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EMR Stimulus Incentive- Common Questions:

We have been told that the US Government Incentives are there for providers who implement an EMR- but what exactly does that mean? Look below for common questions and answers to get a better understanding of who and what qualifies for these funds.

What is the potential financial benefit of the healthcare IT incentives to physicians?

Each office-based physician who meaningfully uses a certified EHR could receive up to $44,000 (Medicare) or $64,000 (Medicaid) in government funding. Office-based physicians practicing in rural or underserved areas would be eligible for up to an additional $4,400 in Medicare incentives. These figures represent the maximum allowable incentives under the Medicare and Medicaid programs. Physicians may only qualify for either the Medicare or the Medicaid funding, but cannot qualify for both.

Who qualifies as an eligible professional?

“Eligible professionals” under the Medicare HIT incentive program are limited to physicians as defined in the Social Security Act (§1861(r)), which includes:

• A doctor of medicine or osteopathy

• A doctor of surgery or of dental medicine

• A doctor of podiatric medicine

• A doctor of optometry

• A chiropractor

To receive Medicare incentive payments, the physician must:

• Not be hospital-based;

• Demonstrate meaningful use of a certified EHR; and

• Submit Medicare Part B claims of at least 133% of the maximum incentive for a program year to qualify for the maximum incentive payment.

The Medicaid HIT Incentive program expands the definition of “eligible professionals” to include:

• Certified nurse mid-wife

• Nurse practitioner

• Physician assistant (under certain circumstances)

To receive Medicaid incentive payments, eligible professionals must:

• Not be hospital-based;

• Demonstrate meaningful use of a certified EHR; and

• Treat a patient population, of which at least 30% receive medical assistance (or 20% if the physician is a pediatrician).

Although the incentives are not dependent on the eligible provider being a participating Medicare provider, the incentive amounts available to any provider is the lesser of 133% of their annual billed Medicare Part B charges or the maximum payment specified for the year in the regulations. (For example, a provider would have to bill $16,000 in Part B charges in order to qualify for a year in which the maximum allowable incentive payment is $12,000.) There are no distinctions between specialty and primary care physicians in terms of the incentives, EXCEPT that hospital-based physicians do not qualify for the physician incentives.

What is meant by “meaningful use” of healthcare IT?

Funding and incentives are tied to “meaningful” use. While no one yet knows the full definition of meaningful use, preliminary descriptions include the following:

An eligible professional shall be treated as a meaningful EHR user for a reporting period for a payment year if the following requirements are met:

• Meaningful use of certified EHR technology. The eligible professional demonstrates to the satisfaction of the HHS Secretary, that during such period the physician is using certified EHR technology in a meaningful manner. The certified EHR shall include the use of electronic prescribing as determined to be appropriate by the HHS Secretary.

• Information exchange. The eligible professional demonstrates to the satisfaction of the HHS Secretary that during such period such certified EHR technology is connected in a manner that provides, in accordance with law and standards applicable to the exchange of information, for the electronic exchange of health information to improve the quality of health care, such as promoting care coordination.

• Reporting of measures using EHR. Using such certified EHR technology, the eligible professional submits information for such period, in a form and manner specified by the HHS Secretary, on such clinical quality measures and such other measures as selected by the HHS Secretary. The HHS Secretary shall seek to improve the use of EHRs and healthcare quality over time by requiring more stringent measures of meaningful use selected under this paragraph.

Which EHR / EMR is certified and qualifies for stimulus money? 

When will the payments be made?

Funds became available for office-based physicians on January 1, 2011. In several states checks have already been issued for those qualifiying under Medicaid. Medicare payments begin in April 2011. Physicians receive payments 4-6 weeks after attestation of Meaningful Use.

Providers should begin planning as soon as possible to allow time to achieve meaningful use of certified solutions during 2011 or 2012 if they would like to receive the maximum reimbursements.

How do I submit for reimbursement? Registration and Attestation

Registration for the Medicaid and Medicare EHR Incentive Program is now open. You can register before you have a certified EHR. Information on registration or to register.

What are the additional incentives for office-based physicians to adopt in the early years of the program?

Office-based physicians’ maximum allowable Medicare incentive for the first year of meaningful use is increased by $3,000, from $15,000 to $18,000, for meaningful EHR use in 2011 or 2012. This “early adopter” incentive raises the total amount physicians can qualify for from $41,000 to $44,000. A benefit for office-based physician early adoption does not exist under the Medicaid incentive program.

What are the penalties if physicians do not adopt an EHR/EMR?

For office-based physicians who do not adopt such technology by 2015, Medicare payments will be reduced by the following factors in the years specified:

• 2015: One percent

• 2016: Two percent

• 2017 and beyond: Three percent

• 2018 and beyond: HHS Secretary may decrease one additional percent/year (max of 5%) if 75% of office based physicians don’t adopt technology by 2018

Who qualifies for the additional 10% rural health incentive?

An “eligible professional” who predominantly furnishes services in a geographic area that is designated by the HHS Secretary as a health professional shortage area may receive a 10% increase in their annual payment.

Are incentives for new systems only or systems already in use?

The incentives are available to meaningful users of certified IT systems described in the legislation regardless of when they were implemented. The qualifier is the date at which the eligible provider can demonstrate meaningful use of the certified technology.

Who benefits from the healthcare IT incentives?

Primarily hospitals and office-based physicians will benefit from the incentives. They are designed to reduce healthcare costs by accelerating the use of IT to improve quality, safety and efficiency. Ultimately, patients and caregivers also will benefit from the automation and connectivity enabled by EHR/EMRs.

Practice Partner version 9.5, Medisoft Clinical v17, and Lytec MD 2011 recently earned certification as “Complete” electronic health record (EHR) systems under the Office of the National Coordinator (ONC) Authorized Testing and Certification Body (ATCB) process. The software was certified by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, as 2011/2012 compliant in accordance with the applicable certification criteria for Eligible Providers adopted by the Secretary of Health and Human Services.* Certification was granted on December 6, 2010.

* McKesson’s Practice Partner 9.5, Medisoft Clinical v17 and Lytec 2011 are now 2011/2012 compliant and were certified as a Complete EHR on December 6, 2010, by the Certification Commission for Health Information Technology (CCHIT®), an ONC-ATCB, in accordance with the applicable certification criteria for eligible providers adopted by the Secretary of Health and Human Services. The certification number is CC-1112-589589-1. ONC-ATCB 2011/2012 certification conferred by CCHIT does not represent an endorsement of the certified EHR technology by the U.S. Department of Health and Human Services nor does it guarantee the receipt of incentive payments.

The clinical quality measures to which Practice Partner Version 9.5, Medisoft Clinical v17 and Lytec 2011 have been certified include: NQF 0421, NQF 0013, NQF 0028, NQF 0041, NQF 0024, NQF 0038, NQF 0059, NQF 0064, and NQF 0061.

The additional software that Practice Partner, Medisoft Clinical and Lytec MD relied upon to demonstrate compliance includes: Windows Server® 2008 Server which includes BitLocker® and IPSec for 170.302(u) & 170.302(v); SureScripts Messenger™ Services for 170.304(b) & 170.302(b); Medi-Span® for 170.302(e) & 170.302(a); AMA’s CPT® codes for 170.302(d), 170.304(e) & 170.304(a); and RelayClinical™ Education for 170.302(m).

Customer Testimonials

Michael S. Barnett, MD.

“Jay Zorro went above and beyond the call of duty. Not only did he fix a chronic computer problem, but he continues to assist with future anti virus control. He took a dedicated effort to my problem, thought about it and fixed it. I am very pleased. He is an excellent employee.”

- Michael S. Barnett, MD.

AZCOMP Technologies
2015-05-21T09:33:40+00:00

- Michael S. Barnett, MD.

“Jay Zorro went above and beyond the call of duty. Not only did he fix a chronic computer problem, but he continues to assist with future anti virus control. He took a dedicated effort to my problem, thought about it and fixed it. I am very pleased. He is an excellent employee.”

Kennetha, Dr. Mira Zelin.

“First of all I was especially appreciative of the fact that I was able to speak to a “person” each time I called, even if someone had to call me back. Sales and Tech support were very friendly and professional and knowledgeable. I was and knew exactly what to do. I was very satisfied. Thanks.”

- Kennetha, Dr. Mira Zelin.

AZCOMP Technologies
2015-05-21T09:35:34+00:00

- Kennetha, Dr. Mira Zelin.

“First of all I was especially appreciative of the fact that I was able to speak to a “person” each time I called, even if someone had to call me back. Sales and Tech support were very friendly and professional and knowledgeable. I was and knew exactly what to do. I was very satisfied. Thanks.”

Christine, Pros Medical Service.

“All the people I have dealt with at AZCOMP have been helpful and professional. Would give all an A++”

- Christine, Pros Medical Service.

AZCOMP Technologies
2015-05-21T09:38:37+00:00

- Christine, Pros Medical Service.

“All the people I have dealt with at AZCOMP have been helpful and professional. Would give all an A++”

Maria, Sugarland EMS.

“AZCOMP has a great staff, always helpful to resolve any tech issue.”

- Maria, Sugarland EMS.

AZCOMP Technologies
2015-05-21T10:08:00+00:00

- Maria, Sugarland EMS.

“AZCOMP has a great staff, always helpful to resolve any tech issue.”

Michael, Michael S. Barnett MD.

“Adjusting to the tech world for an old geezer like me was quite and emotional challenge. My hand was held the entire way by the supportive staff at AZCOMP. There were plenty of struggles and lots of stops and starts, be we did it. I find it hard to imagine going back to non-electronic records. Through every struggle it was easy to get the help I needed. Things work well now, and I cannot thank the staff enough for their support.”

- Michael S. Barnett MD.

AZCOMP Technologies
2015-05-21T10:10:07+00:00

- Michael S. Barnett MD.

"Adjusting to the tech world for an old geezer like me was quite and emotional challenge. My hand was held the entire way by the supportive staff at AZCOMP."

Joleen, Office manager for Family Chiropractic Optimal Health and Nutritin.

“Paul made my whole day! I can’t write down exactly what I told him in excitement of fixing our datapath, etc. but in so many words he was my hero! I was so excited as we had not been able to send claims for approximately two weeks. Paul was very helpful and it would be my pleasure to have him assist us again if needed. He knows his stuff!”

- Joleen, Office manager for Family Chiropractic Optimal Health and Nutritin.

AZCOMP Technologies
2015-05-21T10:11:27+00:00

- Joleen, Office manager for Family Chiropractic Optimal Health and Nutritin.

“Paul made my whole day! I can’t write down exactly what I told him in excitement of fixing our datapath, etc. but in so many words he was my hero! I was so excited as we had not been able to send claims for approximately two weeks. Paul was very helpful and it would be my pleasure to have him assist us again if needed. He knows his stuff!”

John, Lake Gregory Chiropractic.

“Service was very fast and professional. They took care of the problem literally within minutes of the phone call. YOU are my support company from now on!”

- John, Lake Gregory Chiropractic.

AZCOMP Technologies
2015-05-21T10:13:39+00:00

- John, Lake Gregory Chiropractic.

“Service was very fast and professional. They took care of the problem literally within minutes of the phone call. YOU are my support company from now on!”

Casey, All Around Accounting.

“Thank you so much for your help today. I really appreciate how quickly we were able to get my new helpful report added and working. This was the best Christmas present ever! Thank you so much. I believe you just made my job, with the way that I do it, much much more efficient.”

- Casey, All Around Accounting.

AZCOMP Technologies
2015-05-21T10:14:18+00:00

- Casey, All Around Accounting.

“Thank you so much for your help today. I really appreciate how quickly we were able to get my new helpful report added and working. This was the best Christmas present ever! Thank you so much. I believe you just made my job, with the way that I do it, much much more efficient.”

Judy, Douglas Bailes

“AZCOMP has always been very supportive, even if they don’t have the answer right at the time of the call (which isn’t very often). I like the honesty when they say they are not sure, but will check with other support tech’s and get back with me. One person doesn’t know all of the answers so this shows that you have good team work within your office staff. The results then can overflow onto your customers. Thank you for all that you do.”

- Judy, Douglas Bailes

AZCOMP Technologies
2015-05-21T10:15:43+00:00

- Judy, Douglas Bailes

“AZCOMP has always been very supportive, even if they don’t have the answer right at the time of the call (which isn’t very often). I like the honesty when they say they are not sure, but will check with other support tech’s and get back with me. One person doesn’t know all of the answers so this shows that you have good team work within your office staff. The results then can overflow onto your customers. Thank you for all that you do.”

Carolyn, Blackstone Physical Therapy

“You guys are awesome!! I think you help me even when you don’t have to!! THANK YOU!!”

- Carolyn, Blackstone Physical Therapy

AZCOMP Technologies
2015-05-21T10:16:10+00:00

- Carolyn, Blackstone Physical Therapy

“You guys are awesome!! I think you help me even when you don’t have to!! THANK YOU!!”

Stephanie, Healthcare Billing Solutions

“Ever since I started with this company I feel so much better than any previous company I had in the past. This company has helped us in all we need and has done a fantastic job. Thank you very much, also the staff are wonderful!”

- Stephanie, Healthcare Billing Solutions

AZCOMP Technologies
2015-05-21T10:17:50+00:00

- Stephanie, Healthcare Billing Solutions

“Ever since I started with this company I feel so much better than any previous company I had in the past. This company has helped us in all we need and has done a fantastic job. Thank you very much, also the staff are wonderful!”

Kristin, Foot Surgical Center PC.

“I have always had awesome service and very quick replies. The last time my call back was extremely fast! Always very helpful.”

- Kristin, Foot Surgical Center PC.

AZCOMP Technologies
2015-05-21T10:17:17+00:00

- Kristin, Foot Surgical Center PC.

“I have always had awesome service and very quick replies. The last time my call back was extremely fast! Always very helpful.”

Tawnya Strum

“Five Star service!!! Our practice became an AZCOMP Customer in early 2013 and we were immediately wowed at the outstanding level of customer service we received. From the moment we called we felt important and very well taken care of. The sales team took excellent care of us and the technical support team has done a fabulous job every time we have needed them! The training sessions are informative and helpful and the staff are always willing to go the extra mile to make sure we understand changes and updates to the system. Thank you to the entire team - we appreciate your excellent service!!! :) Pain Specialists of Orange County”

- Tawnya Strum

AZCOMP Technologies
2015-05-21T10:21:42+00:00

- Tawnya Strum

“Five Star service!!! Our practice became an AZCOMP Customer in early 2013 and we were immediately wowed at the outstanding level of customer service we received. From the moment we called we felt important and very well taken care of. The sales team took excellent care of us and the technical support team has done a fabulous job every time we have needed them! The training sessions are informative and helpful and the staff are always willing to go the extra mile to make sure we understand changes and updates to the system. Thank you to the entire team - we appreciate your excellent service!!! :) Pain Specialists of Orange County”

Pauline Hastings

“Couldn't be any better unless we got cookies. Service is at least a 5 star or more. Sad to say we left AZCOMP for a short time but now we are back to stay. Once you have the best nothing else compares. The support team is out of this world. Don't know what we would have done without Paul, Robbie, Shelly and Maggie just to name a few. We never have to wait for a call back with any type of issue we may be having. Love these guys.
AZCOMP you are the best and we thank you.”

- Pauline Hastings

AZCOMP Technologies
2015-05-21T10:22:40+00:00

- Pauline Hastings

“Couldn't be any better unless we got cookies. Service is at least a 5 star or more. Sad to say we left AZCOMP for a short time but now we are back to stay. Once you have the best nothing else compares. The support team is out of this world. Don't know what we would have done without Paul, Robbie, Shelly and Maggie just to name a few. We never have to wait for a call back with any type of issue we may be having. Love these guys. AZCOMP you are the best and we thank you.”

Dan Logan D.C. Logan Chiropractic

“I would like to thank everyone at AZCOMP. I just recently started working with this great company. The quality of there products are great. However, it is there customer service that sets them apart. From top to bottom, whether it be the sales team or the technical support team, the service and attention to detail is first rate! Thank you to everyone I have had the pleasure to speak with. Thank you for the excellent service! ”

- Dan Logan D.C. Logan Chiropractic

AZCOMP Technologies
2015-05-21T10:24:08+00:00

- Dan Logan D.C. Logan Chiropractic

“I would like to thank everyone at AZCOMP. I just recently started working with this great company. The quality of there products are great. However, it is there customer service that sets them apart. From top to bottom, whether it be the sales team or the technical support team, the service and attention to detail is first rate! Thank you to everyone I have had the pleasure to speak with. Thank you for the excellent service! ”

Carolyn Dixon Collins

“Azcomp Technical support is phenomenal!!!! They have helped me so much!!!!! I would definitely recommend them!! Thank you Azcomp!!! Keep up the good work!!!”

- Carolyn Dixon Collins

AZCOMP Technologies
2015-05-21T10:25:03+00:00

- Carolyn Dixon Collins

“Azcomp Technical support is phenomenal!!!! They have helped me so much!!!!! I would definitely recommend them!! Thank you Azcomp!!! Keep up the good work!!!”

Sabrina Leal

“I love AZComp! No matter who you speak with, the staff is friendly and they will work with you until the job is done! I am still learning all the ins and out of Medisoft, but what ican not figure out or if I run into trouble - AZComp is there! They respond in a timely manner as soon as I send them a support ticket request, and they diligently work with me to find a good time for me talk to them. Every tech there I have spoken to has been very knowledgeable with great customer service! Keep up the good work!
Pro-Care Medical Center”

- Sabrina Leal

AZCOMP Technologies
2015-05-21T10:26:02+00:00

- Sabrina Leal

“I love AZComp! No matter who you speak with, the staff is friendly and they will work with you until the job is done! I am still learning all the ins and out of Medisoft, but what ican not figure out or if I run into trouble - AZComp is there! They respond in a timely manner as soon as I send them a support ticket request, and they diligently work with me to find a good time for me talk to them. Every tech there I have spoken to has been very knowledgeable with great customer service! Keep up the good work! Pro-Care Medical Center”

Sharon Barnett

“With all of the ICD-9 to ICD-10 regulatory and coding changes coming our way, AZComp has been there every step of the way. It is easy to set up a ticket and response time is phenomenal. Each and every tech we've spoken to to resolve issues with our software or billing has been knowledgeable and helpful. They've made a scary process not so difficult after all. Thank you!!”

- Sharon Barnett

AZCOMP Technologies
2015-05-21T10:26:43+00:00

- Sharon Barnett

“With all of the ICD-9 to ICD-10 regulatory and coding changes coming our way, AZComp has been there every step of the way. It is easy to set up a ticket and response time is phenomenal. Each and every tech we've spoken to to resolve issues with our software or billing has been knowledgeable and helpful. They've made a scary process not so difficult after all. Thank you!!”

Cody Steinhoff

“Our recent experience with AZCOMP, as a new client, was outstanding. We called looking for immediate technical help as a Medisoft Value Added Reseller. Within an hour, we had a return call from technical support and a very personable and knowledgeable support technician. All employees involved were very easy to deal with and, gratefully, very eager to help us out. We would very highly recommend AZCOMP.”

- Cody Steinhoff

AZCOMP Technologies
2015-05-21T10:28:13+00:00

- Cody Steinhoff

“Our recent experience with AZCOMP, as a new client, was outstanding. We called looking for immediate technical help as a Medisoft Value Added Reseller. Within an hour, we had a return call from technical support and a very personable and knowledgeable support technician. All employees involved were very easy to deal with and, gratefully, very eager to help us out. We would very highly recommend AZCOMP.”

Deborah Holden

“I had my server removed from our office as well and my backup. Kevin and all the support people went over and beyond to get me up and running again very quickly. All the service team was very supportive and I even received e-mails and follow up calls just to make sure that all was working well. They felt my pain that I was going through and help me through a very tough time. I have worked with other companies in the past and you could tell it was just a job. With this company it is more personalized and they truly enjoy what they do and enjoy ensuring that all your needs as a customer are met. Again thanks team for a job well done. I had thought friendly customer service was something from the past but they have restored my faith in customer service and customer support. I would encourage anyone needing tech support that this is the only place that I will even go again. May God richly bless each and every team member there. Thank you so much”

- Deborah Holden

AZCOMP Technologies
2015-05-21T10:28:58+00:00

- Deborah Holden

“I had my server removed from our office as well and my backup. Kevin and all the support people went over and beyond to get me up and running again very quickly. All the service team was very supportive and I even received e-mails and follow up calls just to make sure that all was working well. They felt my pain that I was going through and help me through a very tough time. I have worked with other companies in the past and you could tell it was just a job. With this company it is more personalized and they truly enjoy what they do and enjoy ensuring that all your needs as a customer are met. Again thanks team for a job well done. I had thought friendly customer service was something from the past but they have restored my faith in customer service and customer support. I would encourage anyone needing tech support that this is the only place that I will even go again. May God richly bless each and every team member there. Thank you so much”

Kristl Harbour

“From the very first phone call that I made to AZCOMP it has been nothing but a pleasant experience!! Every time I call, with ANY question, (which some have been pretty dumb ;) ) they have always helped me right away and helped me get through my problem. I will never use any other software company but AZCOMP!”

- Kristl Harbour

AZCOMP Technologies
2015-05-21T10:29:53+00:00

- Kristl Harbour

“From the very first phone call that I made to AZCOMP it has been nothing but a pleasant experience!! Every time I call, with ANY question, (which some have been pretty dumb ;) ) they have always helped me right away and helped me get through my problem. I will never use any other software company but AZCOMP!”

Raven Wood

“I can't thank the AZ COMP crew enough. I think I have, over the past almost 4 years, bothered them almost once a week. They are truly phenomenal !! Experts in the field-- get us up and running all the time--on time. We are a busy office practice and when computers/ software don't function properly can shut you down-- but the team at AZ COMP is always there and the problem is resolved in no time. From training us to keeping us "on schedule" as to updates and fixes we couldn't ask for more. Besides, they all have a great personality and sense of humor...I love working with a group of happy professionals and recommend them every chance I get.”

- Raven Wood

AZCOMP Technologies
2015-05-21T10:30:51+00:00

- Raven Wood

“I can't thank the AZ COMP crew enough. I think I have, over the past almost 4 years, bothered them almost once a week. They are truly phenomenal !! Experts in the field-- get us up and running all the time--on time. We are a busy office practice and when computers/ software don't function properly can shut you down-- but the team at AZ COMP is always there and the problem is resolved in no time. From training us to keeping us "on schedule" as to updates and fixes we couldn't ask for more. Besides, they all have a great personality and sense of humor...I love working with a group of happy professionals and recommend them every chance I get.”

Devon Melba Forbes

“AZCOMP Technologies is just phenomenal. I am so pleased with my recent purchase. I was able to speak to Shaun, who is just awesome, and he was as always, super informative. I was able to get quotes and information regarding what system would be best for the company. The tech support is awesome. Tech support goes above and beyond to assist you with any issue you may have. Mike and Russ are great and always patient, considerate, and most of all very kind and courteous. Keep up the great work! You have a customer for life!”

- Devon Melba Forbe

AZCOMP Technologies
2015-05-21T10:31:15+00:00

- Devon Melba Forbe

“AZCOMP Technologies is just phenomenal. I am so pleased with my recent purchase. I was able to speak to Shaun, who is just awesome, and he was as always, super informative. I was able to get quotes and information regarding what system would be best for the company. The tech support is awesome. Tech support goes above and beyond to assist you with any issue you may have. Mike and Russ are great and always patient, considerate, and most of all very kind and courteous. Keep up the great work! You have a customer for life!”

Tammy Parks

“AZCOMP really does a great job with our practice in all areas of support and training. They're always there to get you back on track when "things" don't run as smooth as you'd like. Thanks AZCOMP for all you do!”

- Tammy Parks

AZCOMP Technologies
2015-05-21T10:32:04+00:00

- Tammy Parks

“AZCOMP really does a great job with our practice in all areas of support and training. They're always there to get you back on track when "things" don't run as smooth as you'd like. Thanks AZCOMP for all you do!”

Mo Soulati

“My experience with AZCOMP has extraordinary. I have the ability to either log in and create a ticket explaining my issue or sending an email to their support team. Instantly I get a email back a ticket number that they are looking into my issue. Without any delays I either get a call back or an email on how to resolve my issue. They represeantives are very kind and help resolve the issue as simple as possible. I have had great experiences with AZCOMP and would recommend them to anyone. Using electronic medical records has been really to use and understand with their help.”

- Mo Soulati

AZCOMP Technologies
2015-05-21T10:32:40+00:00

- Mo Soulati

“My experience with AZCOMP has extraordinary. I have the ability to either log in and create a ticket explaining my issue or sending an email to their support team. Instantly I get a email back a ticket number that they are looking into my issue. Without any delays I either get a call back or an email on how to resolve my issue. They represeantives are very kind and help resolve the issue as simple as possible. I have had great experiences with AZCOMP and would recommend them to anyone. Using electronic medical records has been really to use and understand with their help.”
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