HIE Encounter Notification Solutions and Meaningful Use
By Rob Horst
I joined esteemed colleagues from Johns Hopkins Community Physicians (JHCP) in presenting an HIStalk webinar on November 12 titled “3 Ways to Improve Care Transitions Using an HIE Encounter Notification Service.” Some of the attendee questions during and after the webinar required more insight into how ENS helps Eligible Hospitals (EHs) meet Meaningful Use Stage 2 (MU2) and the Transitions of Care (TOC) Measure.
In the way of background, EHs and critical access hospitals (CAHs) that transition or refer a patient to another setting of care are required to provide a summary of care record for more than 50 percent of transitions of care and referrals. This MU2 measure has proven challenging for many organizations to achieve. The method of getting a summary of care record to the right destination and then calculating the number of summary of care records that are actually received is imprecise.
On September 22, CMS issued FAQ 10660, clarifying that a third-party organization that plays a role in determining the next provider of care and that ultimately delivers the summary of care document can count in the measure’s numerator for EHs.
Part of the challenge of meeting the TOC measure is that EHs/CAHs and providers must clearly identify the intended recipient of the transition or referral and verify that the summary of care was received by the intended recipient via one of the allowed transport methods. ENS has a unique capability that can help EHs/CAHs meet the TOC measure.
ENS is capable of sending a C-CDA summary record using the same logic that it uses to send EHs/CAHs encounter notifications to subscribers. Using the patient demographic information in the header of the C-CDA, ENS is able to match the patient with the subscriber’s patient panel and send the document with the same accuracy and predictability that it does with encounter notifications. Once the C-CDA is sent to the subscriber, ENS logs the acknowledgement of when it was accessed and is able to provide a report back to the C-CDA sender with the critical metric needed to calculate the numerator for this measure.
We received these questions during and after the webinar that might provide clarity for those considering their options.
How does ENS help EHs/CAHs satisfy the TOC requirement?
EHs/CAHs, primary care physicians, and specialists submit panels (patient rosters) to ENS. When a patient is discharged from the EH/CAH, the EH/CAH generates a C-CDA from their Certified Electronic Health Record Technology (CEHRT) and sends the C-CDA to ENS via one of the allowed transport methods. ENS uses the patient data in the C-CDA header and the patient rosters to identify the correct PCP or specialist and automatically send a summary of care document to the receiving provider.
How does ENS help provide relevant metrics for the EH/CAH to use in its numerator calculation?
ENS will provide a report to the EH/CAH that includes data elements such as the patient identifiers, receiving subscribers, and time of receipt of the C-CDA. These data elements can be used in calculating the numerator.
Does ENS have to be CEHRT?
No. ENS is not the technology that is creating and transmitting the C-CDA and therefore does not need to be CEHRT.
Rob Horst is a principal with Audacious Inquiry of Baltimore, MD.