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SECTION #  Section 170.304(i)—Exchange Clinical Information

MU OBJECTIVE Capability to exchange key clinical information (for example, problem list, medication list, medication allergies, diagnostic test results), among providers of care and patient authorized entities electronically.

MU STAGE 1 MEASURE Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information.

CERTIFICATION CRITERION Final Rule Text: §170.304(i) (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 §170.205(a)(1) or §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: (i) The standard (and applicable implementation specifications) specified in §170.205(a)(1) or §170.205(a)(2); and (ii) For the following data elements the applicable standard must be used: (A) Problems. The standard specified in §170.207(a)(1) or, at a minimum, the version of the standard specified in §170.207(a)(2); (B) Laboratory test results. At a minimum, the version of the standard specified in §170.207(c); and (C) Medications. The standard specified in §170.207(d).

STANDARDS §170.205(a)(1) §170.205(a)(2) §170.205(a)(2) §170.207(a)(1) §170.207(a)(2) §170.207(c) §170.207(d)

TEST CRITERIA # §170.304(i) http://healthcare.nist.gov/docs/170.304.i_ExchangeClinicalinforPatientSummaryRecordAmb_v1.0.pdf

SOLUTION DESIGN / TECHNOLOGY (Add details here)

DELIVERABLE (Add details here - Ex. KIDS patch, Delphi code, User guide, Web resources, Manual test script, etc)

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PREVIOUS NOTES (1) This capability will be provided by the code coming from the CCR-CCD project. The latest project code can be found on http://trac.opensourcevista.net and there are calls almost every Tuesday night at 9 PM Eastern to work on the project. You can sign up to receive notices of the meetings at http://groups.google.com/group/ccd-ccr-project?hl=en. Both a CCR and CCD level 2 are being produced at this time and we are hoping that there will be the capability of transmitting a CCD level 3 in the future as that work is underway. WorldVistA will be submitting a recommendation to the ONCHIT to use both the CCR and CCD as standards for transmission of these health summaries. The production of an XSLT transform to create a CCD level 3 from a CCR, which is the current goal of some work being done by Ken Miller of Solventus as an open source project funded by Oroville Hopital in California, should make this easily possible for healthcare providers. (2)This will also be covered by the CCR-CCD project. Either a CCR or CCD level 2 is something that can be extracted at this time. (see above) This particular standard does not specify how the transmission must be done. It is clear that it must be encrypted but it is not clear how it may be transmitted. Then NHIN is mentioned but there it is not clear that other methods of transport are not allowed such as email with an encrypted attachment. (There is mention that if it is physically transported outside of a healthcare facility, it should be encrypted.)

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