Stimulus

The Platinum System team has spent countless hours gathering information over the last year in order to provide our clients and all
chiropractors with the most accurate information about the stimulus package plan.

What YOU need to know!

The most important thing to be eligible in receiving up to $44,000.00 from the stimulus package is not only to buy a
CCHIT or ARRA certified software, but to provide “Meaningful Use” as described by the current “Meaningful Use
Guidelines”.

The “Meaningful Use Guidelines” are a set of 25 objectives all doctors, including chiropractors, will have to fulfill to be eligible. 24
are not enough. To be eligible, doctors will need to meet the entire 25 objectives. So here they are and see if you want to qualify:

[1] Objective: Use CPOE (Computerized Physician Order Entry) Measure: CPOE is used for at least 80 percent of all orders

[2] Objective: Implement drug-drug, drug-allergy, drug- formulary checks Measure: The EP (Eligible Provider) has enabled this
functionality

[3] Objective: Maintain an up-to-date problem list of current and active diagnoses based on ICD-9-CM or SNOMED CT® Measure:
At least 80 percent of all unique patients seen by the EP have at least one entry or an indication of none recorded as structured
data.

[4] Objective: Generate and transmit permissible prescriptions electronically (eRx). Measure: At least 75 percent of all permissible
prescriptions written by the EP are transmitted electronically using certified EHR technology.

[5] Objective: Maintain active medication list. Measure: At least 80 percent of all unique patients seen by the EP have at least one
entry (or an indication of “none” if the patient is not currently prescribed any medication) recorded as structured data.

[6] Objective: Maintain active medication allergy list. Measure: At least 80 percent of all unique patients seen by the EP have at
least one entry (or an indication of “none” if the patient has no medication allergies) recorded as structured data.

[7] Objective: Record demographics. Measure: At least 80 percent of all unique patients seen by the EP or admitted to the eligible
hospital have demographics recorded as structured data

[8] Objective: Record and chart changes in vital signs. Measure: For at least 80 percent of all unique patients age 2 and over seen
by the EP, record blood pressure and BMI; additionally, plot growth chart for children age 2 to 20.

[9] Objective: Record smoking status for patients 13 years old or older Measure: At least 80 percent of all unique patients 13 years
old or older seen by the EP “smoking status” recorded

[10] Objective: Incorporate clinical lab-test results into EHR as structured data. Measure: At least 50 percent of all clinical lab tests
results ordered by the EP or by an authorized provider of the eligible hospital during the EHR reporting period whose results are
either in a positive/negative or numerical format are incorporated in certified EHR technology as structured data.

[11] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research,
and outreach. Measure: Generate at least one report listing patients of the EP with a specific condition.

[12] Objective: Report ambulatory quality measures to CMS or the States. Measure: For 2011, an EP would provide the aggregate
numerator and denominator through attestation are discussed in section II.A.3 of this proposed rule. For 2012, an EP would
electronically submit the measures are discussed in section II.A.3. of this proposed rule.

[13] Objective: Send reminders to patients per patient preference for preventive/ follow-up care. Measure: Reminder sent to at least
50 percent of all unique patients seen by the EP that are 50 and over.

[14] Objective: Implement five clinical decision support rules relevant to specialty or high clinical priority, including for diagnostic test
ordering, along with the ability to track compliance with those rules. Measure: Implement five clinical decision support rules relevant
to the clinical quality metrics the EP is responsible for as described further in section II.A.3.

[15] Objective: Check insurance eligibility electronically from public and private payers. Measure: Insurance eligibility checked
electronically for at least 80 percent of all unique patients seen by the EP

[16] Objective: Submit claims electronically to public and private payers. Measure: At least 80 percent of all claims filed
electronically by the EP.

[17] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list,
medication lists, and allergies) upon request. Measure: At least 80 percent of all patients who request an electronic copy of their
health information are provided with it within 48 hours.

[18] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list,
medication lists, allergies) Measure: At least 10 percent of all unique patients seen by the EP are provided with timely electronic
access to their health information.

[19] Objective: Provide clinical summaries to patients for each office visit. Measure: Clinical summaries provided to patients for at
least 80 percent of all office visits.

[20] Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies, and diagnostic
test results), among providers of care and patient authorized entities electronically. Measure: Performed at least one test of
certified EHR technology’s capacity to electronically exchange key clinical information.

[21] Objective: Perform medication reconciliation at relevant encounters and each transition of care. Measure: Perform medication
reconciliation for at least 80 percent of relevant encounters and transitions of care.

[22] Objective: Provide summary care record for each transition of care and referral. Measure: Provide summary of care record for
at least 80 percent of transitions of care and referrals.

[23] Objective: Capability to submit electronic data to immunization registries and actual submission where required and accepted.
Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries.

[24] Objective: Capability to provide electronic syndromic surveillance data to public health agencies and actual transmission
according to applicable law and practice. Measure: Performed at least one test of certified EHR technology’s capacity to provide
electronic syndromic surveillance data to public health agencies (unless none of the public health agencies to which an EP or
eligible hospital submits such information have the capacity to receive the information electronically).

[25] Objective: Protect electronic health information maintained using certified EHR technology through the implementation of
appropriate technical capabilities. Measure: Conduct or review a security risk analysis in accordance with the requirements under
45 CFR 164.308 (a)(1) and implement security updates as necessary.

Advice if you wish to implement all 25 objectives in your practice to be eligible for the stimulus package and you are
shopping for software:

1. There are two types of EHR Certifications CCHIT and ARRA. CCHIT certifications are fully certified and will cover all 25
objectives as long as you can show you use them. At of the time of this article only two Medical software programs (none for
Chiropractors) in the world are CCHIT certified. ARRA certification only meets one or a few of the objectives and are required to
state which ones they meet. To become a meaningful use user, you will have to purchase another (or multiple) ARRA certified
program to meet the other requirements not met by the first to qualify for the stimulus package. Make sure the software will provide
for all 25 objectives by itself. Chiropractic software companies that do become certified will most likely only be ARRA certified so
be careful as this will not guarantee you any part of the stimulus package.

2. Make sure it is clear in your contract with the software vendors that they will support you in obtaining “Meaningful Use”. (Or they
should have to pay you $44,000.00 within a specific timeframe.)

3. A letter of intent to be CCHIT or ARRA Certified means absolutely nothing and has no value.

4. Promising a free upgrade when they get certified also means nothing. If they do not get certified, you will never receive an
upgrade.

5. If you are looking at just getting ARRA certified software the basics for this software is to meet the security measures as set forth
by the HIT guidelines. Included in these security measures is the ability to communicate audit messages between Secure Nodes
and to establish Audit Repository nodes to collect audit information.

6. Remember that the “Meaningful Use” is the most important condition to be eligible. Before investing make sure you
are ready to possibly change how you practice.

Platinum System position:

Since we believe the vast majority of chiropractors could not meet “Meaningful Use" guidlines if they wish to keep practicing the
same way they presently do, we wrote an email to CCHIT (the company in charge of certification) asking if they have some plan to
accommodate chiropractors. Here is their answer:

----- Original Message -----
From: "Michelle Knighton" <mknighton@cchit.org>
To: "Nadine Brunet" <n.brunet@platinumsystem.com>
Sent: Tuesday, January 12, 2010 11:00 PM
Subject: RE: Platinum System - Certification for Security and Privacy for Chiropractic

Hi Nadine,
CCHIT currently has no plans to develop and launch a certification program specific to Chiropractic EHRs under our
CCHIT Certified comprehensive certification program. However, Chiropractic EHRs are welcome to apply for certification
under the ARRA certification program **. You can find all material on our website at www.cchit.org/get_certified. Please note that
CCHIT is in the process of revamping our certification programs to ensure they meet compliance with the ARRA Interim Final Rule
that will be published in the Federal Register on January 13, 2010. …..
The Office of the National Coordinator (ONC) will publish the ARRA Interim Final Rule in the Federal Register on January 13th and
will become effective 30 days after that. ... This rule has the definition of "meaningful use of EHRs". As we are still in the process
of revamping our certification materials, I cannot tell you definitively whether only the Foundational Infrastructure Privacy & Security
module will be required for ARRA certification. I believe this will continue to hold true, but would ask that you check back with me in
early February for a definitive answer.

Best regards,
Michelle Knighton,
MBA, RHIA Certification Manager,
CCHIT Certification Commission for Health Information Technology
541.926.2597 voice | 888.634.2140 fax
mknighton@cchit.org
Learn more about CCHIT Learn more about EHR Decisions

** ”ARRA certification program” provide the possibility to get partially certified for some of the 25 objectives to be “Meaningful use”.
This means that if you use software that is ARRA certified, you will have to use another (or multiple) software to get all 25 objectives
in place.

Platinum System's conclusion:

For now, unless “Meaningful Use” definitions change for chiropractors, the Platinum System team will continue to work to provide
the very best system and the very best service in the chiropractic industry as always. Besides being the only system that provides
so many unique modules and functionality, we have many new great modules and new services that will come out in 2010. These
modules and services will allow every chiropractor to recuperate much more than $44,000.00 over 5 years.

The Platinum System team
“People you can trust”