, our plans are to certify our 6.0 platform for 2009 this year and to get that out the door and we're sort of waiting to hear what ONCHIT and HHS have to say about the final certification requirements. What we're hoping happens, is that just to get this package off the ground and for people to take advantage of the dollars, that HHS will come out and say, 2007 plus interoperability certification are sort of the minimum criteria. Otherwise I think it will be difficult for many of our customers and customers in general out in the place to take advantage of the dollars, so that's going to be our recommendation.

John: Good, good. And Paul, any additional thoughts on certification and customer base and what you're hearing?

Paul: Well clearly it's a concern. The need for certification is important, however, our conversations with MEDITECH customers fortifies the history of the company's ability to put products together, get them certified, and I don't hear any fear out there that products will not meet the federal guidelines. So in general, there is a high confidence level in MEDITECH's ability.

Hoda: The other part of certification is that ONCHIT and HHS have yet to define what "meaningful use" is. So as soon as that becomes clearer, I think the certification year will become more clear as well, with being able to meet those requirements. Right now, "meaningful use" is sort of loosely defined as making sure that you have an electronic health record that has demographic and clinical information, being able to have a system that has clinical decision support, that enforces best practices, that has physician order entry as a component, and the ability to exchange and do that interoperability that I talked about previously, and the last but probably most important component, is for these dollars they are not for free, so reporting is a key element of this. So anyone who is seeking stimulus dollars should count on being able to pull reports out of Data Repository in order to report back to CMS to certainly qualify for the stimulus dollars.

John: Excellent, that's a good way to frame it because again it's a lot more than certification, it's the capabilities of the applications and the certification is merely one of the important points.

Clip #3 You Need to Act Now

John: Another interesting area we'll talk about a little bit is the information that's out there, the plans that we have for MEDITECH, and for Perot, the short question and the long answer, maybe, is why now? Hoda, I'd like to start with you. Why MEDITECH customers should be acting quickly and now.

Hoda: There are several reasons to start now. Number one, I think all of health care needs to be pursuing quality, effectiveness, and cost, and safety and all of those components and that's the business that we're in. The second reason is that in order to implement all the Advanced Clinical Systems, it will take some time to get those components up and running that you need to qualify for those stimulus dollars, which might mean updates, it might mean consulting services from Perot Systems to help you with your roll out of Computerized Physician Order Entry, or Bedside Medication Verification, as possible elements of that initiative. The other reasons are that the incentive dollars actually start in fiscal year 2011, which really means October of 2010. And probably the most compelling reason, besides the quality effort, is, you know, the dollars aren't going to last forever, so the ones that are in first are going to get the bulk of the dollars so that would be sort of my recommendation, to get moving as quickly as possible. But the key in doing that is not really just to go after the dollars. If you start by your main emphasis is to go after the dollars, that's the wrong reason to do it. It really is to promote that quality and safety and if that is your mission, then go at the pace that you might go at it to make sure it's successful and maybe you don't get 100% reimbursement in 2011, but go for the 75% reimbursement that follows in 2012.

John: Good points. And from Perot Systems' perspective, again, why now?

Paul: In our point of view, having quality software is certainly a key to achieving a meaningfully used EHR by 2011, but there is much more that goes into it obviously. The uptake of these technologies is going to require some real introspection on the organizations' part as to how to assimilate the use of these technologies, how to really approach the continuum of care and make sure that that electronic health record has what it needs to have in order to promote the kind of outcomes that we think the stimulus package is driving towards. Another aspect of moving forward is to potentially take advantage of some of the funding that the federal government and state level organizations will make available to health care providers to help with the capital outlay that is going to be necessary to bring some of these technologies to the floor. So I totally concur that organizing and becoming prepared to move down this migration towards the EHR should start as soon as the organization can muster the right resources and focus. And sooner rather than later.

Hoda: HHS is going to be looking for outcomes out of all of this. They're going to be looking for a fundamental change in how we deliver health care, the types of outcomes that we're getting, and essentially their motto is going to be, "no outcomes, no income." So, the sooner you start off on that path, the better off you're going to be.

John: That certainly makes a lot of sense.

Clip #4 Readiness Assessment

John: Ok, picking up on why now, I'd like to roll forward and start with you Paul, what are some of the tools that might be available for the customer base to help them get ready and start implementing now?

Paul: John, as we were mentioning earlier, we believe that the tools, the software applications, are well positioned to achieve a meaningful electronic health record. The question now is, where are individual hospitals on that migration path? What have they implemented, whether its MAGIC, Client/Server, or 6.0? How well have they implemented them in anticipation of an electronic health record? So the first question would be, in our mind, do you have a clear understanding of your current usage, and does it project well into the 2011 mandate for an EHR? And so what we thought about is an approach where in a minimal amount of time, our consultants can work with hospitals to better understand where they are on that migration path, make suggestions, not only about the technology and the appropriate use of it, but how well the practitioners and end users have assimilated the use. And further, how they can extend these capabilities to interact with the surrounding providers in that continuum of care. So in essence, we believe that a lot of good can come from an assessment, an ARRA assessment, if you will, to help organizations better position their technology investments and their over all strategies.

John: And Hoda, we've been doing some things internally as well here at MEDITECH.

Hoda: Right, we've come up with an assessment that we're posting on our Web page, so look for that, on our EHR Web page on meditech.com, which will have some of the components that we talked about earlier, with the applications that you need to get rolling with, and hopefully, as soon as CMS creates the definition for "meaningful use", we'll post those things as well. The other thing that we're following is the National Quality Forum, and their parameters for reporting, like what are those elements that need to be reported in order to satisfy CMS conditions to receive any of that Medicaid reimbursement. So all of those things will be on our Web page and we'll make a variety of different announcements on our Web page, and e-mails, and during our workshops as well, so all of these things will be packaged up so that our customers can take advantage and know what is going to be expected of them.

Client/Server and MAGIC

John: Lets expand a little bit on our collaborative readiness assessments for our collective customer base. Paul, MAGIC and Client/Server offerings?

Paul: Absolutely John, the thought processing around MAGIC and Client/Server is something we've considered in the assessment and interrogatives that our consultants would bring to the hospital, yes, absolutely.

John: Hoda, assessments for MAGIC and Client/Server customers?

Hoda: Yes, absolutely. The work that we've done at MEDITECH and in conjunction with Perot Systems, with customers such as Parkview, and Phelps, Citizens Memorial, St. Agnes, and several others have shown that our 5.6 Client/Server and 5.6 MAGIC customers are able to achieve meaningful use in those platforms, so I think we're very, very well positioned.

John: Good for our customers.

Clip #5 Taking Advantage of Grants

John: We focused a lot on the incentives up to this point, what about the funds available right now Paul, navigating the process, the grant writing process especially, is quite an undertaking.

Paul: Yeah, it is John, and we understand that there will be reimbursements appropriate to when a hospital achieves a meaningful EHR and that would occur at the point that they've actually demonstrated meaningful use, but to get started, to take advantage of the funding from the federal level, and also through the state level, hospitals or health care providers in general, need to take a look at their circumstance, what their qualifiers are, and effectively identify grants and funding opportunities, that will help jump start or give them the necessary capital to acquire technologies, to train people, and to bring these technologies to the point that they're serving the purpose of high quality care and safe patient experiences. From the Perot Systems point of view, we've taken a look at those state level opportunities and we've positioned people who can go to hospitals, help them understand what they might be qualified for, and once those opportunities are effectively targeted, we have people who can help with the application process and the political nurturing to hopefully arrive at a successful grant being afforded to the institution. So what we're advising our clients to do is to have an opportunity for us to come in, discuss with the executive teams in a way where we can better understand their particular circumstance, then use our expertise to help them target the grant writing and grant application process. We're also, and I think everybody in the industry is, waiting for some more definition, certainly, from the federal folks, but interestingly enough, there were and are funding opportunities apart from the stimulus package, which fit very nicely into what we know the challenges to be. So we're hopeful that our specialists can help our MEDITECH clients better understand where those opportunities are and how to effectively vie for those start up dollars.

Hoda: And Paul, although the HIT grants for hospitals haven't been announced yet, several other grants are out there, primarily for research and education, so even community hospitals who are doing research and want to take advantage of those types of grants to educate their employees and so forth, they can do that. In addition to those, there are also grants out there for folks wanting to jump into the world of disease management, chronic disease management, in particular. So our customers who want to use our home care products as well as our well@home product, with Patient Care Technologies, there are chronic disease management grants to take advantage of, so I think that might be a good place to start, the funding in those particular areas.

John: Excellent, so we were able to touch on the types of grants that are out there and the services to help you work those grants.

Well Hoda and Paul, I want to thank you for attending this Webcast, and I want to remind our customers that things are changing constantly with the American Recovery and Reinvestment Act, so therefore a good place to check out is meditech.com, and check out the EHR portal, the links there to a wealth of information, and also Perotsystems.com, the Insights portal area. So again, thank you to you both for coming.