1. HITSC Implementation Workgroup Practice Fusion CCDA Experience Presented By: Emily Richmond, MPH Senior Product Advisor July 27, 2014

2. Practice Fusion Facts 2 +Certified as a 2014 complete ambulatory EHR since December 17, 2013 +One of 8 EHR vendors with Stage 2 attestations as of last data reported by CMS +Cloud-based technology that is completely free to all healthcare provider customers. <8% of PF customers have sent a CCDA clinical document to another provider 1% of PF customers have both sent and received a CCDA clinical document

3. CCDA Interoperability Experiences 3 +Current standards and implementation guides still allow a great deal of variability, which results in different interpretations when developed and configured by different organizations. +Greater interoperability would require stricter and more clearly defined standards with less flexibility in implementation. +Interoperability scenarios that are challenging include:  Patient matching using CCDAs across different settings  Ability to display, parse, and ingest data from CCDAs generated by external systems.  Using data from a CCDA for the purposes of quality measure calculations.

4. CCDA Interoperability Experiences 4 +Meaningful Use CCDA standard areas for improvement:  Requires all sections to be present even if there is no data.  Minimum code set defined as required but doesn’t allow for updates (RxNorm, SNOMED, etc.)  Required metadata or metadata necessary for utilization of the data not strictly defined for all coded data elements.  Does not require presence of numeric personal unique identifiers (HIC, SSN) that would facilitate patient matching +Difficulties arise when developing and testing a system for minimum and very defined test case (CCDA samples from authorized testing lab)