One of the objectives to demonstrate data exchange within Stage 2 of the electronic health records program is the ability to exchange a summary of care record with a provider using a different EHR, or proving you can do exchange by sending the record to one of two CMS test EHRs.

But there are flaws with the CMS EHRs--only providers accredited under the Direct Trust secure messaging initiative can complete a test. Consequently, CMS has issued new guidance on how to meet the criteria for meaningful use Measure 3 if a provider can’t test with another provider and doesn’t have access to a CMS EHR. Here is the guidance:

“Question: When reporting on the Summary of Care objective in the EHR Incentive Programs, how can eligible professionals, eligible hospitals, and critical access hospitals (CAHs) meet measure 3 if they are unable to complete a test with the CMS Designated Test EHR (NIST EHR-Randomizer Application)?

“Answer: CMS is aware of difficulties eligible professionals, eligible hospitals, and CAHs are having in the use of the CMS Designated Test EHR to meet measure 3 of the Stage 2 Summary of Care objective. At this time the two CMS Designated Test EHRs can only exchange/match with an eligible professional or eligible hospital that is Direct Trust (DT) Accredited. There is not a non-DT Accredited Test EHR for providers to use to successfully complete the test.

“The following actions are currently in place to meet the Summary of Care objective for measure 3:

1. Exchange a summary of care with a provider or third party who has different CEHRT as the sending provider as part of the 10% threshold for measure #2. A successful exchange in measure #2 allows the provider to meet the criteria for measure #3 without the need to conduct a test with the Randomizer as outlined in measure #3, or

2. Conduct at least one successful test with the CMS designated test EHR (if the provider is Direct Trust Accredited).

“If providers do not exchange summary of care documents with recipients using a different CEHRT in common practice, and cannot use the CMS Designated Test EHR for the reasons outlined above, they may retain documentation on their circumstances and attest “Yes” to meeting measure #3 if they have and are using a certified EHR which meets the standards required to send a CCDA (§ 170.202).

“This exchange may be conducted outside of the EHR reporting period timeframe, but must take place no earlier than the start of the EHR reporting year and no later than the end of the EHR reporting year or the attestation date, whichever occurs first.

“For example, an eligible professional or eligible hospital that is reporting meaningful use for a 90-day EHR reporting period may conduct this exchange outside of this 90-day period as long as it is completed no earlier than the first day of the EHR reporting year and no later than the last day of the EHR reporting year.

“For more information on the NIST EHR-Randomizer Application, please visit: https://ehr-randomizer.nist.gov/ehr-randomizer-app/#/home.

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