The Missouri Health Information Technology

Assistance CenterThe Missouri Health Information Technology Assistance Center will support physicians in selecting, implementing, and achieving meaningful use of an EHR so they are able to draw down incentive payments beginning in 2011.

The federal grant that will fund the Center includes support from organizations like the University of Missouri and Primaris, Missouri’s Quality Improvement Organization, which was specifically chosen to assist because of its expertise in improving the efficiency of EHR use.

To receive incentive payments of up to $44,000 per physician, you must:

• Select and implement a certified EHR

• Provide evidence of meaningful use as defined by the American Recovery and Reinvestment Act of 2009

The Center will assist physicians on:

• Selecting and purchasing an EHR that meets the required criteria, including group purchasing and contract negotiation

• EHR management through individualized on-site assistance and tailoring of your system to meet meaningful use criteria

• Developing processes and systems for health information exchange with other providers and local/state exchange organizations

• Seminars, training, and knowledge dissemination on successful EHR strategies and practices

• Redesign office practices, roles, and workflows necessary to achieve meaningful use while improving office efficiency

• Technical assistance to reach federal and state privacy and security requirements

Already have an EHR? The Center will still serve as a valuable resource through on-site assistance and effectively incorporating health information technology into your practice!

Demand for the Center’s services will be high when work begins in May. By completing the form on the back, we will place you on the priority list!Mail or fax back the form to:Mail: Primaris • 200 North Keene Street • Columbia, MO 65201Fax: 573-817-8322

For more information contact: Cora Butler, JD, RN, CHC

573-673-4099cbutler@primaris.org

MO-10-01-PR

Missouri Health Information Technology Assistance Center

Interest Form

Yes! We would like to be placed on the priority list to receive assistance from the Missouri Health Information Technology

Assistance Center. This Center will provide technical assistance and specific recommendations to help us meet “meaningful use” of electronic health records and assist us to receive incentive payments as early as 2011. This form expresses our interest in the voluntary project and does not obligate us to participate. ______________________________________ _________________________________ ___________________ Authorized Representative Signature Authorized Representative Title Date _____________________________________ Printed Name Please fill out the following information for each prescriber at your location. Prescriber includes an M.D., D.O., physician assistant, and nurse practitioner. *Use additional sheets if necessary. List of Prescribers:

Name NPI Number (if available) Credentials Specialty

Practice Name:_________________________________________________________________________ Address: ______________________________________________________________________________ City: _________________________________ State: ______________ ZIP: ________________________ #MDs/DOs: ____________ #PAs/APNs: _____________

#Practice Sites: _____________Does each site have the same tax ID #? YES. NO. Practice Contact Name: _________________________________________________________________ Phone: _________________________________ E-Mail: _______________________________________

Are you currently using an EMR? YES. Vendor:___________________ NO.

Please complete this form and mail to: ATTN: Missouri Health Information Technology Assistance Center c/o Primaris 200 N. Keene Street Columbia, MO 65201 OR fax to (573) 817-8322