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Stage 1 Core Measure 14

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Measure at a Glance

Type: task to be performed

Denominator: none

Duration: completed any time during the reporting period’s year, so long that the date is on or before the last day of the reporting period

Objective: Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, and diagnostic test results), among providers of care and patient authorized entities electronically.
Measure: Performed at least one test of certified EHR technology’s capacity to electronically exchange key clinical information.
Exclusion: No exclusion.
This objective and measure will not be required beginning in 2013.

CMS Technical Specification

TennCare Notes
The technical specification thoroughly addresses concerns regarding with what data to test and with whom.

The attestation portal will require the EP to choose yes or no to having completed this test.
Additionally, the portal will require the EP submit with whom the test was performed (name, practice, location) and the result of the test: failed, or succeeded.

Relevant CMS FAQs

  • 10270: explaining the distinct legal entities between which info must be exchanged
  • 10638: non-applicability of USB, CD-ROM, and other formats to this measure
  • 10978: conducting a test from a test environment or test domain of certified EHR technology
  • 10979: conducting tests for each physical location if multiple EPs are using the same EHR

Additional Resources
None at this time.

Federal Regulations Governing This Measure

CMS' Final Rule

§ 495.6(d)(14) see objective and measure above

Standards and Certification Final Rule

§ 170.304 (i) Exchange clinical information and patient summary record

  1. Electronically receive and display. Electronically receive and display a patient's summary record, from other providers and organizations including, at a minimum, diagnostic tests results, problem list, medication list, and medication allergy list in accordance with the standard (and applicable implementation specifications) specified in Sec. 170.205(a)(1) or Sec. 170.205(a)(2). Upon receipt of a patient summary record formatted according to the Alternative standard, display it in human readable format.
  2. Electronically transmit. Enable a user to electronically transmit a patient summary record to other providers and organizations including, at a minimum, diagnostic test results, problem list, medication list, and medication allergy list in accordance with:
    1. The standard (and applicable implementation specifications) specified in Sec. 170.205(a)(1) or Sec. 170.205(a)(2); and
    2. For the following data elements the applicable standard must be used:
      1. Problems. The standard specified in Sec. 170.207(a)(1) or, at a minimum, the version of the standard specified in Sec. 170.207(a)(2);
      2. Laboratory test results. At a minimum, the version of the standard specified in Sec. 170.207(c); and
      3. Medications. The standard specified in Sec. 170.207(d).

§ 170.205(a) Patient summary record

  1. Standard. Health Level Seven Clinical Document Architecture (CDA) Release 2, Continuity of Care Document (CCD) (incorporated by reference in Sec. 170.299). Implementation specifications. The Healthcare Information Technology Standards Panel (HITSP) Summary Documents Using HL7 CCD Component HITSP/C32 (incorporated by reference in Sec. 170.299).
  2. Standard. ASTM E2369 Standard Specification for Continuity of Care Record and Adjunct to ASTM E2369 (incorporated by reference in Sec. 170.299).

§ 170.207(a) Problems

  1. Standard. The code set specified at 45 CFR 162.1002(a)(1) for the indicated conditions.
  2. Standard. International Health Terminology Standards Development Organization (IHTSDO) Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT ®) July 2009 version (incorporated by reference in Sec. 170.299).

§ 170.207(c) Laboratory test results. Standard. Logical Observation Identifiers Names and Codes (LOINC ®) version 2.27, when such codes were received within an electronic transaction from a laboratory (incorporated by reference in Sec. 170.299).

§ 170.207(d) Medications. Standard. Any source vocabulary that is included in RxNorm, a standardized nomenclature for clinical drugs produced by the United States National Library of Medicine.