1. Electronic Exchange of Clinical Information Configuring RPMS-EHR for Meaningful Use Resource Patient Management System

2. Presenters: Cecelia Rosales Office of Information Technology Meaningful Use Requirements Manager (DNC Contractor) James Garcia, PMP Office of Information Technology MPI & HIE Federal Project Manager Jamie Furniss, RHIT, CCS-P Portland Area HIM Consultant Electronic Exchange of Clinical Information

3. Training Objectives Understand the MU objective and the measure Comprehend the different components of HIE (HIE, MPI & C32) Recognize the necessary sequence and relationship of patient merge, MPI, C32 & HIE Understand the process and purpose of exchanging patient health information with other I/T/U facilities and other health care organizations Electronic Exchange of Clinical Information

4. MU Objective and Measure Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, diagnostic test results), among providers of care and patients authorized entities electronically. Perform at least one test of certified EHR technology's capacity to electronically exchange key clinical information. Electronic Exchange of Clinical Information

5. MU Measure Basics Type of Measure: Attestation This will be accomplished using the C32 button to enable delivery of C32 documents to outside destinations. All federal sites will perform the test by submitting their C32s to the IHS national repository. Electronic Exchange of Clinical Information

6. C32 Test Results Results from this test should be entered as a “Yes” or “No” in the Stage 1 Meaningful Use Performance Report for EPs for the purposes of attestation. Tribal RPMS sites have the option to perform the test as described above or with another entity (e.g. a state Health Information Exchange (HIE). Electronic Exchange of Clinical Information

7. Measure Specifics Measure Inclusions: Count eligible professionals, eligible hospitals and CAHs that conduct at least one test of the certified EHR technology’s capacity to electronically exchange key clinical information during the EHR reporting period. Exchange Key Clinical Information

8. Measure Specifics (continued) Additional CMS Final Rule Information: The test of electronic exchange of key clinical information must involve the transfer of information between two different legal entities with distinct certified EHR technology or other system capable of receiving the information. Simulated transfers of information are not acceptable to satisfy this objective. Exchange Key Clinical Information

9. Measure Specifics (continued) The transmission of actual patient information is not required for the purposes of a test. The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective. Exchange Key Clinical Information

10. Measure Specifics (continued) Professionals can use their clinical judgment to identify what clinical information is considered key clinical information for purposes of exchanging clinical information about a patient at a particular time with other providers of care. A minimum set of information is identified in the HIT Standards and Criteria rule at 45 CFR 170.306(f): diagnostic test results, problem list, medication list, medication allergy list. Exchange Key Clinical Information

11. Measure Specifics (continued) An EP, eligible hospital or CAH should test their ability to send the minimum information set in the HIT Standards and Criteria rule at 45 CFR 170.306(f). If the EP, eligible hospital or CAH continues to exchange information beyond the initial test, then the professional may decide what information should be exchanged on a case-by-case basis. Exchange Key Clinical Information

12. Measure Specifics (continued) EPs, Eligible hospitals and CAHs must test their ability to electronically exchange key clinical information at least once prior to the end of the EHR reporting period. Testing may also occur prior to the beginning of the EHR reporting period. Every payment year requires its own, unique test. Exchange Key Clinical Information

13. Measure Specifics (continued) An unsuccessful test of electronic exchange of key clinical information will be considered valid for meeting the measure of this objective. Exchange Key Clinical Information

14. What HIM Needs to Know Patient merge must be installed as a prerequisite for MPI, i.e., MPI cannot be installed until Patient Merge has been installed. It is ideal to have merge completed, but is not absolutely essential. Electronic Exchange of Clinical Information

15. Implementation Configuration of MPI, C32, and HIE – There are 28 process steps involved in fully configuring a site and bringing that site up on the central MPI, C32 and HIE (They are categorized here): Electronic Exchange of Clinical Information Install MPI Send a test C32 Get on the “Queue” Vangent/GDIT Queue C32 Bulk Loading is scheduled Perform MPI Bulk Loading C32’s are scheduled nightly Schedule Missing ICN Task

16. Policy and Procedure Policies and Guidelines around the exchange of data in the Nationwide Health Information Network are being worked on in coordination with Jan Chase and others. Electronic Exchange of Clinical Information

17. Questions & Discussion Electronic Exchange of Clinical Information