Beyond the 13 core objectives, you must also choose from a list of 10 "Menu Set" objectives to demonstrate MU. Because most chiropractors have exclusions from three of the 10, you will only need to choose four of the remaining seven items.

1. Generate at least one list of patients organized by their specific conditions. This list must be used for quality improvement, reduction of disparities, research, or outreach.
2. Send reminders to patients, for preventive or follow-up care. You must send these reminders to 20 percent of all of your patients 65 years old or older, or to the parents/guardians of patients 5 years old or younger, during the reporting period. You are excluded from this if you have no patients in these age groups.
3. Use certified EHR technology to identify patient-specific education resources and provide those resources to the patient if appropriate. More than 10 percent of all patients seen must be provided patient-specific education resources.
4. If you transition a patient to another care setting or refer a patient to another care provider, you must have a summary care record for each care transition or referral. You must provide a summary of care record for more than 50 percent of all transitions of care and referrals. You are exempt from this objective if you neither transfer a patient nor refer a patient to another provider during the EHR reporting period.

2011 Early Adopters Catch a Break

Eligible providers are required to achieve meaningful use of their certified EHR system for only 90 continuous days in 2011, rather than for a full year thereafter.

Once you have achieved 90 days of MU, you may submit an application for incentive funding. The 2011 payment will be by paper application and then via electronic means from 2012 to 2015.

From 2012 to 2015, a full year of MU will be required. You will submit an application for the incentive payment at the end of the year. Reporting will be part of the EHR rather than a manual application. The deadline for submission is no later than February 28 of the following year to receive payment for the prior year.

You must register to be in the EHR incentive program. Registration is expected to begin in January 2011. You will be able to find registration and other program information at www.cms.gov/EHRIncentivePrograms when it becomes available.

You must also be registered in the Medicare Internet-Based Provider Enrollment, Chain and Ownership System (PECOS) to participate in the EHR incentive program. For information on PECOS, visit www.acatoday.org/medicare under "Medicare Enrollment FAQS."

Take Action

Now that you know what EHR is, be sure that the vendor's product you choose is certified.

Create a plan to implement EHR adoption with your practice team and to train all providers on eligible use. If you have an associate doctor who will be using an EHR system that you are purchasing, you should determine how the incentive payments will be disbursed prior to implementing the program. It's time to decide where your practice will be next year. In regards to EHR, it is choice, not chance, that will determine your destiny.

Important EHR Dates to Remember

• Fall 2011: Certified EHR technology listed online at: http://dhhs.gov/healthit.
• January 2011: Registration for the EHR Incentive Programs begins at www.cms.gov/EHRIncentivePrograms.
• May 2011: Medicare incentive payments begin.
• Feb. 29, 2012: Last day for providers to register and attest to receive an incentive payment for calendar year 2011.

Dr. Mark Sanna, a 1987 graduate of New York Chiropractic College, is a member of the ACA Governor's Advisory Board and a member of the President's Circle of NYCC and Parker College of Chiropractic. He is the president and CEO of Breakthrough Coaching (www.mybreakthrough.com).